Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700882
Report Date: 03/28/2017
Date Signed: 03/29/2017 12:52:50 PM

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:SAINT PATRICK PRESCHOOLFACILITY NUMBER:
376700882
ADMINISTRATOR:EUGENIA GOMEZFACILITY TYPE:
850
ADDRESS:3583 30TH STREETTELEPHONE:
(619) 487-9538
CITY:SAN DIEGOSTATE: CAZIP CODE:
92104
CAPACITY:29CENSUS: 23DATE:
03/28/2017
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:31 PM
MET WITH:Eugenia GomezTIME COMPLETED:
03:01 PM
NARRATIVE
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Licensing Program Analyst, Rita Magana completed a random annual inspection to the above address. I met with site director, Eugenia Gomez. A tour was completed of the two preschool classrooms and play yard. The school does not prepare lunch on site, the children either bring their lunch from home, or purchase through the San Diego Unified School District. The snack and school district menu were visibly posted. There were no bodies of water, weapons, or ammunition on the premises. All furniture and equipment appeared to be in good repair. Fountains, faucets and toilets appeared to be operational. The preschool is cleaned by a custodian. Solid waste containers had tight fitting lids. A random review was completed of the children's records, and staff files. At least three staff had valid pediatric, CPR and First Aid cards. Reviewed today was the following: SB 792 (Mendoza) Day Care Facilities: Immunizations: Exemptions, SB 277 (Pan) Child Day Care: Immunization Requirements, Section 101173 (Title 22) Plan of Operation, Incidental Medical Services. Also discussed was cushion materials underneath any type of climbing structure (i.e., slides, etc).





This is an electronic copy of a handwritten report. Please see facility file for original signatures. The following information regarding ADA was provided: US Department Of Justice (USDOJ) toll-free ADA Information (800) 514-0301 (voice) (800) 514-0383(TTY) and link to publication: Commonly Asked Questions about Child Care Facilities and the ADA, available at: http://www.ada.gov/childqanda.htm Community Care Licensing: WEB SITE: http://www.ccld.ca.gov The report shall remain available at the facility for public review for three years. LIC 9213 was visibly posted today, for 30 days. Appeal rights were reviewed.
SUPERVISOR'S NAME: Carol AugustTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Rita MaganaTELEPHONE: 619-767-2213
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2017
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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