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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700685
Report Date: 11/16/2021
Date Signed: 11/29/2021 08:30:00 AM

Document Has Been Signed on 11/29/2021 08:30 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
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:SACRED HEART ACADEMY PRESCHOOLFACILITY NUMBER:
376700685
ADMINISTRATOR:WYDRA, SUZIEFACILITY TYPE:
850
ADDRESS:4895 SARATOGA AVENUETELEPHONE:
(619) 222-7252
CITY:SAN DIEGOSTATE: CAZIP CODE:
92107
CAPACITY: 137TOTAL ENROLLED CHILDREN: 60CENSUS: 53DATE:
11/16/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:55 AM
MET WITH:Rebecca GodinaTIME COMPLETED:
01:00 PM
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On 11/16/2021 at 11:55am, Licensing Program Analyst (LPA), Martha Malane conducted an unannounced Case Management Inspection to follow-up on a self-reported Unusual Incident. Upon arrival, LPA met with Assistant Director, Rebecca Godina and was led on a tour of the facility. There were 53 children and six (6) staff present during today’s inspection.

On 11/12/2021 at 11:30am the facility self-reported to the Department that on 11/12/2021 at 8:50am a small fire started in a light fixture in room #3. No children were present in room #3 at the time the staff member noticed the small fire. The staff member extinguished the fire while 911 was being called. The Fire Department arrived and deemed the facility to be safe for children, however room #3 is closed pending repairs. The Pre-K II children, who were utilizing room #3 will utilize room #4, which is currently not being used due to low enrollment, until room #3 is repaired and cleared by the fire department as safe for children. LPA inspected room #3 and observed one of the light fixtures to be burned and residue from a fire extinguisher covering the room. The assistant director stated repairs should be completed by January 2022 and she will notify the Department when repairs are complete.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, no deficiencies are cited.

An exit interview was conducted with Assistant Director, Rebecca Godina. Ms. Godina was provided with the following: LIC809, notice of site visit and appeal rights (LIC 9058).
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Martha Malane
LICENSING EVALUATOR SIGNATURE: DATE: 11/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/16/2021
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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