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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700798
Report Date: 10/30/2023
Date Signed: 10/30/2023 03:02:32 PM

Document Has Been Signed on 10/30/2023 03:02 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:CHINESE BILINGUAL PRE-SCHOOLFACILITY NUMBER:
376700798
ADMINISTRATOR:NANCY SHENFACILITY TYPE:
850
ADDRESS:5075 RUFFIN ROADTELEPHONE:
(858) 633-2950
CITY:SAN DIEGOSTATE: CAZIP CODE:
92123
CAPACITY: 90TOTAL ENROLLED CHILDREN: 90CENSUS: 50DATE:
10/30/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Nancy ShenTIME COMPLETED:
03:20 PM
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On 10/30/23 at 1:00 PM, Licensing Program Analyst (LPA) Keturah Lane conducted an unannounced case management visit to follow up on an unusual incident reported by the facility. Upon arrival, LPA met with Director Nancy Shen and toured the facility. It was during naptime and census was as follows:
  • Classroom #1/2 (2 year old classroom) had 11 children with staff member Ms. Cindy (Ying Wang) & Ms. Kat (Yick Nieskens)
  • Classroom #3 (2-3 years) had 9 children with staff member Ms. Julie (Hong Yao)
  • Classroom #4 (Preschool) had 12 children with staff member Ms. Mei (Rongmei Wu)
  • Classroom #5 (Pre-K) had 9 children with staff member Ms. Desiree (Desiree Seng)
  • Classroom #5 (Pre-K) had 9 children with staff member Ms. Zhang (Huixiang Zhang)

During this visit, LPA interviewed 4 staff members, Director and 3 children including C1 involved in the reported incident. LPA requested updated LIC500 personnel report and LIC9040 Facility roster. Prior to the visit, LPA reviewed camera footage on day of incident and also spoke with the parent of the child involved in the incident via phone. Based upon the above interviews conducted and review of video footage, LPA was unable to substantiate that a teacher violated C1's personal rights. LPA provided Technical Support Program (TSP) resources and additional technical assistance to the Director during the visit. No follow up needed.

No deficiencies were cited. Exit interview conducted and report was reviewed with Director, Nancy Shen. Notice of Site visit was provided and must remain posted for 30 days.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE: DATE: 10/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/30/2023
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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