376105218-8-5-2025-51-CC-SCLA-DK9U5B-20250805151629

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376105218
Report Date: 08/05/2025
Date Signed: 08/05/2025 03:17:47 PM

Document Has Been Signed on 08/05/2025 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	JEWISH COMMUNITY CENTER; M. LARRY LAWRENCE BRANCH		FACILITY NUMBER:	376105218
ADMINISTRATOR/ DIRECTOR:	FRAN FORMAN		FACILITY TYPE:	860
ADDRESS:	4126 EXECUTIVE DRIVE		TELEPHONE:	(858) 362-1171
CITY:	LA JOLLA	STATE: CA	ZIP CODE:	92037
CAPACITY: 235	TOTAL ENROLLED CHILDREN: 174	CENSUS: 126	DATE:	08/05/2025
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:10 AM
MET WITH:	Fran Forman		TIME VISIT/ INSPECTION COMPLETED:	03:45 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 08/05/25 at 11:10am, Licensing Program Analyst (LPAs), Samantha Clenista and Selina Siao conducted an announced Pre-Licensing inspection to add an infant component and conversion to a single license. Upon arrival, LPAs met with Director/Facility Representative, Fran Forman. Applicant is requesting to be licensed for 10 infants (3-24 months) in Room 15 and 16, 24 toddlers (18-36 months) in Rooms 3 & 4, and 201 preschoolers (2-5 years old) in Rooms 1, 2, 5 – 14. Hours of operation will be 7:30am-5:30pm Monday thru Thursday, and 7:30am-5:00pm on Friday’s. All indoor and outdoor activity space utilized for the children was inspected today. LPAs informed Director that staff are required to maintain direct visual supervision of the children at all times during indoor and outdoor activities to ensure their overall health and safety. When medications are on site, Director stated that they are kept in the Assistant Director’s office. A fully equipped first aid kit is in the preschool courtyard. There is an operational carbon monoxide detector on site located in Room 15 and 16. All required licensing documents were observed posted in the main preschool lobby. Children will be signed in and out via app Remini. LPAs continued to tour the facility and measured all indoor and outdoor activity space. Total indoor activity space for infants measured at 656.57 sq. ft. which is sufficient to accommodate the requested capacity of 10 infants. Total indoor activity space for toddlers measured at 1067.32 sq. ft., which is sufficient to accommodate the requested capacity of 24 toddlers. Total indoor activity space for preschoolers measured at 8073.58 sq. ft., which is sufficient to accommodate the requested capacity of 201 preschoolers. LPAs observed all indoor activity space to be complete with safe, age-appropriate furniture and equipment, including tables, chairs, cubbies, napping cots/mats, cribs, bookshelves, and other activity supplies for the children. Infant toys are safe with no sharp edges, splinters, or points, nor made of small parts that can present a choking hazard. Drinking water is available in the classrooms via filtered water using a Home Master HMF 25 mg CC Whole House Water Filter. LPAs observed all hazardous items to be inaccessible to children.

NAME OF LICENSING PROGRAM MANAGER: Monica Cuddy
NAME OF LICENSING PROGRAM ANALYST: Samantha Clenista
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/05/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: JEWISH COMMUNITY CENTER; M. LARRY LAWRENCE BRANCH	FACILITY NUMBER: 376105218
	VISIT DATE: 08/05/2025

NARRATIVE

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LPAs observed there to be a big water feature located in front of the building, on the right-hand side of the main entrance. It consists of a tall statue holding a bowl where water was dripping down into a stream that runs about 34-40 ft. long. The stream has various rocks placed in it, with some plants and bigger boulder rocks surrounding it. The level of water (from surface to top of rocks) varied from 1 inch, to as deep as 15-16 inches. The facility stated that they will drain the water that is currently present and add more rocks to make the level of water shallower to refrain from potential drowning.

The director also mentioned that the facility has swimming pools on site, however, they are located on the completely opposite side of the building, away from the licensed areas. There are at least 3 separate locked doors to enter and leave the preschool area to get to the main lobby, where a key fob is required. LPAs measured about 401 ft. from the main building entry door to the door that leads directly to the pool, and measured about 461 ft. from the main preschool door within the building to the door that leads directly to the pool area. There are various programs and amenities located within the building that are between the preschool area and pool area which include but not limited to, gym, theater, art gallery, restaurant, coffee shop, adult learning classrooms, etc.

The swimming pools are part of the community center, used for preschool children during the summer months only. Director stated that the preschool children are escorted to and from the preschool areas to the pool by qualified teachers (teachers stay with the children during swimming time) and lifeguards are on site overseeing the pool. The Director stated that they obtain parent/guardian approval prior to having the preschool utilize the pools. LPAs observed 3 separate bodies of water within the pool area; jacuzzi, small pool for younger children, and Olympic size pool. The entire pool area was observed to be enclosed via chain-link fencing (higher than 6ft) with mesh on the outside, and metal door gates that push away from the pool area. LPAs observed several lifeguards on duty during inspection. The director stated that there is an armed guard on the premises for safety. Fire clearance was granted on 07/24/25.

In the infant room(s) highchairs and feeding tables have broad-based legs, plastic seats are in good repair and trays lock onto chairs. Highchairs are made of washable, moisture-resistant material. Changing tables have at least 1” padding covered with moisture-resistant, washable material. Sides of the changing table are at least 3” high and the changing table is within arm’s reach of a sink. Diapering sink is not used for meal preparation or dishwashing. Cribs meet regulatory requirements. Crib area is separated from activity space via plexiglass/wood.

NAME OF LICENSING PROGRAM MANAGER: Monica Cuddy
NAME OF LICENSING PROGRAM ANALYST: Samantha Clenista
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/05/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2025

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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: JEWISH COMMUNITY CENTER; M. LARRY LAWRENCE BRANCH	FACILITY NUMBER: 376105218
	VISIT DATE: 08/05/2025

NARRATIVE

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This barrier is at least four feet high, made of sound absorbing material and allows for supervision of napping children, however, does not fully enclose the crib area. There is a space between the barrier and wall where the cabinet is, where it is shy of 4ft. Sleep logs, Needs and Services Plans and Sleep Plans will be kept in a binder located in the respective child’s classroom, and the Director was reminded that they must be updated quarterly.

LPAs observed a total of 27 sinks and 14 toilets available for preschool use, 4 sinks and 2 toilets for toddler use, and 3 sinks for infant use. The number of toilets and sinks are sufficient to accommodate the requested capacity per program. There is a separate staff restroom equipped with a toilet and a sink. The isolation area for children who are ill will be the director’s office and staff restroom. The Director is reminded that any changes to the facility must be reported to and approved by Community Care Licensing.

Facility provides AM and PM snacks. The kitchen area currently includes 2 sinks, a refrigerator, oven and microwave. The kitchen area and food storage areas were observed to be free of rodents and/or vermin. Food was observed to be properly stored separate from cleaning materials. Hazardous items in the kitchen are inaccessible to children.

The facility currently has a fully fenced playground area for toddlers and preschoolers. Fencing consists of brick/cement wall and/or iron gate and was observed to be at least four feet high. The total square footage for all the outdoor activity space for the preschool is 12,670.47 sq. ft., which is not sufficient to accommodate the requested capacity of 201 preschoolers. The total square footage for all the outdoor activity space for the toddlers is 1,504 sq. ft., which is not sufficient to accommodate the requested capacity of 24 toddlers. A playground waiver for the toddlers and preschool to share their designated yards at different times in the AM and PM due to limited square footage shall be submitted and approved prior to licensure.

The Director stated that she would also like to request a waiver to share the toddler yard with the infants at separate times, due to not having a separate infant yard. The Director stated she would also like to request for a waiver to share the toddler playground with the younger preschoolers (2-year-old) at separate times. Playground areas are shaded via sail shade, umbrellas, and trees. There are sufficient outdoor age-appropriate toys and play equipment available on the playgrounds. There is a climbing structure in the toddler and preschool playground which were observed to be properly anchored and was observed to be age appropriate. There is adequate cushioning in fall zones of climbers provided by rubber cushioning. LPAs observed all hazardous items on the playground(s) to be inaccessible to children

NAME OF LICENSING PROGRAM MANAGER: Monica Cuddy
NAME OF LICENSING PROGRAM ANALYST: Samantha Clenista
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/05/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2025

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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: JEWISH COMMUNITY CENTER; M. LARRY LAWRENCE BRANCH	FACILITY NUMBER: 376105218
	VISIT DATE: 08/05/2025

NARRATIVE

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For childcare center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP). If the facility has had a lead tea completed within the last five years from todays date and is using the same outlets, you may submit a waiver request from the lead testing requirement to the Regional Office.

The director was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. 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) or (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
LPAs reviewed with the director the LIC 311A, Records to Be Maintained at The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

LPAs discussed the safe sleep regulations with the Director and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep, as an additional resource. LPAs also informed the Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at: https://www.cpsc.gov/, and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

NAME OF LICENSING PROGRAM MANAGER: Monica Cuddy
NAME OF LICENSING PROGRAM ANALYST: Samantha Clenista
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/05/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2025

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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: JEWISH COMMUNITY CENTER; M. LARRY LAWRENCE BRANCH	FACILITY NUMBER: 376105218
	VISIT DATE: 08/05/2025

NARRATIVE

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The Director was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

A notice of site visit was given to the Director and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Exit interview conducted and report was reviewed with the Director, Fran Forman.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

The following corrections are needed prior to the issuance of the license:

Fully barricade the crib area located in the infant #15 classroom.
Submit a shared playground waiver for the toddler and preschool program to share their designated playground at separate times due to limited square footage – 101238.2(a).
Submit a shared playground waiver to allow the infants to share the toddler playground – 101438.2(b).
Submit a shared playground waiver to allow the younger preschoolers (2-year-old) to share the toddler playground – 101216.4(a)(2).
Place more rocks in the stream water feature located in front of the building to make it high enough to refrain from potential drowning and provide LPA Clenista photos and videos once completed.

The Director, Fran Forman stated she understands that all proof of corrections must be provided to the Department within 30 days, or the application may be denied.

NAME OF LICENSING PROGRAM MANAGER: Monica Cuddy
NAME OF LICENSING PROGRAM ANALYST: Samantha Clenista
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/05/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2025

LIC809 (FAS) - (06/04)

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