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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700685
Report Date: 05/25/2022
Date Signed: 05/25/2022 09:33:10 PM

Document Has Been Signed on 05/25/2022 09:33 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:SACRED HEART ACADEMY PRESCHOOLFACILITY NUMBER:
376700685
ADMINISTRATOR:SUZIE WYDRAFACILITY TYPE:
850
ADDRESS:4895 SARATOGA AVENUETELEPHONE:
(619) 222-7252
CITY:SAN DIEGOSTATE: CAZIP CODE:
92107
CAPACITY: 137TOTAL ENROLLED CHILDREN: 67CENSUS: 54DATE:
05/25/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Rebecca GodinaTIME COMPLETED:
05:30 PM
NARRATIVE
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On 5/24/22, at 1:00pm, Licensing Program Analyst (LPA) Martha Malane, conducted an unannounced annual inspection and met with Assistant Director, Rebecca Godina. LPA disclosed the purpose of the inspection and toured the facility indoors and outdoors. This is a full day program which operates year-round. Days and hours of operation are Monday – Friday 7:30am – 5:00pm. There are currently five (5) rooms in operation (room 4 is not being utilized at this time). Children were observed napping during the inspection. The following ratios were observed:

The following ratios were observed:
Room 1 (serves children age 2 - 3 years): there were 13 children and one (1) staff
Room 2 (serves children age 4 - 5 years): there were 11 children and one (1) staff
Room 3 (serves children age 3 – 4 years): there were eight (8) children and one (1) staff
Room 5 (serves children age 3 - 4 years): there were 10 children and one (1) staff
Room 6 (serves children age 4 - 5 years): there were 12 children and one (1) staff

There were 54 children and five (5) staff present.

Assistant director stated there are no bodies of water on the premises and LPA did not observe any bodies of water. Assistant director stated there are no firearms or ammunition allowed or stored on the premises. Disinfectants, cleaning solutions and other hazardous items are made inaccessible. No poisons were observed.

Furniture and equipment are in good condition. Playground equipment is in safe condition. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. Areas around high climbing equipment, swings and slides have rubber cushioning material to absorb falls. Toilets and hand-washing facilities are in safe and sanitary operating condition. Floors in the facility are clean and safe. Solid waste storage containers have tight-fitting covers and are in good repair. Drinking water is available both indoors and outdoors. Meals and snacks are provided from home. Facility has a functioning carbon monoxide detector that met statutory requirements. See LIC809C continuation...
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Martha Malane
LICENSING EVALUATOR SIGNATURE: DATE: 05/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/25/2022
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
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: SACRED HEART ACADEMY PRESCHOOL
FACILITY NUMBER: 376700685
VISIT DATE: 05/25/2022
NARRATIVE
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A review of staff records on this date indicates facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Director was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Capacity and limitations as specified on the license are being maintained. At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at offsite activities. The person who signs the child in/out of the facility shall use their full legal signature and record the time of day. Children are under supervision, including visual supervision, of a teacher at all times. Facility maintains a ratio of one teacher supervising no more than 12 children in care. LPA reviewed a sample of children’s files and observed files were complete with contact information for authorized representative and or relatives or others who can assume responsibility for the child and medical assessment. LPA reviewed a sample of staff files and observed files were not complete with immunization records for influenza and measles and current documentation of completed mandated reporter training.

This facility provides Incidental Medical Services (IMS), however no children are receiving medication at this time. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiencies are being cited: (see next page, 809 D).

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.

Exit interview conducted with Assistant Director, Rebecca Godina.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Martha Malane
LICENSING EVALUATOR SIGNATURE:

DATE: 05/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/25/2022 09:33 PM - It Cannot Be Edited


Created By: Martha Malane On 05/25/2022 at 04:45 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: SACRED HEART ACADEMY PRESCHOOL
FACILITY NUMBER: 376700685

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/25/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above in four (4) out of eight (8) staff (S1, S2, S6 and S7) did not have complete immunization records on file for review which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/20/2022
Plan of Correction
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Assistant director stated she will review staff files at the begining of each school year to ensure each staff has current paperwork. Assistant director stated she will submit proof of immunization records to CCL by 6/20/2022.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above in seven (7) out of eight (8) staff did not have a current mandated reporter training certificate on file which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/20/2022
Plan of Correction
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Assistant director stated she will review staff files at the begining of each school year to ensure each staff has current paperwork. Assistant director stated she will submit proof of current mandated reporter training certificates to CCL by 6/20/2022.
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: 05/25/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/25/2022


LIC809 (FAS) - (06/04)
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