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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376105086
Report Date: 07/13/2022
Date Signed: 07/13/2022 10:19:58 PM

Document Has Been Signed on 07/13/2022 10:19 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:CHAI PRESCHOOL & INFANT CENTERFACILITY NUMBER:
376105086
ADMINISTRATOR:SHTERNA GOLDSTEINFACILITY TYPE:
850
ADDRESS:16934 CHABAD WAYTELEPHONE:
(858) 451-0455
CITY:POWAYSTATE: CAZIP CODE:
92064
CAPACITY: 56TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
07/13/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Shterna GoldsteinTIME COMPLETED:
05:30 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 07/13/2022 at 2:00pm, Licensing Program Analyst, Selina Siao, conducted an announced Pre-Licensing inspection. LPA met with Site Director Sherna Goldstein who meets qualification requirements and Assistant Director Paulina Escamilla. The Preschool Program will operate in the following classrooms:3, 4, 5 and 6. First Aid Kit and medication are kept in Director's office. Some of the children's IMS medications will be stored in the child's classroom staff's backpack. Fire clearance was granted on 05/18/2022.

All indoor and outdoor activity space utilized for the children was inspected and measured today:
Indoor:
· Room 3 measures 467.28 square feet
· Room 4 measures 524.85 square feet
· Room 5 measures 579 square feet
· Room 6 measures 472.97square feet
· Total indoor activity space is 2044.1 square feet, which can accommodate up to 56 children.

Outdoor:
· Preschool Playground area measures 3031.63 square feet (play structure area) and Sandbox area 4326.19. Total outdoor activity space for preschool children is 7357.82, which can accommodate up to 98 children at one time.

The rooms are complete with age-appropriate furniture and equipment, including tables, chairs, cubbies, napping cots/ mat, bookshelves, and other activity supplies for the children. There are 6 toilets which is sufficient enough for 90 children. There are 9 sinks which is
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE: DATE: 07/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/13/2022
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 3
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: CHAI PRESCHOOL & INFANT CENTER
FACILITY NUMBER: 376105086
VISIT DATE: 07/13/2022
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
26
27
28
29
30
31
32
sufficient for 135 children. Children are to be escorted and supervised by staff to and from the bathroom and direct visual observation is required. There is a separate bathroom for staff located in classroom 1 and one of the toilet and sink located in the hallway restroom will also be use for staff and it is also designated for use by children who are ill. There is a carbon monoxide detector on site located in each of the classrooms. The kitchen area currently includes a sink, refrigerator, stove, storage units. Menu is posted, as well as all other required documents for the parents and employees. Facility will be using the electronic sign-in and out through the Brightwheel App on their own phone or they could use the staff's phone or the tablet located in the office to sign in and out.

The outdoor play area was inspected. LPA observed two separate playgrounds. Areas are completely fenced, have large blue tarp for shade, age appropriate play equipment, and sufficient rubber mat cushioning under the climbing play structure. The children will be bringing their own water bottles or cups inside and outside.

This facility plans to provide Incidental Medical Services – IMS. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: CHAI PRESCHOOL & INFANT CENTER
FACILITY NUMBER: 376105086
VISIT DATE: 07/13/2022
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
26
27
28
29
30
31
32
LPA reviewed the updated LIC311A with the facility representative today and reminded to keep anything that reads, “Keep Out of Reach of Children” inaccessible to children.

Exit interview was conducted. Once all documents are received and a final file review is conducted, a license for 56 children will be granted.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2022
LIC809 (FAS) - (06/04)
Page: 3 of 3