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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701422
Report Date: 06/29/2022
Date Signed: 06/29/2022 04:01:50 PM

Document Has Been Signed on 06/29/2022 04:01 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:WARREN-WALKER EARLY LEARNING CENTERFACILITY NUMBER:
376701422
ADMINISTRATOR:SUSANNAH TAYLOR-COOKFACILITY TYPE:
850
ADDRESS:2905 CADIZ STREETTELEPHONE:
(619) 771-3663
CITY:SAN DIEGOSTATE: CAZIP CODE:
92110
CAPACITY: 45TOTAL ENROLLED CHILDREN: 45CENSUS: 7DATE:
06/29/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Vivian BennettTIME COMPLETED:
01:15 PM
NARRATIVE
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On 6/29/22 at 12:30 PM Licensing Program Analyst (LPA) Adrian Mangina conducted a Case Management - Deficiency. Present at the facility were 7 children and 2 staff.

Staff #1 is fingerprint cleared, but not associated to the facility.

See LIC 809-D for Type B deficiency cited and civil penalty issued during today's visit.

Exit interview conducted and report was reviewed with the Facility Representative Vivian Bennett. The Licensee was provided a copy of this report.. A Notice of Site Visit (LIC9213) was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.



SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE: DATE: 06/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/29/2022
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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Document Has Been Signed on 06/29/2022 04:01 PM - It Cannot Be Edited


Created By: Adrian L Mangina On 06/29/2022 at 01:41 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: WARREN-WALKER EARLY LEARNING CENTER
FACILITY NUMBER: 376701422

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/29/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/30/2022
Section Cited
CCR
101170(e)(2)

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CRIMINAL RECORD CLEARANCE
All individuals subject to a criminal record review...shall prior to working, residing or volunteering in a licensed facility…Request a Transfer of a criminal record clearance...

This requirements was not met as evidenced by:
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Facility Representative associated staff #1 to facility while LPA was present. Facility representative states will ensure that in the future, all employees will be fingerprint cleared and associated prior to working with children.
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Based on Record review LIcensee did not comply with regulation above as staff #1 was fingerprint cleared but not associated to the facility as required.
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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:Renesha Askew
LICENSING EVALUATOR NAME:Adrian L Mangina
LICENSING EVALUATOR SIGNATURE:
DATE: 06/29/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/29/2022


LIC809 (FAS) - (06/04)
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