376700303-3-11-2025-20-CC-MHOD-DENPEM-20250311111524

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376700303
Report Date: 03/11/2025
Date Signed: 03/11/2025 11:16:12 AM

Document Has Been Signed on 03/11/2025 11:16 AM - 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 CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	JOHNSON STATE PRESCHOOL		FACILITY NUMBER:	376700303
ADMINISTRATOR:	JENKINS-MARTIN, TRACEY		FACILITY TYPE:	850
ADDRESS:	1355 KELTON ROAD		TELEPHONE:	(619) 264-0103
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92114
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 20	DATE:	03/11/2025
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Lisa Ramirez, ECE Teacher/Facility Representative		TIME COMPLETED:	11:45 AM

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 03/11/2025 at 9:15 AM, Licensing Program Analysts (LPAs), Michelle Hood and Shannan Williams, met with Facility Representative, Lisa Ramirez for the purpose of an unannounced Required - 1Year inspection. There were 20 children present with two teachers and one aide in K1 classroom. The facility is within ratio and capacity. The program operates an AM session 7:30 am to 10:30 am and a PM session 11:05 am to 2:05 pm. LPAs toured the facility. On 08/30/2023, a fire clearance was approved for the facility to serve up to 24 children in classroom K2. Classroom K1 measures 1273.12 sq.ft. The classroom can provide up to 32 children; however, the facility has a capacity of 24 children. The room was clean, orderly and at a comfortable temperature during this visit. Adequate ventilation and heating are available. The furniture, books, games, and toys are safe, age-appropriate, and in good repair. There is a variety of activities available throughout the day. All required forms were posted. All storage containers and trashes have tight-fitting lids and are in good repair. The kitchen is clean and sanitary. Food is stored in covered containers at 45 degrees or less and there is no expired or contaminated food present. Staff preparing food are using proper personal hygiene and food service practices. The food meets the nutritional requirements per regulation and is of good quality and proper quantity. The breakfast and lunch menu is posted, changes are recorded, and menus are stored for 30 days. Food has been stored separately from any chemicals or cleaning products. Drinking water is readily available. Children are evaluated upon entry and monitored throughout the day for signs of illness. The isolation area for ill children awaiting pick up is in the classroom. Licensing (619-767-2248) to report the unusual incident or general questions.

SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Michelle Hood
LICENSING EVALUATOR SIGNATURE:	DATE: 03/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2025

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 CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: JOHNSON STATE PRESCHOOL	FACILITY NUMBER: 376700303
	VISIT DATE: 03/11/2025

NARRATIVE

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LPA reviewed the digital signatures, a sample of personnel records, and a sample of children's records. There is at least one staff present with current CPR and First Aid certification. The facility is reminded the Mandated Reporter Training is to be retaken every two years and can be accessed at the following website: www.mandatedreporterca.com.

Hand washing and toileting areas are in safe, sanitary, and operating condition. Any wastewater used to clean is discarded after use. Medications are kept, inaccessible to children. Poisons, disinfectants, cleaning solutions, and other items that are dangerous to children have been made inaccessible. There is no evidence of rodent or insect activity. The outdoor play area is fully fenced with sufficient cushioning and adequate shade, separate from other programs. Age-appropriate playground equipment and outdoor surfaces are in a safe condition with any equipment securely bolted to the ground. Portable water is used outdoors. There are no bodies of water, firearms, or ammunition on the property. The carbon monoxide detector is operational. The facility has a written disaster plan in place that meets the regulatory requirement and has been conducting and documenting evacuation drills every six months. The facility does not transport children.

This facility does not provide Incidental Medical Services – IMS at this time. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. Services are/are not in place today

Facility representative was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, before the initial presence in a Child Care Center.

SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Michelle Hood
LICENSING EVALUATOR SIGNATURE:	DATE: 03/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2025

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 CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: JOHNSON STATE PRESCHOOL	FACILITY NUMBER: 376700303
	VISIT DATE: 03/11/2025

NARRATIVE

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LPA conducted a childcare quality management interview with Lisa Ramirez. An exit interview was conducted, and the report was reviewed with the facility representative Lisa Ramirez. The facility representative was provided the licensing report and licensee was advised that acknowledgment of receipt of the report and appeal rights (LIC 9058 12/15).. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. No deficiencies were cited.

SUPERVISORS NAME: Cynthia Biszant
LICENSING EVALUATOR NAME: Michelle Hood
LICENSING EVALUATOR SIGNATURE:	DATE: 03/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2025

LIC809 (FAS) - (06/04)

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