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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600318
Report Date: 10/28/2021
Date Signed: 10/28/2021 02:49:46 PM

Document Has Been Signed on 10/28/2021 02:49 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 CUYAMACA CENTERFACILITY NUMBER:
376600318
ADMINISTRATOR:KENDRA DEDMONFACILITY TYPE:
850
ADDRESS:9735 CUYAMACA STREETTELEPHONE:
(619) 562-3423
CITY:SANTEESTATE: CAZIP CODE:
92071
CAPACITY: 96TOTAL ENROLLED CHILDREN: 96CENSUS: 34DATE:
10/28/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Kendra DedmonTIME COMPLETED:
01:30 PM
NARRATIVE
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On 10/28/21 @ 12:45PM, Licensing Program Analyst (LPA) Nancy Diaz conducted an unannounced inspection LPA met an toured the classrooms with Kendra Dedmon, Site Director. Observed present today were 34 (napping) children in the following rooms:
- Preschool A with 12 children and staff Victoria Cagney
- PreK with 13 children and staff Gulya Ibrahimova & Monica Collins
- Discovery with 9 children and staff Wendy Ruiz.

All staff were observed wearing masks. Fingerprint records reviewed today indicated that Wendy Ruiz is not associated to the facility.

Type A deficiency is cited. Civil Penalty was assessed.

Type A deficiency if not corrected poses an immediate risk to the health, safety or personal rights of children in care.

Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.

Exit interview was conducted with Kendra Dedmon. Appeal rights were discussed. A copy of this report and written appeal rights were provided to Ms. Dedmon today.

CONTINUED...
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 10/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/28/2021
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 2
Document Has Been Signed on 10/28/2021 02:49 PM - It Cannot Be Edited


Created By: Nancy Diaz On 10/28/2021 at 01:56 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: KINDERCARE CUYAMACA CENTER
FACILITY NUMBER: 376600318

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/28/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/28/2021
Section Cited
CCR
101170(e)(2)

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CRIMINAL RECORD CLEARANCE. All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: Request a transfer of a criminal record clearance...
This requirement was not met as evidenced by:
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Ms. Dedmon shall submit form LIC 9182 (with a copy of staff photo ID and signed LIC 508) to the department before end of business day of 10/28/21.
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Based on LPA's review of staff fingerprint clearance database, staff Wendy Ruiz' fingerprint clearance is not associated to the facility (Ms. Ruiz started employment on 10/18/21).
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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:Nancy Diaz
LICENSING EVALUATOR SIGNATURE:
DATE: 10/28/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/28/2021


LIC809 (FAS) - (06/04)
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