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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600816
Report Date: 09/05/2025
Date Signed: 09/05/2025 11:39:17 AM

Document Has Been Signed on 09/05/2025 11:39 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:ESCONDIDO COMMUNITY CHILD DEVELOPMENT CENTERFACILITY NUMBER:
376600816
ADMINISTRATOR/
DIRECTOR:		MONIQUE GAPUZFACILITY TYPE:
850
ADDRESS:613 E LINCOLN AVENUETELEPHONE:
(760) 839-9330
CITY:ESCONDIDOSTATE: CAZIP CODE:
92026
CAPACITY: 109TOTAL ENROLLED CHILDREN: 109CENSUS: 67DATE:
09/05/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:39 AM
MET WITH:Director Monique GapuzTIME VISIT/
INSPECTION COMPLETED:
11:49 AM
NARRATIVE
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 Licensing Program Analyst (LPA), Kelly Gerth conducted a Case Management visit to follow up on Unusual Incident Report (UIR) that was submitted by the facility and received by Licensing on August 25, 2025. LPA met with Director Monique Gapuz to discuss the incident reported.
The unusual incident report stated that on 08/15/2025, a child in care required emergency medical attention and was transported to a medical facility.
During the visit, LPA Gerth interviewed staff and obtained copies of pertinent documents relating to the incident. LPA found that during the incident on 08/15/2025, staff reported that upon finding the child in distress, classroom staff first contacted on site supervisors who then assessed the child and contacted non-emergency services. At that time, non-emergency services contacted 911 for immediate medical attention and paramedics were dispatched. The nature of the child’s illness was such that there should have been no delay in getting medical treatment for the child and although the CCC did take action, it was not immediate. Therefore, LPA Gerth determined that the CCC is in violation of Title 22 regulation and will be cited for CCR 101226(c).
In addition, LPA Gerth found based on the information obtained during the visit, that required records on file for the child were not current and therefore the CCC is being cited a deficiency for CCR 101221(a).
See 809 D
An exit interview was conducted, and a copy of this report, exit interview and notice of site visit was provided to Director Monique Gapuz. The Facility Representative was reminded that the notice of Site Visit must remain posted for 30 days.
NAME OF LICENSING PROGRAM MANAGER: Carlos Martinez
NAME OF LICENSING PROGRAM ANALYST: Kelly Gerth
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 09/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/05/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 09/05/2025 11:39 AM - It Cannot Be Edited


Created By: Kelly Gerth On 09/05/2025 at 11:05 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
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: ESCONDIDO COMMUNITY CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 376600816

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/05/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/17/2025
Section Cited
CCR
101226(c)

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101226(c) The licensee shall obtain emergency medical treatment without specific instructions from the child's authorized representative if the authorized representative cannot be reached immediately, or if the nature of the child's illness or injury is such that there should be no delay in getting medical treatment for the child.
This requirement was not met as evidenced by;
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By POC, CCC agrees to conduct staff training on the regulation cited and submit training materials and a sign in/out staff training attendance sheet to CCL.
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Based on interviews and evidence collected, LPA found that staff revealed a delay in contacting 911/getting emergency medical services for a child in distress, poses/posed a potential health, safety or personal rights risk to persons in care.
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Type B
09/15/2025
Section Cited
CCR101221(a)

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101221(a) A separate, complete and current record for each child is maintained in the childcare center. This requirement was not met as evidenced by;
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By POC, Licensee agrees that in order for continued enrollment/attendance of the child at the CCC, licensee will submit evidence of a complete and current record for the child involved in the UIR/incident reported, to CCL.
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Based on interviews and evidence collected, LPA found that the child referenced in the unusual incident report did not have a current and complete file at the CCC, which poses/posed a potential health, safety or personal rights risk to persons 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.
Carlos Martinez
NAME OF LICENSING PROGRAM MANAGER:
Kelly Gerth
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/05/2025


LIC809 (FAS) - (06/04)
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