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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701499
Report Date: 11/03/2023
Date Signed: 11/03/2023 02:08:08 PM


Document Has Been Signed on 11/03/2023 02:08 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
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108



FACILITY NAME:CHILDREN'S CHOICE ACADEMY, INC - INFANTFACILITY NUMBER:
376701499
ADMINISTRATOR:JENNIFER GRAWVUNDERFACILITY TYPE:
830
ADDRESS:73 NORTH SECOND AVENUETELEPHONE:
(619) 425-9933
CITY:CHULA VISTASTATE: CAZIP CODE:
91910
CAPACITY:24CENSUS: 15DATE:
11/03/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Brenda CasillasTIME COMPLETED:
02:00 PM
NARRATIVE
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On 11.3.23 LPA Hopkins and LPA Castellon conducted an unannounced complaint visit . LPAs met with director Brenda Casillas.

During record reviews, staff interviews, as well as observation the facility will be cited 2 deficiencies.
It was revealed by reviewing record that sleeping plans were not being filled out and utilized for any of the 7 infants in care under 12 months of age. There were no completed plans available for review.
It was revealed during interviews and record review that 15 minute sleeping logs were not being documented for 2 children observed to be asleep during LPA visit.

This LIC809 and LIC809D will be used to document the citation.

See LIC809D for the 2 Type B deficiencies cited.

Exit interview conducted. Appeal rights were discussed and given to director on this date. Notice of Site Visit was given to director .
SUPERVISOR'S NAME: Cynthia GrayTELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Amber HopkinsTELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:
DATE: 11/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/03/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


Document Has Been Signed on 11/03/2023 02:08 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108


FACILITY NAME: CHILDREN'S CHOICE ACADEMY, INC - INFANT
FACILITY NUMBER: 376701499

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/03/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/03/2023
Section Cited
CCR
101419.2(b)(2)

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Infants up to 12 months of age shall have a completed Individual Infant Sleeping Plan [LIC 9227 (3/20)], which is incorporated by reference.
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The facility will ensure that a LIC 9227 will be filled out for all infants enrolled at the facility under 12 months of age. Facility will send LPA completed forms within 1 week timeframe.
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This requirementt was not met as evidenced by record reviews and staff stating that forms were not being completed and followed. This poses a risk to health and safety in care.
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Type B
11/03/2023
Section Cited
CCR101429(2))B)

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Staff shall physically check on sleeping infant(s) every 15 minutes and document the following:
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The facility will ensure that all children under 24 months have completed a sleep log daily and keep on file for 3 years. Facility will send 15 minute logs to LPA within 1 week timeframe.
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This requirment was not met as evidenced by record reviews and staff stating that forms were not being completed and followed today. This poses a risk to health and safety in care.
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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: Cynthia GrayTELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Amber HopkinsTELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:
DATE: 11/03/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/03/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2