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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376105074
Report Date: 10/13/2022
Date Signed: 10/13/2022 01:43:35 PM

Document Has Been Signed on 10/13/2022 01:43 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:EVERBROOK ACADEMY DBA PRESTIGE PRESCHOOL ACADEMYFACILITY NUMBER:
376105074
ADMINISTRATOR:AIMEE AINSWORTHFACILITY TYPE:
850
ADDRESS:7150 RANCHO SANTA FE ROADTELEPHONE:
(760) 891-0902
CITY:CARLSBADSTATE: CAZIP CODE:
92009
CAPACITY: 146TOTAL ENROLLED CHILDREN: 146CENSUS: 44DATE:
10/13/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Interim Director, Sherri BrownTIME COMPLETED:
02:00 PM
NARRATIVE
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On 10/13/22 at 11:30AM, an unannounced case management inspection made by Licensing Program Analysts (LPAs) Saraliz Velando and Nancy Diaz to follow up on an incident report that occurred on 9/29/22 at approximately 12:23PM. Upon arrival, LPAs met with Interim Director, Sherri Brown. A tour of the facility was conducted and LPAs observed 44 children in care.

The facility self-reported the incident to the department by email on 10/10/22. During the incident of 9/29/22, two children ran into each other and bumped their heads.
Staff member involved was interviewed and based on the information, it appears that appropriate supervision was being provided at the time of the incident. Staff stated she was in an outdoor play area with the children and while helping a child tie their shoelace, two other children ran into each other and bumped their heads. She immediately checked their heads for signs of injury and did not observe any.

A fingerprint association was reviewed today and it revealed that a staff member is not associated to the facility, this particular staff began employment on 10/10/22.

Type A Violation is being cited. Civil penalty is being assessed.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Saraliz Velando
LICENSING EVALUATOR SIGNATURE: DATE: 10/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/13/2022
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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Document Has Been Signed on 10/13/2022 01:43 PM - It Cannot Be Edited


Created By: Saraliz Velando On 10/13/2022 at 11:33 AM
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: EVERBROOK ACADEMY DBA PRESTIGE PRESCHOOL ACADEMY
FACILITY NUMBER: 376105074

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/13/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type A
10/13/2022
Section Cited
CCR
102370(d)

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Criminal Record Clearance-
(d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596. 871
shall prior to working, residing, or volunteering in a licensed facility:
This requirement was not met as evidenced by:
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Interim Director will submit the required forms to the Licensing Email:SDIncidentReports@dss.ca.gov by the end of the day on 10/13/22.
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Based on record review of fingerprint clearance, staff Mayra Meza's fingerprint clearance was not associated to the facility. Staff, Mayra Meza started employment on 10/10/22.
Type A deficiency if not corrected poses an immediate risk to health, safety or personal rights of 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:Saraliz Velando
LICENSING EVALUATOR SIGNATURE:
DATE: 10/13/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/13/2022


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Document Has Been Signed on 10/13/2022 01:43 PM - It Cannot Be Edited


Created By: Saraliz Velando On 10/13/2022 at 11:44 AM
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: EVERBROOK ACADEMY DBA PRESTIGE PRESCHOOL ACADEMY
FACILITY NUMBER: 376105074

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/13/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/13/2022
Section Cited
CCR
101216.1(b)(1)

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Teacher Qualifications and Duties
(b) Prior to employment, a teacher shall meet the requirements of (b)(1) or (b)(2) below:(1) A teacher shall have completed.. or shall have obtained a Child Development Assistance Permit issued by the California Commission on Teacher Credentialing.
This requirement was not met as evidenced by:
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Corrected today, Interim Director, Sherri Brown, removed Ms. Patricio and replaced her with a qualified teacher, Ms. Jennifer Fuertes.
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Based on record review staff Destiny Patricio is not a fully qualified teacher because she is missing units in Child Family and Community. Ms. Patricio is not currently enrolled in any Child Development Course.
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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:Saraliz Velando
LICENSING EVALUATOR SIGNATURE:
DATE: 10/13/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/13/2022


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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: EVERBROOK ACADEMY DBA PRESTIGE PRESCHOOL ACADEMY
FACILITY NUMBER: 376105074
VISIT DATE: 10/13/2022
NARRATIVE
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LPA Saraliz Velando informed facility representative, Sherri Brown that this report dated 10/13/22 documents one Type A citation. Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.
Also, LPA Saraliz Velando informed Sherri Brown to provide a copy of this licensing report dated 10/13/22 that documents any Type A citation 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.

Refer to the next page LIC 809D for deficiency citation. Facility was provided a copy of the appeal rights.

Exit interview was conducted and report was reviewed with Interim Director, Sherri Brown.

A notice of site visit was given and observed posted, this notice shall remain posted for 30 days.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Saraliz Velando
LICENSING EVALUATOR SIGNATURE:

DATE: 10/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2022
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