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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600278
Report Date: 08/25/2022
Date Signed: 08/25/2022 04:46:14 PM

Document Has Been Signed on 08/25/2022 04:46 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:MAAC GOSNELLFACILITY NUMBER:
376600278
ADMINISTRATOR:CLARIBEL ZORRILLAFACILITY TYPE:
850
ADDRESS:139 GOSNELL WAYTELEPHONE:
(760) 736-3066
CITY:SAN MARCOSSTATE: CAZIP CODE:
92069
CAPACITY: 112TOTAL ENROLLED CHILDREN: 41CENSUS: 36DATE:
08/25/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Claribel ZorrillaTIME COMPLETED:
02:29 PM
NARRATIVE
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On August 25, 2022 at 12:30 p.m. Licensing Program Analyst (LPA) Leilani Curtis conducted an unannounced case management inspection in reference to the Licensee’s request to have the facility’s newly remodeled playground inspected and approved. Upon arrival LPA met with Director Claribel Zorrilla and proceeded to tour the facility. There were 36 children with 8 staff members present. Appropriate capacity and ratio were observed. Staff members have the required background clearances and are associated to the facility. The total licensed capacity of the facility is for 112 children.

LPA measured and inspected the preschool playground. The playground measures a total of 7588.28 square feet, which is sufficient space for 101 children. The area is completely fenced and includes age-appropriate play equipment and sufficient cushioning material (pour and play rubber surface) under the climbing structure. The director states that a covered sandbox will be added to the playground. There are several large shade trees on the playground. Additional shade is provided by awning/canopy. Drinking water is readily accessible via a water jug.

LPA observed that classroom #5 has been altered and is now two separate classrooms numbered classroom 5a and classroom 5b. A floor to ceiling wall with large windows and a door connecting room 5a to 5b has been installed. Classroom 5a has an exterior door leading outside and classroom 5b does not have an exterior door which exits outside. The director states that wall was added to limit the amount of noise entering into classroom 5a from the adjoining classroom (classroom 5b). The director states that the wall was erected on 7/14/22 without windows and on 8/12/22 windows were added completing the wall. According to Director Zorrilla Community Care Licensing was not notified of the construction or the alteration to the building because the wall is not considered to be a structural wall. The director provided LPA with an updated facility sketch at the time of inspection.

See LIC809 for cited deficiency.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Grace Curtis
LICENSING EVALUATOR SIGNATURE: DATE: 08/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/25/2022
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: MAAC GOSNELL
FACILITY NUMBER: 376600278
VISIT DATE: 08/25/2022
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Prior to licensure of the playground, the licensee will submit a playground waiver request to allow up to 112 children to use the playground on a scheduled basis. Once the playground waiver has been reviewed and approved the new playground may be used. In addition, the temporary preschool playground located on the patio will be dismantled upon approval of the waiver and use of the new permanent playground.

An exit interview was conducted with the director and appeal rights (LIC 9058 1/16) were discussed. A copy of this report as well as a copy of the appeal rights were given to the director at the conclusion of the inspection. The director’s signature on this form acknowledges receipt of these rights. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS. LPA observed the director post notice of site visit.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Grace Curtis
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2022
LIC809 (FAS) - (06/04)
Page: 3 of 3
Document Has Been Signed on 08/25/2022 04:46 PM - It Cannot Be Edited


Created By: Grace Curtis On 08/25/2022 at 02:55 PM
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: MAAC GOSNELL
FACILITY NUMBER: 376600278

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/25/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/02/2022
Section Cited
CCR
101237(a)

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101237 Alterations to Existing Buildings or New Facilities: (a) Prior to construction or alterations, the licensee shall notify the Department of the proposed change(s). This requirement was not met as evidenced by:
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The director states that she will provide a written statement to Community Care Licensing confirming that the department will be notified of any alterations or construction to the building in the future. The letter will be sent to LPA via email by POC due date of 9/2/22.
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Based on LPA's observation and the Director's statement a floor to ceiling wall was added to room #5 to create two separate rooms (5a and 5b). The licensee did not notify the department of this alteration to the building. This poses a potential health and safety risk to 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:Tashima Daniel
LICENSING EVALUATOR NAME:Grace Curtis
LICENSING EVALUATOR SIGNATURE:
DATE: 08/25/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/25/2022


LIC809 (FAS) - (06/04)
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