<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376105075
Report Date: 02/28/2023
Date Signed: 02/28/2023 04:56:05 PM

Document Has Been Signed on 02/28/2023 04:56 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:
376105075
ADMINISTRATOR:AIMEE AINSWORTHFACILITY TYPE:
830
ADDRESS:7150 RANCHO SANTA FE ROADTELEPHONE:
(760) 891-0902
CITY:CARLSBADSTATE: CAZIP CODE:
92009
CAPACITY: 24TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
02/28/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Director, Patricia MunozTIME COMPLETED:
04:56 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 2/28/23 at 3:00PM, an unannounced case management inspection was conducted by Licensing Program Analyst (LPA) Saraliz Velando to follow up on a self-reported incident that occurred on 2/10/23. Upon arrival, LPA met with Director, Patricia Munoz. A tour of the facility was conducted and LPA observed 2 staff and 10 children in care.

The facility self-reported the incidents to the department by email on 2/16/23. During the incident on 2/10/23, staff had a mix up of two infant’s bottles. According to staff, one of the infants was given a bottle of formula with the label of a different infant’s name.

Staff members involved were interviewed and based on the information, it appears that there is no procedure in place to make sure the infant gets the correct bottle.

Type B Violation was cited. 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 the director, Patricia Munoz.

A notice of site visit was posted and this notice shall remain posted for 30 days.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Saraliz Velando
LICENSING EVALUATOR SIGNATURE: DATE: 02/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/28/2023
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 02/28/2023 04:56 PM - It Cannot Be Edited


Created By: Saraliz Velando On 02/28/2023 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: 376105075

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/28/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/08/2023
Section Cited
CCR
101223(a)(2)

1
2
3
4
5
6
7

Personal Rights - (a)The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Director stated that she will conduct a training on bottle feeding procedure on 3/3/23 and submit a sign in sheet for the training by 3/8/23 to the department.
8
9
10
11
12
13
14
Based on staff interviews the licensee did not make sure the correct baby bottle was given to the correct infant. This poses a potential risk to the health and safety of children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: 02/28/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/28/2023


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