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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600310
Report Date: 07/14/2021
Date Signed: 07/14/2021 02:26:10 PM

Document Has Been Signed on 07/14/2021 02:26 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:KINDERCARE ROTHGARD - PRESCHOOLFACILITY NUMBER:
376600310
ADMINISTRATOR:CELIA CARRIZOSAFACILITY TYPE:
850
ADDRESS:10130 ROTHGARD ROADTELEPHONE:
(619) 670-6566
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY: 106TOTAL ENROLLED CHILDREN: 0CENSUS: 52DATE:
07/14/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Celia CarrizosaTIME COMPLETED:
12:30 PM
NARRATIVE
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On 07/14/2021, at 8:30am, Licensing Program Analysts (LPAs) Martha Malane and Casey Gulley, conducted an unannounced Annual Inspection for the preschool license and met with Assistant Director, Liliana Arredondo and Director, Cella Carrizosa. LPAs disclosed the purpose of the inspection and toured the facility indoors and outdoors. This is a full day program which operates year round. Days and hours of operation are Monday - Friday 6:00am to 6:00pm. There are currently four (4) classrooms in operation. The following ratios were observed:
· Discovery Preschool Room serves children age 2 years: There were 12 children present with one (1) staff member
· Preschool Room serves children age 2–3 years: There were 12 children present with two (2) staff members
· Pre-K Room serves children age 4-5 years: There were 12 children present with 1 staff member
· Transitional-K/School-Age Room serves children age 5-12 years: There were 16 children present with two (2) staff members

Director stated there is no swimming pool or other bodies of water on the premises and LPAs did not observe any swimming pools or bodies of water. Director stated there are no firearms or ammunition allowed or stored on the premises. Director was reminded that disinfectants, cleaning solutions and other hazardous items are to be inaccessible, Technical Advisory.

Furniture and equipment are in good condition. Playground equipment was inspected. The surface of the outdoor activity space was inspected. Toilets and handwashing facilities are in safe and sanitary operating condition. Floors in the facility are clean. Kitchen, food preparation and storage areas are clean, free of litter/rubbish and free of rodents/vermin. Solid waste storage containers have tight-fitting covers and are in good repair. Drinking water is available both indoors and outdoors. Areas around high climbing equipment, swings and slides have cushioning material to absorb falls. The facility is free of flies, insects and rodents. Facility has a functioning carbon monoxide detector that meets requirements.

See continuation LIC809C...
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Martha Malane
LICENSING EVALUATOR SIGNATURE: DATE: 07/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/14/2021
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: KINDERCARE ROTHGARD - PRESCHOOL
FACILITY NUMBER: 376600310
VISIT DATE: 07/14/2021
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A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Upon notification from the Department, the licensee will comply and act immediately to terminate the employment of, remove from the facility or bar from entering the facility for any person it is deemed necessary while the Department considers granting or denying an exemption. Capacity and limitations as specified on the license are being maintained. At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at offsite activities. The name of the child care center director or fully-qualified teacher(s) designated to act in the director’s absence has been reported to the Department. The person who signs the child in/out of the facility shall use their full legal signature and record the time of day. Children are under supervision, including visual supervision, of a teacher at all times. Facility maintains a ratio of one teacher supervising no more than 12 children in care. LPAs reviewed a sample of children’s files and observed files were complete with contact information for authorized representative and or relatives or others who can assume responsibility for the child and medical assessment. LPAs reviewed a sample of staff files and observed files were complete with health screening, immunization records for influenza, pertussis and measles and current documentation of completed mandated reporter training. Menus are posted at least one week in advance where an authorized representative can view them.

This facility provides Incidental Medical Services (IMS). LPAs reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. LPAs observed expired medication, see LIC809D for deficiency sited. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

LPAs and director discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, California Megan’s Law (www.meganslaw.ca.gov), Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiency is being cited: see LIC809D. An exit interview was conducted with director. Director was provided a copy of their appeal rights (LIC 9058).

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Martha Malane
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2021
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/14/2021 02:26 PM - It Cannot Be Edited


Created By: Martha Malane On 07/14/2021 at 11:24 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: KINDERCARE ROTHGARD - PRESCHOOL
FACILITY NUMBER: 376600310

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/14/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/14/2021
Section Cited
CCR
101226(e)(3)(A)

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101226(e)(3)(A) Health Related Services (e) In centers where the licensee chooses to handle medications: Prescription medications shall be administered in accordance with the label directions as prescribed by the child's physician. This requirement was not met as evidenced by:
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Director stated she conduct a montly check of the medication box to ensure medication is not expired. Director stated she will set a montly reminder on Outlook.
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Based on LPAs observation and director's admission facility staff did not maintain medication per the label's instructions. 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:Tulam Vu
LICENSING EVALUATOR NAME:Martha Malane
LICENSING EVALUATOR SIGNATURE:
DATE: 07/14/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/14/2021


LIC809 (FAS) - (06/04)
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