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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600816
Report Date: 07/12/2022
Date Signed: 07/12/2022 03:42:15 PM

Document Has Been Signed on 07/12/2022 03:42 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:ESCONDIDO COMMUNITY CHILD DEVELOPMENT CENTERFACILITY NUMBER:
376600816
ADMINISTRATOR:MONIQUE GAPUZFACILITY TYPE:
850
ADDRESS:613 E LINCOLN AVENUETELEPHONE:
(760) 839-9330
CITY:ESCONDIDOSTATE: CAZIP CODE:
92026
CAPACITY: 109TOTAL ENROLLED CHILDREN: 67CENSUS: 19DATE:
07/12/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:43 PM
MET WITH:Director, Monique GapuzTIME COMPLETED:
03:55 PM
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Licensing Program Analyst's (LPA's ) Linda Almaraz and Sumayya Habeebulla conducted an unannounced case management visit in regards to an incident report received on 6/16/22. Per incident report, Child 1 (C1) had gone limb while playing outside and turned pale on 6/1/22.

LPA's interviewed the Director and Staff #1 in regards to the incident. Per Director, the child has gone limb before, two times prior to this incident. Director also stated they were told it was a seizure but they are waiting for the child to have an appointment with the neurologist. Interview with Staff #1 revealed while C1 went limb, Staff #2 grabbed C1 and was assessing the incident and also instructed her to call 911. Staff #1 stated while trying to call 911, Staff #3 notified her they were already calling 911 at the front office. Paramedics arrived and assessed the child and said C1 was fine. The Director called the parents and one of C1's emergency contact arrived to pick up C1. Per Director, once they have a diagnosis from the parents, a plan will be put in place for C1.

Based on all the information obtained by LPA's, there did not appear to be any violations of Title 22 Regulations pertaining to the reported incident.

An exit an interview was conducted. A copy of this report and appeal rights were provided at the time visit.

A notice of site visit was given and shall remain posted for 30 days.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Linda M Almaraz
LICENSING EVALUATOR SIGNATURE: DATE: 07/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/12/2022
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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