376700079-8-16-2023-51-CC-SCLA-CURTKG-20230816144754

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376700079
Report Date: 08/16/2023
Date Signed: 08/16/2023 02:47:58 PM

Document Has Been Signed on 08/16/2023 02:47 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	CARLSBAD EDUCATIONAL FOUNDATION - KELLY ELEMENTARY		FACILITY NUMBER:	376700079
ADMINISTRATOR:	IZABELLA ROMO		FACILITY TYPE:	840
ADDRESS:	4885 KELLY DRIVE		TELEPHONE:	(760) 331-5865
CITY:	CARLSBAD	STATE: CA	ZIP CODE:	92008
CAPACITY: 90	TOTAL ENROLLED CHILDREN: 90	CENSUS: 0	DATE:	08/16/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	01:20 PM
MET WITH:	April Smith		TIME COMPLETED:	02:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 08/16/2023 at 1:20pm, Licensing Program Analyst (LPA), Samantha Clenista conducted an unannounced case management inspection. Upon arrival, LPA met with April Smith, Area Manager. Purpose of this visit is to address facility’s request to add the multipurpose room (MPR) to their license and increase their overall capacity from having 90 children to 140 children. The facility is requesting to be licensed for children (ages TK-12 years old) in the following rooms: 6, 9, 10, 11, 24, 25, 26, 31 and multipurpose room (aka MPR). There are no changes in room usage, other than the names of the rooms. Fire clearance was granted on 08/15/23. Facility is exempt from indoor and outdoor square footage per Title 22, sections 101538.2(c) and 101538.3(c). No measuring of any sort was conducted today. There were no children present due to school being out of session. Ms. Smith stated that the school year will start next Wednesday, 08/23/23. Ms. Smith stated that the main classrooms that will be utilized is Room 26, 31 and multipurpose room for overflow. Room 26 (main classroom) was equipped with tables and chairs and age-appropriate equipment. Room 31 was not set up yet ready for children. LPA advised Ms. Smith to provide LPA pictures once it is set up prior to usage. Multipurpose room is used for overflow and was observed safe and free of hazards during inspection. Drinking water is readily accessible via water jugs, water fountains and water cups/water bottles. Snacks are provided and prepared in the classroom. Classroom has storage space for food. Outdoor play areas include: covered picnic area, blacktop area and grassy area. There are trees and gazebo used for shade. LPA observed 3 play structures located near the black top area which had a sticker for ages 2-5 and 5-12 years old, however did not specify what areas of the structure is for what ages. Ms. Smith stated that the children enrolled in this program do not/will not use the playground structure during hours of operation, other than the swings and that direct supervision will be provided to ensure this.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Samantha Clenista
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: CARLSBAD EDUCATIONAL FOUNDATION - KELLY ELEMENTARY	FACILITY NUMBER: 376700079
	VISIT DATE: 08/16/2023

NARRATIVE

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Restrooms designated for children were observed to be separate and allowed for individual privacy. Toilet facilities shall not be utilized simultaneously by children of both sexes. There is a separate staff restroom located in the office. There is an operational carbon monoxide detector located near the teacher's desk. Medications, when present, are stored in a box located behind the teacher's desk. Ms. Smith is reminded to keep anything that reads, “Keep Out of Reach of Children” inaccessible to children. Isolation area is a small area located in Room 31. Isolation bathroom is the staff restroom. Sign-in area is in front of the Kinder gate and sign-out area is in front of the bear paw gate. Cleaning supplies and other toxins are inaccessible to children through latches, locks and/or placed on high surfaces. Ms. Smith was reminded that any changes to the facility must be reported to and approved by Community Care Licensing.

Exit interview was conducted and report was reviewed with facility representative, Ms. Smith. A notice of site visit was given to facility representative and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. LPA observed the facility to be in compliance with Title 22 regulation. A school-aged license for 140 children (ages TK-12 years old) in rooms 6, 9, 10, 11, 24, 25, 26, 31 and multipurpose room (aka MPR) is granted and effective today's date, 08/16/23. Ms. Smith stated she understands that this report shall be kept available at the facility for public review for 3 years.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Samantha Clenista
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2023

LIC809 (FAS) - (06/04)

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