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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700787
Report Date: 06/07/2024
Date Signed: 06/07/2024 02:12:02 PM

Document Has Been Signed on 06/07/2024 02:12 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:ECS 4TH AND D HEAD STARTFACILITY NUMBER:
376700787
ADMINISTRATOR/
DIRECTOR:		JAQUELINE ANDRADEFACILITY TYPE:
850
ADDRESS:385 D STREETTELEPHONE:
(619) 591-9136
CITY:CHULA VISTASTATE: CAZIP CODE:
91910
CAPACITY: 37TOTAL ENROLLED CHILDREN: 37CENSUS: 13DATE:
06/07/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Cecilia Evans-HernandezTIME VISIT/
INSPECTION COMPLETED:
02:20 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 6/7/24, at 11:30 a.m., Licensing Program Analyst (LPA) Adrian Castellon conducted an unannounced Case Management inspection to follow upon on the Unusual Incident reported to the Department on 6/3/2024. Upon arrival, LPA met with Area Supervisor Cecilia Evans-Hernandez and discussed the purpose of the inspection. LPA was led on a tour of the facility. There were 13 children present and 8 staff during the inspection.

Based on interviews conducted, review of staff statement (own admission) and review of video footage of the incident, it was determined that on 5/14/24, Staff #1 tied a transitional rope (used to gather children while transitioning from classrooms to outdoor areas) around the waist/chest of Child #1 while C1 was on the ground. Per S1 statement, C1 was not following directions to return back to classroom prior to rope being placed around C1. Per video, C1 was lead and slightly pulled with rope around waist in order to achieve compliance. Per California Code of Regulations, (Title 22, division 12 & Chapter 1) one (1) Type A citation and one (1) Type B citation are being cited on the attached LIC 809-D. Incident was not reported in the required time frame.

LPA Castellon informed Area Supervisor that this report dated 6/7/24 document(s) (1) Type A citation which shall be posted for 30 consecutive days as there is immediate risk(s) to the health, safety, or personal rights of children in care. Also, LPA Castellon informed the Area Supervisor to provide a copy of this licensing report dated 6/7/24 that documents the 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 conducted and report was reviewed with the facility representative, Cecilia Evans-Hernandez. Appeal Rights, and Notice of Site Visit were given. 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. LPA observed Notice of Site Visit posted.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Adrian Castellon
LICENSING EVALUATOR SIGNATURE: DATE: 06/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/07/2024
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 06/07/2024 02:12 PM - It Cannot Be Edited


Created By: Adrian Castellon On 06/07/2024 at 01:29 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: ECS 4TH AND D HEAD START
FACILITY NUMBER: 376700787

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/07/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/17/2024
Section Cited
CCR
101223(a)(3)

1
2
3
4
5
6
7
101223 Personal Rights (a) The licensee shall ensure that each child is accorded the following personal rights: (3)To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule "...or other actions of a punitive nature including but not limited to": interference with functions
1
2
3
4
5
6
7
Area Supervisor states that S1 has been fired from her position at the facility. Area Supervisor will hold all staff meeting where Personal Rights regulation will be reviewed and discussed, Facility Management recently attended a Children's Rights training and that information will be shared at meeting.
8
9
10
11
12
13
14
of daily living including eating, sleeping or toileting;" ... or physical functioning." This requirement was not met as evidenced by S1 tying transitional rope around C1 and leading/pulling child to achieve compliance. This poses an immediate threat to the health and safety of children in care.
8
9
10
11
12
13
14
Area Supervisor will submit attendance sheet to Licensing office by POC date.
Type B
06/17/2024
Section Cited
CCR101212(d)(1)(C)

1
2
3
4
5
6
7
101212 Reporting Requirements (d) Upon the occurrence "... a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours." In addition, a written report "... shall be submitted to the Department within seven days following
1
2
3
4
5
6
7
Area Supervisor will submit LIC624b to the Licensing Office regarding initial incident of 5/22/24 by POC date. Area Supervisor will hold meeting with facility management to discuss required reporting requirements. Area Supervisor will submit meeting minutes.
8
9
10
11
12
13
14
the occurrence of such event." This requirement was not met as evidenced by facility not reporting to the Licensing Office incident of S1 tying transitional rope around C1 to achieve compliance. This may pose a threat to the health and safety of children in care.
8
9
10
11
12
13
14
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:Cynthia Gray
LICENSING EVALUATOR NAME:Adrian Castellon
LICENSING EVALUATOR SIGNATURE:
DATE: 06/07/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/07/2024


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