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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701294
Report Date: 03/30/2026
Date Signed: 03/30/2026 01:03:53 PM

Document Has Been Signed on 03/30/2026 01:03 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 CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:ST. JOHN'S HEAD STARTFACILITY NUMBER:
376701294
ADMINISTRATOR/
DIRECTOR:		DULCE HUERTAFACILITY TYPE:
850
ADDRESS:760 FIRST AVENUETELEPHONE:
(619) 869-8983
CITY:CHULA VISTASTATE: CAZIP CODE:
91910
CAPACITY: 270TOTAL ENROLLED CHILDREN: 196CENSUS: 73DATE:
03/30/2026
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:28 AM
MET WITH:Maria CabelloTIME VISIT/
INSPECTION COMPLETED:
01:18 PM
NARRATIVE
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On 03/30/2026 at 11:28AM, Licensing Program Analyst (LPA) Saul Zazueta conducted an unannounced case management inspection regarding a self-reported incident wherein a 4-year-old child (C1) was injured playing on the playground. LPA met with Site Supervisor, Maria Cabello. LPA discussed the purpose of the inspection and was led inside the facility.

The following ratios were observed: seventy-three (73) children and thirty-two (32) staff members.

Cabello stated that on 03/10/2026 at 10:38AM, there were fifteen (15) pre-school children with two (2) staff from classroom #4 on the playground. Cabello stated that C1 was playing on the playground when they fell and hurt themselves. Cabello stated that C1 could not explain where they were hurt and refused to let staff inspect them due to the pain. Cabello stated that C1 cried incessantly, which is uncommon for them, so they called the child’s parents. C1’s grandma arrived to pick them up and signed them out at 11:54AM.

LPA interviewed staff present at the time of the incident and they explained that several children had been jumping over small cones as a part of a game. Staff #1 (S1) denied the possibility of C1 tripping on a cone as being the cause of the fall. Although staff claimed to have not seen C1 fall, they believe that they lost their balance. Staff stated that C1 fell on their shoulder and began crying. Staff stated that no other children were a cause in C1’s accident and they notified site supervisor.

C1 was taken to the Emergency Room and was determined to have suffered a fractured bone as a result of the incident. C1 has not returned to the program since the incident, but the facility has been in contact with the family who hopes the child will return to the facility real soon.
NAME OF LICENSING PROGRAM MANAGER: Tulam Vu
NAME OF LICENSING PROGRAM ANALYST: Saul Zazueta
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/30/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: ST. JOHN'S HEAD START
FACILITY NUMBER: 376701294
VISIT DATE: 03/30/2026
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Staff revised activities to remove small cones from being used during outdoor play. LPA observed the playground and did not observe any potential hazards. Ratios were followed and supervision was adequate at the time of the incident. All required reports were made and notification procedures were completed.

Based on documentation and staff interviews, no deficiencies are being cited today. A notice of site visit was given and must remain posted for 30 days.

An exit interview was conducted, and this report was reviewed with Site Supervisor, Maria Cabello.
NAME OF LICENSING PROGRAM MANAGER: Tulam Vu
NAME OF LICENSING PROGRAM ANALYST: Saul Zazueta
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2026
LIC809 (FAS) - (06/04)
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