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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376105062
Report Date: 03/24/2022
Date Signed: 03/24/2022 03:17:49 PM

Document Has Been Signed on 03/24/2022 03:17 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:BORREGO SPRINGS CHILDREN'S CENTERFACILITY NUMBER:
376105062
ADMINISTRATOR:TERESA WESTFACILITY TYPE:
850
ADDRESS:580 CIRCLE J DRIVETELEPHONE:
(760) 767-3658
CITY:BORREGO SPRINGSSTATE: CAZIP CODE:
92004
CAPACITY: 35TOTAL ENROLLED CHILDREN: 35CENSUS: 8DATE:
03/24/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Teresa WestTIME COMPLETED:
02:30 PM
NARRATIVE
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On 3/24/22 at 1:30 PM, Licensing Program Analysts (LPAs) Patrick Ma and Keturah Lane conducted an unannounced case management inspection. LPAs met with Director Teresa West upon arrival and toured the facility. Total census was 8 children (6 preschool and 2 toddlers) with 5 staff including Director. LPAs observed volunteer Nancy Wright helping with the children and is not fingerprint cleared or associated to the facility. This facility has a toddler component attached to the preschool license. LPAs observed preschool children playing outside. Toddlers were observed playing outside in separate playground area. At 11:15 AM – 1:05 PM, LPAs conducted staff interviews and interviewed the Director. LPAs reviewed staff files.

LPAs also obtained information from outside agencies and interviews with parents of enrolled children that sign in/out sheets have been incomplete, inaccurate and/or signed by someone other than the person bringing and removing the child from the center. Pursuant to Title 22 of the CA Code of Regulations, the following Type B deficiency was cited (refer to LIC 809-D).

LPAs Lane and Ma informed facility representative, Teresa West (Director), that this report dated 3/24/22 documents 1 Type A citations which shall be posted for 30 consecutive days as there are immediate risks to the health, safety, or personal rights of children in care.

Also, LPAs Lane and Ma informed the facility representative to provide a copy of this licensing report dated 3/24/22 that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. (continued on LIC809-C...)

SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE: DATE: 03/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/24/2022
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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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: BORREGO SPRINGS CHILDREN'S CENTER
FACILITY NUMBER: 376105062
VISIT DATE: 03/24/2022
NARRATIVE
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Civil penalties were assessed in the amount of $500. Licensee was provided a copy of Civil Penalties Assessment LIC421BG. Exit interview conducted and report was reviewed with the facility representative Teresa West, Director. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/24/2022 03:17 PM - It Cannot Be Edited


Created By: Keturah Lane On 03/24/2022 at 02:14 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: BORREGO SPRINGS CHILDREN'S CENTER
FACILITY NUMBER: 376105062

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/24/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/25/2022
Section Cited
CCR
101170(a)

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101170 Criminal Record Clearance (a) The Department shall conduct a criminal record review of all persons specified in Health and Safety Code Section 1596.871(b). The Department has the authority to approve or deny a facility license, or employment, residence or presence in the facility, based on the results of this review. This requirement was not met as evidenced by…
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Director will provide proof of fingerprint clearance and association to facility by 3/25/22 via e-mail to: Keturah.Lane@dss.ca.gov

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Based upon LPA observation and record review, volunteer Nancy Wright was not fingerprint cleared or associated to the facility which is an immediate health, safety and personal rights risk to children 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:Monica Cuddy
LICENSING EVALUATOR NAME:Keturah Lane
LICENSING EVALUATOR SIGNATURE:
DATE: 03/24/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/24/2022


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/24/2022 03:17 PM - It Cannot Be Edited


Created By: Keturah Lane On 03/24/2022 at 02:16 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: BORREGO SPRINGS CHILDREN'S CENTER
FACILITY NUMBER: 376105062

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/24/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/25/2022
Section Cited
CCR
101229.1(b)

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101229.1 Sign In and Sign Out
(b) The person who brings the child to, and removes the child from, the center shall sign the child in/out. This requirement was not met as evidenced by…
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Director will provide written plan stating how she will ensure sign in and out sheets are accurate and signed by the authorized individual and provide this by via e-mail to: Keturah.Lane@dss.ca.gov
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Based upon documents received from other sources and interviews with parents and outside agencies, some of the sign in and out sheets were not completed by the person bringing/removing the child from the center which is a potential health, safety and personal rights risk to children 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:Monica Cuddy
LICENSING EVALUATOR NAME:Keturah Lane
LICENSING EVALUATOR SIGNATURE:
DATE: 03/24/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/24/2022


LIC809 (FAS) - (06/04)
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