<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700361
Report Date: 10/18/2022
Date Signed: 10/18/2022 07:22:35 PM

Document Has Been Signed on 10/18/2022 07:22 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
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:GREG ROGERS STATE PRESCHOOLFACILITY NUMBER:
376700361
ADMINISTRATOR:JANETTE RIDGELSFACILITY TYPE:
850
ADDRESS:510 EAST NAPLES STREETTELEPHONE:
(619) 656-2082
CITY:CHULA VISTASTATE: CAZIP CODE:
91911
CAPACITY: 30TOTAL ENROLLED CHILDREN: 43CENSUS: 13DATE:
10/18/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Aida BravoTIME COMPLETED:
02:00 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 10/18/22 at 12:15pm, Licensing Program Analyst (LPA), Martha Malane conducted a case management inspection to amend a report dated 9/19/22. In addition, to issue a citation from information obtained during the incident review. Upon arrival, LPA met with Lead Teachers, Ireri Caro and Aida Bravo and toured the facility. There were 13 children and five (5) staff members present. Hours of operation are Monday - Friday with an AM session 8:00am-11:00am and a PM session 12:00pm-3:00pm.

On 9/7/22 the facility self-reported an incident in which child 1 (C1) was released from care without being signed out by an authorized person on 9/6/22. See LIC809-D for deficiency cited. C1 currently attends the facility.

LPA, Martha Malane informed Lead Teacher, Aida Bravo that this report dated 10/18/22 documents one (1) Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care. Also, LPA, Martha Malane informed lead teacher to provide a copy of this licensing report dated 10/18/22 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview was conducted with Lead Teacher, Aida Bravo. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Martha Malane
LICENSING EVALUATOR SIGNATURE: DATE: 10/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/18/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 10/18/2022 07:22 PM - It Cannot Be Edited


Created By: Martha Malane On 10/18/2022 at 12:50 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: GREG ROGERS STATE PRESCHOOL
FACILITY NUMBER: 376700361

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/18/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/18/2022
Section Cited
CCR
101229.1(a)(1)

1
2
3
4
5
6
7
101229.1(a)(1) Sign in and Sign out (a) … the licensee shall develop… and implement a written procedure to sign the child in/out of the child care center that shall, at a minimum, include the following: (1) The person who signs the child in/out shall use his/her full legal signature and shall record the time of day.
This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Facility staff stated they have face to face contact with each authorized person and they must sign the child out prior to the child being released from the classroom. LPA reviewed sign in/out sheets and procedures and received a written plan for sign out from Lead Teacher, Ireri Caro.
8
9
10
11
12
13
14
Based on interviews and record review the licensee did not comply with the above regulation in that on 9/6/22 C1 was released from care without being signed out by an authorized person which posed an immediate health, safety or personal rights risk to children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Tulam Vu
LICENSING EVALUATOR NAME:Martha Malane
LICENSING EVALUATOR SIGNATURE:
DATE: 10/18/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/18/2022


LIC809 (FAS) - (06/04)
Page: 2 of 2