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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701430
Report Date: 05/21/2026
Date Signed: 05/21/2026 02:32:49 PM

Document Has Been Signed on 05/21/2026 02:32 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:VILLAGE BLOOM CHILD DEVELOPMENT CENTERFACILITY NUMBER:
376701430
ADMINISTRATOR/
DIRECTOR:
PAULINE ASCUEFACILITY TYPE:
850
ADDRESS:448 RANCHO SANTA FE ROADTELEPHONE:
(760) 704-8314
CITY:ENCINITASSTATE: CAZIP CODE:
92024
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 42DATE:
05/21/2026
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:58 AM
MET WITH:AllisonTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On May 21, 2026 at 9:00A, Licensing Program Analysts (LPA) Hector Canton arrived unannounced at Village Bloom Child Development Center to conduct the required annual inspection. Upon arrival, LPA met with Allison Wachtel and Pauline Ascue, and explained the purpose of the visit. LPA toured the facility, indoors and outdoors, to assess compliance with Title 22/Health and Safety regulation. LPA conducted a full tour of the indoor and outdoor areas. The following census was observed:

• Sunflower Room (Pre-K): 20 Children with 2 Staff (1 Fully Qualified Teacher and 1 Substitute)

• Daisy Room (2-3s): 12 Children with 3 Staff (All Fully Qualified Teachers)

• Poppy Room (2-3s): 10 Children with 3 Staff (2 Fully Qualified Teacher and 1 Teacher’s Aide)

Indoor areas were inspected and found to contain age-appropriate furniture, equipment, and materials in good condition. Heating, lighting, and ventilation were adequate throughout classrooms and activity areas. Floors were clean and free of hazards. Drinking water was readily accessible to children. Bathrooms were sanitary, stocked with necessary supplies, and fixtures were operational. There are changing table available for any children that are diapering. Children bring food and snacks from home. Solid waste containers had tight fitting lids and were in good repair.

The outdoor play space was fully fenced and free from hazards. LPA did not observe any bodies of water on the premises. Outdoor play equipment was in good condition, with adequate cushioning material underneath climbing structures. Shade and drinking water were readily accessible to children during outdoor activity. There are animals (a guinea pig, bunnies, chickens, and a swine) in the outdoor area, LPA observed them to be caged and inaccessible to children.

NAME OF LICENSING PROGRAM MANAGER: Renesha Askew
NAME OF LICENSING PROGRAM ANALYST: Hector Canton
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/21/2026
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 N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: VILLAGE BLOOM CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 376701430
VISIT DATE: 05/21/2026
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LPA discussed the safe sleep regulations with the 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 the facility representative of the importance of checking for and removing any recalled infant devices on the United States Consumer Product Safety Commission 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing 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: https://www.ada.gov/resources/child-care-centers/.

Facility Representative was informed of the MyChildCarePlan.org website, a consumer education resource that helps families obtain child care by connecting them to licensed providers and Resource and Referral Agencies throughout California.

No violations were observed during today’s inspection, advisory notes are listed on the LIC 9102, and the facility was found to be operating in substantial compliance with Title 22 and Health and Safety code. An exit interview was conducted, and the report was reviewed in its entirety with the facility representative, Allison Wachtel and Pauline Ascue. Appeal rights were provided and explained. A Notice of Site Visit was issued and must remain posted for 30 days.

To improve the quality and value of the inspection process, a survey may be sent to the email address provided. If received, please complete the survey and share your inspection experience. If there are any questions about this inspection or about CARE tools, email inquiries may be sent to inspectionprocess@dss.ca.gov. Additional information regarding the inspection process and available resources can be found at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

NAME OF LICENSING PROGRAM MANAGER: Renesha Askew
NAME OF LICENSING PROGRAM ANALYST: Hector Canton
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2026
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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: VILLAGE BLOOM CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 376701430
VISIT DATE: 05/21/2026
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Required postings, including the facility license, emergency disaster plan, parents’ rights notice, and personal rights information, were displayed in areas accessible to parents and guardians. Sign‑in and sign-out procedures were reviewed, and records appeared complete and current. Hazardous materials were locked and inaccessible. Smoke and carbon monoxide detectors were present and operational. The most recent emergency disaster drill was documented on 9/8/2025. LPA reminded the director that emergency disaster drills must be conducted within 6 month intervals.

Children’s records were reviewed and found to contain required documentation, including admission agreements, emergency contact information, medical assessments, and immunization records. Staff files were reviewed and contained the required health screenings, immunization records, mandated reporter training certificates, CPR and First Aid certifications, and documentation of educational qualifications.

Lead testing requirements for Child Care Centers were reviewed. Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers 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 five years afterward, as outlined in Health and Safety Code section 1597.16. For centers licensed after July 1, 2022, water testing must be completed within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPAs verified that the lead testing was completed in accordance to the Written Directives (Interim Licensing Standards) outlined in PIN 21-21.1-CCP:

The center currently does not use any water outlets in the facility for food preparation or drinking. The facility representative was advised if they plan or expect to begin using an outlet for food preparation or drinking water, they must notify the local regional office. In addition, it is recommended that parents and authorized representative are notified that the facility plans to test and begin using tap water for drinking and/or food preparation. The facility must then follow the testing guidance outlined in the written directives, and test outlets prior to initial use for drinking water or food preparation.

LPAs referred the facility representative to the Department’s website for lead information at https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information.

Criminal record clearances were reviewed for all required individuals. 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.

NAME OF LICENSING PROGRAM MANAGER: Renesha Askew
NAME OF LICENSING PROGRAM ANALYST: Hector Canton
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2026
LIC809 (FAS) - (06/04)
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