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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700080
Report Date: 06/01/2021
Date Signed: 06/03/2021 10:56:15 AM

Document Has Been Signed on 06/03/2021 10:56 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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:CARLSBAD EDUCATIONAL FOUNDATION - JEFFERSON ELEM.FACILITY NUMBER:
376700080
ADMINISTRATOR:LYNNE LARUSSAFACILITY TYPE:
840
ADDRESS:3743 JEFFERSON STREETTELEPHONE:
(760) 331-5566
CITY:CARLSBADSTATE: CAZIP CODE:
92008
CAPACITY: 120TOTAL ENROLLED CHILDREN: 0CENSUS: 38DATE:
06/01/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:20 PM
MET WITH:Jennifer RodriguezTIME COMPLETED:
03:00 PM
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On 06/01/2021 at 2:20pm, Licensing Program Analyst (LPA) Samantha Salunga conducted an unannounced case management inspection. Due to COVID-19, inspection was conducted using Face Time to tour the facility with Jennifer Rodriguez, Area Manager. This facility currently is licensed to operate in rooms 703, 704, 705 and 706. Facility is requesting to add rooms 708 and 709 to their license. No change in capacity. Fire clearance was granted on 05/27/2021. There was a total of 38 children with 3 staff. Appropriate ratios and capacity was observed.

Room 708 and 709 were inspected during this visit. Drinking water is readily accessible via water jugs. Age-appropriate supplies and equipment were observed available in the indoor activity space. The classrooms were not measured as they are exempt from square footage requirements as long as they are certified by the principal for use as classrooms during the day. There is an operational carbon monoxide detector located in Room 705. Cleaning supplies and other toxins are inaccessible to children through latches, locks and/or placed on high surfaces. Ms. Rodriguez is reminded to keep anything that reads, “Keep Out of Reach of Children” inaccessible to children. Rooms were to be observed safe per regulation.

Child Care Providers can now sign up for Quarterly Updates and PINS through the DSS website. Please go to www.ccld.ca.gov and click on “Receive Important Updates,” then enter your email address and choose which program(s) you would like to subscribe to and click “subscribe.”

A license for 120 children (transitional kinder thru 12 years old) in rooms 703, 704, 705, 706, 708 and 709 is granted and effective today’s date, 06/01/2021. Exit interview was conducted with Ms. Rodriguez. A copy of this report and Notice of Site Visit (NOS) was reviewed and will be e-mailed to Ms. Rodriguez. Ms. Rodriguez was advised that acknowledgement of the receipt of the report is to be received within twenty-four hours. NOS is to posted at the facility for 30 days and failure to keep it posted will result in a $100 civil penalty.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Samantha Salunga
LICENSING EVALUATOR SIGNATURE: DATE: 06/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/01/2021
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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