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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376105011
Report Date: 04/13/2023
Date Signed: 04/13/2023 01:45:48 PM

Document Has Been Signed on 04/13/2023 01:45 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:GOLDEN POPPY PRESCHOOL & INFANT CENTERFACILITY NUMBER:
376105011
ADMINISTRATOR:MONIQUE REYCASAFACILITY TYPE:
830
ADDRESS:3422 TRIPP COURTTELEPHONE:
(858) 794-9130
CITY:SAN DIEGOSTATE: CAZIP CODE:
92121
CAPACITY: 44TOTAL ENROLLED CHILDREN: 44CENSUS: DATE:
04/13/2023
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Monique ReycasaTIME COMPLETED:
01:15 PM
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On 04/13/23 at 1:00 PM, Licensing Program Analyst (LPA), Annette Sutherland and Licensing Program Manager (LPM), Monica Cuddy conducted a virtual office meeting to discuss the facility's recent citations issued. Meeting was conducted with Owner Shri Rival, Director Monique Reycasa, and Assistant Director Miriam Moreno.

02/28/23 Annual visit. 3 staff members not associated. Type B and Civil penalties issued.

07/14/22 Case management for self-reported incident involving infant flipping out of broken crib. (type A cited) Facility not conducting safe sleep logs (Type B cited).

LPM Cuddy discussed with Facility Representatives the above deficiencies. Facility representatives were provided the following resources: A link to the Care Tool was provided https://cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/inspection-process-project/care-tools, a Technical Support Program (TSP) brochure, for questions related to the TSP, email: childcaretechnicalsupport@dss.ca.gov, active supervision handout, ccld.childcarevideos.org, provided a copy of the children’s personal rights.
Advocate information was provided: (714)-703-2800 or childcareadvocatesprogram@dss.ca.gov, sdincidentreports@dss.ca.gov and the Duty Line (619)-767-2248. Licensee will review and reach out.

Continued on LIC 809C
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Annette Sutherland
LICENSING EVALUATOR SIGNATURE: DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/13/2023
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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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: GOLDEN POPPY PRESCHOOL & INFANT CENTER
FACILITY NUMBER: 376105011
VISIT DATE: 04/13/2023
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Facility Representatives were informed that repeated violations or failure to comply with licensing laws and regulations may result in administrative action taken by the Department. Facility Representatives, Shri Rival, Monique Reycasa, and Miriam Moreno stated they understood and will ensure the facility complies with all regulations and laws governing Child Care Centers.

An exit interview was conducted with Facility representatives. A copy of this report, Appeal Rights (LIC 9058) have been provided via email.

An email read receipt confirms the documents were received.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Annette Sutherland
LICENSING EVALUATOR SIGNATURE:

DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023
LIC809 (FAS) - (06/04)
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