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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700690
Report Date: 02/06/2023
Date Signed: 02/06/2023 11:34:50 AM

Document Has Been Signed on 02/06/2023 11:34 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:LEMON GROVE SCHOOL DISTRICT - SAN MIGUEL PRESCHOOLFACILITY NUMBER:
376700690
ADMINISTRATOR:SUMMER LOCKEFACILITY TYPE:
850
ADDRESS:7059 SAN MIGUEL AVENUETELEPHONE:
(619) 825-5619
CITY:LEMON GROVESTATE: CAZIP CODE:
91945
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 19DATE:
02/06/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:42 AM
MET WITH:Melvetta Owens TIME COMPLETED:
11:45 AM
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On 02/06/2023, at 8:42 a.m., Licensing Program Analyst (LPA), Rajani Goudreau conducted an unannounced Annual Inspection and met with Director of Early Childhood Education, Melvetta Owens. LPA disclosed the purpose of the inspection and toured the facility indoors and outdoors. This is a full day program operating under a traditional school year schedule following the Lemon Grove School District. Days and hours of operation are Monday through Friday from 8:00 a.m. to 2:30 p.m. Program operates in classroom #3 located behind the office of the site. The following ratios were observed: 19 children with three staff present.

There is no swimming pool or other bodies of water on the premises, per observation. There are no firearms or ammunition on the premises, per licensee representative. Disinfectants, cleaning solutions, medication and other hazardous items were made inaccessible, per observation. No poisons were observed during the inspection. Furniture and equipment in the classroom were observed to be in good condition, free of sharp, loose or pointed parts. The playground equipment and play materials were observed to be in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space was observed to be maintained in a safe condition and is free of hazards. Areas around high climbing equipment (play structure and swings) were observed to have sufficient cushioning material by the use of rubber matting to absorb falls. Shade was observed in the outdoor activity space by the use of shade kites. There are two restrooms exclusive to the preschool children located in the preschool classroom; containing one toilet in each of the restrooms. Also, there are two sinks in the classroom for the children’s use. All toilets and hand washing facilities were observed to be in safe and sanitary operating condition. The floors in the facility were observed to clean and safe. Solid waste storage containers were observed to have tight-fitting covers and in good repair. Drinking water is available both indoors and outdoors by the use of refillable water containers and disposable cups provided by the facility or cups brought from home. Based on observation, the facility has one functioning carbon monoxide detector and a first aid kit that meets statutory requirements. The isolation area and the isolation restroom are located in the nurse’s office for ill children. The elementary school site provides breakfast, lunch and snacks.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Rajani Goudreau
LICENSING EVALUATOR SIGNATURE: DATE: 02/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/06/2023
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: LEMON GROVE SCHOOL DISTRICT - SAN MIGUEL PRESCHOOL
FACILITY NUMBER: 376700690
VISIT DATE: 02/06/2023
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Capacity and limitations as specified on the license are being maintained, per observation. At least one person trained in CPR and Pediatric First Aid is present when children are at the facility, per licensee representative. Children were observed to be under supervision, including visual supervision. Based on observation, the facility maintains a ratio of one teacher supervising no more than 8 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. Facility roster reviewed and complete. LPA reviewed a sample of staff files and observed files were complete with immunization records and current documentation of completed mandated reporter training. Required documents were observed to be posted. Fire and disaster drills conducted once every six months and documented, per file review. Licensee representative submitted a director’s packet for site director and is currently under review.

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/inspection-process.

This facility provides provide Incidental Medical Services (IMS). LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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 publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

No deficiencies issued during today's visit. The following reports were reviewed with the licensee representative: LIC809 reports, LIC9213 - Appeal Rights. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted with the Director of Early Childhood Education, Melvetta Owens.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Rajani Goudreau
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2023
LIC809 (FAS) - (06/04)
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