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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376105087
Report Date: 07/13/2022
Date Signed: 07/13/2022 10:23:05 PM

Document Has Been Signed on 07/13/2022 10:23 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:
376105087
ADMINISTRATOR:SHTERNA GOLDSTEINFACILITY TYPE:
830
ADDRESS:16934 CHABAD WAYTELEPHONE:
(858) 451-0455
CITY:POWAYSTATE: CAZIP CODE:
92064
CAPACITY: 27TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
07/13/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Shterna GoldsteinTIME COMPLETED:
05:30 PM
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On 07/13/2022 at 2:00pm, Licensing Program Analyst, Selina Siao, conducted an announced change of ownership Pre-Licensing inspection. LPA met with Site Director Sherna Goldstein who meets qualification requirements and Assistant Director Paulina Escamilla. The Infant Program will operate in the following classrooms: 1 and 2 also the crib area. First Aid Kit and Medication are kept in the Director's office. Fire clearance was granted on 5/18/2022.

The infant indoor and outdoor activity space are physically separate from the space used by other day care children. All indoor and outdoor activity space utilized for the infants/toddlers was inspected and measured today.

Indoor:
· Room 1 (ages 6 weeks to 12 months) measures 398.44 square feet
· Room 2 (ages 12 months to 24 months) measures 593.78 square feet
· Total indoor activity space is 992.22 square feet, which will accommodate a total of 28 children.

Outdoor:
· Infant Playground area measures 327.29 square feet and there is another area located in the middle of the two preschool playground that measures to be 1281 square feet. The total outdoor areas for infants is 1608.29, which will accommodate no more than 21 children at one time. An outdoor waiver will be needed.
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)
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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: CHAI PRESCHOOL & INFANT CENTER
FACILITY NUMBER: 376105087
VISIT DATE: 07/13/2022
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The rooms are complete with age-appropriate furniture and equipment, including tables, chairs, cubbies, cribs and cots and other activity supplies for the children. There is a separate crib area partitioned from the activity area currently located in room 1 and room 2. The crib area was not included in the square footage. There are currently 4 cribs in room 1 and 5 cribs in room 2 inside the napping area. Mats and cots are also available for children over age 12 months. Visual observation to all infants shall be maintained at all times. The infant room currently includes 2 sink for food preparation and 3 sink for diaper changing. There is a refrigerator in between the infant rooms. The ratio in this room will be 1:4. 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 small outdoor play area was inspected. It is complete with age-appropriate play equipment, shade, rubber mat and is surrounded by a 4 feet high fence. There is another designated outdoor stroller area that is also available for the infants. Blankets and strollers are available for the young infants. Drinking water is readily accessible via zippy cups.

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: 3 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: 376105087
VISIT DATE: 07/13/2022
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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.

Prior to licensure, the following is needed:
  • The crib area in room#2 partitions, shall be at least four feet high; shall be constructed of sound-absorbing material or the cribs will be move into room 1.

  • Submit an outdoor waiver request and be approved by the department.

Exit interview was conducted. Once all documents are received and a final file review is conducted, a license for 27 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)
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