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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701281
Report Date: 08/28/2023
Date Signed: 08/28/2023 01:10:43 PM

Document Has Been Signed on 08/28/2023 01:10 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:ALCOTT PRESCHOOLFACILITY NUMBER:
376701281
ADMINISTRATOR:STEPHEN LEWISFACILITY TYPE:
850
ADDRESS:4680 HIDALGO AVENUETELEPHONE:
(619) 605-1200
CITY:SAN DIEGOSTATE: CAZIP CODE:
92117
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 20DATE:
08/28/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Stephen LewisTIME COMPLETED:
01:30 PM
NARRATIVE
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On 8/28/23 at 9:30 AM, Licensing Program Analyst (LPA) Adrian Mangina visited the facility to conduct an annual inspection. Upon arrival LPA met with Facility Representative, Principal Stephen Lewis. Principal Lewis escorted LPA to the classroom. LPA and Teacher Lynn Hull toured the facility. During today's inspection, there were 20 children with 3 teachers and 3 aids in classroom #14. Appropriate ratios and capacity were observed. Appropriate care & visual supervision were also observed during the inspection while children were in circle time and participating in classroom activities. The facility operates Monday-Friday from 8:20 a.m. to 2:20 p.m.

Furniture and age-appropriate equipment is in good condition. Rooms have adequate heating, lighting, ventilation. Floors appear to be clean and safe. Drinking water is readily accessible. Bathrooms are maintained with operational toilets and faucets with appropriate temperature. Paper towels and toilet paper are available. Bathroom is lighted and has ventilation. Food service area consists of a kitchen which is clean and free of hazards. Menu is posted. Adequate food is available for snacks. Cleaning supplies are kept separate from food and are inaccessible to children. Facility Representative was reminded that storage containers for solid waste must have tight-fitting covers and be kept in good repair.

Outdoor play area is a fenced playground. Climbing structures, swings and slides are securely fixed to the ground. Area has trees and large canopies used for shade. Equipment is age appropriate. Area has drinking water readily accessible and grounds are free of debris or potential hazards. Drinking water is available outside in the two drinking faucets on the playground. There are no bodies of water or weapons at this facility. Facility Representative reminded that all trash cans must have tightly fitting covers.

LPA reviewed medication storage. Medications are administered by the school nurse and stored in the nurse’s office. LPA reviewed staff records. Five of six staff do not have complete staff files. One teacher had

continued on LIC809 page 2

SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE: DATE: 08/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/28/2023
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: ALCOTT PRESCHOOL
FACILITY NUMBER: 376701281
VISIT DATE: 08/28/2023
NARRATIVE
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LIC809 page 2

no file, one aid and one teacher had no mandated report training certificates, 2 aids had mandated reporter training certificates that are not AB1207 approved, one staff has positive TB test and no x-ray showing no active TB, and two staff have no Health screenings. Facility Representative was advised needs to ensure that all staff have records of FLU vaccine every year flu refusals in files and current AB1207 mandated reporter training certificates. At least one staff member has current CPR and First Aid certifications. Personnel record contains documentation of educational background and training. Sign-ins were reviewed. LPA reviewed five child files and five of five child files are incomplete. Sign-ins were reviewed. Facility Representative reminded to ensure all parents sign in/out with full names.


LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. . LPA also informed facility representative of the importance of checking for recalled child devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. There are no children who nap at the facility as it is a half day program.

All facility staff who require caregiver background checks have received criminal record and child abuse clearances or exemptions through San Diego Unified School District. Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

continued on LIC809 page 3
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2023
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: ALCOTT PRESCHOOL
FACILITY NUMBER: 376701281
VISIT DATE: 08/28/2023
NARRATIVE
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LIC809 page 3

Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For childcare center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

This facility provides Incidental Medical Services. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records.
For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.

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.



See LIC809-D for deficiencies cited.

Exit interview conducted and report was reviewed with the facility representative, Stephen Lewis. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2023
LIC809 (FAS) - (06/04)
Page: 2 of 6
Document Has Been Signed on 08/28/2023 01:10 PM - It Cannot Be Edited


Created By: Adrian L Mangina On 08/28/2023 at 12:52 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: ALCOTT PRESCHOOL
FACILITY NUMBER: 376701281

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/28/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Section Cited
Responsibility for Providing Care and Supervision
Deficient Practice Statement
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4
POC Due Date:
Plan of Correction
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Type B
Section Cited
CCR
101217(a)
Personnel Records
(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information:

This requirement is not met as evidenced by:
Deficient Practice Statement
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4
Based on record review, the licensee did not comply with the section cited above asfour of six tstaff do not hame complete personnel iles which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/27/2023
Plan of Correction
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Facility Representative states will provide complete personnel files for all staff to LPA no later than close of business 9/27/23 and will in future ensure all staff have complete personnel files.
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:Renesha Askew
LICENSING EVALUATOR NAME:Adrian L Mangina
LICENSING EVALUATOR SIGNATURE:
DATE: 08/28/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/28/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/28/2023 01:10 PM - It Cannot Be Edited


Created By: Adrian L Mangina On 08/28/2023 at 12:52 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: ALCOTT PRESCHOOL
FACILITY NUMBER: 376701281

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/28/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101221(b)(8)(C)
Child's Records
(C) A signed consent form for emergency medical treatment unless the child's authorized
representative has signed the statement specified in Section 101220(f).

This requirement is not met as evidenced by:
Deficient Practice Statement
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4
Based on record review, the licensee did not comply with the section cited above as five of five which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/27/2023
Plan of Correction
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3
4
Facility Representative states will provide complete child files to LPA no later than close of business 9/27/23 and will in future ensure that all children have complete child files.
Section Cited
Deficient Practice Statement
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3
4
POC Due Date:
Plan of Correction
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3
4
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:Renesha Askew
LICENSING EVALUATOR NAME:Adrian L Mangina
LICENSING EVALUATOR SIGNATURE:
DATE: 08/28/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/28/2023


LIC809 (FAS) - (06/04)
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