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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600318
Report Date: 03/16/2022
Date Signed: 03/16/2022 02:30:04 PM

Document Has Been Signed on 03/16/2022 02:30 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: 42DATE:
03/16/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Monica CollinsTIME COMPLETED:
01:30 PM
NARRATIVE
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On 3/16/2022 @ 1:00PM, Licensing Program Analysts (LPAs) Nancy Diaz and Jennifer Lott conducted an unannounced case management inspection. LPAs tour the classrooms with site director, Monica Collins. Facility's assistant director, Haley Adams was also present today. The following census were observed in the following Preschool classrooms today:

Preschool A (3 y.o.) with 10 children and staff Erin Markert.
Preschool B (3 y.o.) with 11 children and staff Ann Pacheco & Kim Walz.
Pre-K with 11 children and staff Shuhad Althabiti.
2 y.o. with 10 children and staff Shirley Demello.

Type A deficiency was cited today. Civil penalty was assessed.

Type A deficiency if not corrected poses and 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 Monica Collins. LPAs provided a copy of this report and appeal rights were discussed and provided today. Notice of site visit was observed posted. This notice shall remain posted for 30 days.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 03/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/16/2022
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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Document Has Been Signed on 03/16/2022 02:30 PM - It Cannot Be Edited


Created By: Nancy Diaz On 03/16/2022 at 02:05 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: 03/16/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/16/2022
Section Cited
CCR
101170(f)

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CRIMINAL RECORD CLEARANCE. A licensee or applicant for a license may request a transfer of a criminal record clearance from one state licensed facility to another, or from TrustLine to a state licensed facility by providing the following documents to the Department:
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Monica Collins stated that she will submit LIC 9182 (Criminal record transfer request); copy of photo ID and LIC 508 to the department no later than end of business day of 3/16/2022.
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This requirement was not met as evidenced by: Based on LPAs review of staff files the following staff are not associated to the facility:
Erin Markert (started employment 11/2021); Kim Walz (started 3/15/2022) & Shirley Demello (started employment 12/2021).
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FAX # is (619) 767-2203. It is strongly recommended that facility print out a transmission sheet to verify that the document completed transmission.

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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: 03/16/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/16/2022


LIC809 (FAS) - (06/04)
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