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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700383
Report Date: 05/17/2024
Date Signed: 05/17/2024 11:27:19 AM

Document Has Been Signed on 05/17/2024 11:27 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
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:LAKE MURRAY CHRISTIAN PRESCHOOLFACILITY NUMBER:
376700383
ADMINISTRATOR/
DIRECTOR:		FOUST, MARYFACILITY TYPE:
850
ADDRESS:5777 LAKE MURRAY BOULEVARDTELEPHONE:
(619) 465-3916
CITY:LA MESASTATE: CAZIP CODE:
91942
CAPACITY: 22TOTAL ENROLLED CHILDREN: 12CENSUS: 11DATE:
05/17/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Mary FoustTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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On 5/17/2024, at 10:00am., Licensing Program Analyst (LPA) Vicky Williamson conducted an unannounced case management inspection to follow up on a self reported incident. LPA met with Facility Representative, Mary Foust. LPA discussed the purpose of the inspection and was led on a tour of the facility. There were 11 children present with the facility representative, one (1) assistant and one (1) volunteer.

On 3/27/2024, the facility representative self- reported an incident regarding Child 1 (C1) sustaining an injury requiring medical attention. Per Facility Representative the alleged incident occurred on 3/20/2024 at about 12:50pm and there were five (5) children present with her and one (1) assistant.

During today’s inspection, LPA conducted interviews with facility representative, a staff member, C1, and C1's authorized representative. LPA reviewed and obtained a copy of facility roster and related documentation. Facility Representative and Staff (S1), stated that C1 was observed leaning down on the floor to pick up an object while playing in the kitchen area of the classroom. Facility Representative and S1 observed C1 bump his head on the children's wood toy cabinet. Facility Representative stated that first aid and pressure were immediately applied to C1's injury. C1 disclosed that he hit his head on the wood toy cabinet inside of the classroom. Per C1's authorized representatives they were notified immediately and medical attention was required.

LPA inspected the children's wood toy cabinet inside of the preschool classroom and observed that it does not have any sharp edges or sharp points. The incident is determined to be an accident.

No deficiencies cited. Exit interview was conducted with Facility Representative, Mary Foust and a copy of this report, Appeal Rights and Notice of Site Visit were provided. Notice of Site Visit is 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: Vicky Williamson
LICENSING EVALUATOR SIGNATURE: DATE: 05/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/17/2024
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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