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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701404
Report Date: 09/29/2021
Date Signed: 09/29/2021 10:49:02 AM

Document Has Been Signed on 09/29/2021 10:49 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:PLAYHOUSE PRESCHOOL INFANT CENTERFACILITY NUMBER:
376701404
ADMINISTRATOR:ALICIA PEREZFACILITY TYPE:
830
ADDRESS:6545 BALBOA AVENUE, SUITE BTELEPHONE:
(858) 279-2009
CITY:SAN DIEGOSTATE: CAZIP CODE:
92111
CAPACITY: 43TOTAL ENROLLED CHILDREN: 0CENSUS: 11DATE:
09/29/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Alicia PerezTIME COMPLETED:
11:05 AM
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On 9/29/21 @ 8:45AM, LPA Nancy Diaz conducted an unannounced inspection. LPA met and toured the facility with Alicia Perez, Site Director. Shelley McDole, Licensee was also present. Observed present today were 11 infants and toddlers. There were 6 infants with Shelley McDole, Lazeeta Wiggers & Caitlin Provido; there were 5 toddlers with staff Patricia Bobb. Program operates Monday-Friday; 6:30AM to 6:00PM.

A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. The licensee has not exceeded the conditions, limitations and capacity specified on the license. Children were observed to be visually supervised by a qualified teacher. Majority of the staff are trained in CPR and Pediatric First aid.

The child care center was observed to be clean, safe, sanitary and in good repair to ensure the well-being of children, employees and visitors. Disinfectants, cleaning solutions, medications or poisons are inaccessible to children. All toilets, handwashing facilities are in safe and sanitary operating condition. All floors are clean and safe. A carbon monoxide detector is maintained in the facility. An isolation area has been designated for children who becomes ill during the day.

Kitchen and food preparation areas are kept clean. All food and beverage are stored appropriately. Uncontaminated drinking water are readily available both indoors and out.

CONTINUED
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 09/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/29/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: PLAYHOUSE PRESCHOOL INFANT CENTER
FACILITY NUMBER: 376701404
VISIT DATE: 09/29/2021
NARRATIVE
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The surface of the outdoor activity space are maintained in a safe condition, and free of hazards.

Children’s files were review. The person who signs the child in/out use their full legal signature and recorded the time of day. An emergency information is maintained for all children in care.

Staff files were reviewed. Staff have current physician’s report on file. Staff qualification are maintained that included educational background, training and or experience. Staff have been immunized against pertussis, influenza and measles.

Infant changing tables have a padded surface not less than one inch thick. Infant changing tables have raised sides at least three inches high. Toys are observed to be safe, and did not have sharp points or edges or splinters or made of small parts that can be pulled off and swallowed. Facility maintains sufficient napping equipment. Direct visual supervision are provided by staff at all times. Facility maintains infant sleeping plans. Infant individual feeding and needs and services plans are maintained. Nap documentations are maintained that included: infant’s name, date, time of each 15-minute check and initials of the person who conducted each check.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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

CONTINUED

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 09/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2021
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Document Has Been Signed on 09/29/2021 10:49 AM - It Cannot Be Edited


Created By: Nancy Diaz On 09/29/2021 at 10:10 AM
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: PLAYHOUSE PRESCHOOL INFANT CENTER
FACILITY NUMBER: 376701404

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/29/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/06/2021
Section Cited
HSC
1596.8662(b)(1)

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MANDATED REPORTER. On or before March 30, 2018...a licensed daycare provider, administrator, or employee...shall complete the mandated reporter training...and shall complete renewal training every 2 years...
This requirement was not met as evidenced by:
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Ms. Perez stated that she will have staff complete the course online (mandatedreporterca.gov) and will submit proof of renewal to the department no later than October 6, 2021.
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Based on LPA's review of staff record, the following staff have expired Mandated Reporter Training: Lazeeta Wiggers, Shelley McDole, Patricia Bobb & Rosemarie Mentone.
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Type B
10/01/2021
Section Cited
CCR101429(a)(2)(B)

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RESPONSIBILITY FOR PROVIDING CARE AND SUPERVISION FOR INFANTS. Staff shall physically check on sleeping infant(s) every 15 minutes and document...

This requirement was not met as evidenced by:
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Ms. Perez stated that she will have a clipboard designated for each napping infant near the nap room. Staff will be trained this afternoon in filling out the form. Ms. Perez will submit a sample of completed form to the department no later than 10/06/2021.
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Based on LPA's review of children's files, facility is not maintaining a complete record of the 15 minute-check on sleeping infants.
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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:Tashima Daniel
LICENSING EVALUATOR NAME:Nancy Diaz
LICENSING EVALUATOR SIGNATURE:
DATE: 09/29/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/29/2021


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