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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700080
Report Date: 05/15/2023
Date Signed: 05/15/2023 04:35:49 PM

Document Has Been Signed on 05/15/2023 04:35 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:CARLSBAD EDUCATIONAL FOUNDATION - JEFFERSON ELEM.FACILITY NUMBER:
376700080
ADMINISTRATOR:LYNNE LARUSSAFACILITY TYPE:
840
ADDRESS:3743 JEFFERSON STREETTELEPHONE:
(760) 331-5525
CITY:CARLSBADSTATE: CAZIP CODE:
92008
CAPACITY: 120TOTAL ENROLLED CHILDREN: 120CENSUS: 54DATE:
05/15/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:54 PM
MET WITH:Jennifer RodriguezTIME COMPLETED:
04:55 PM
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On 05/15/2023 at 2:54pm, Licensing Program Analyst (LPA), Samantha Clenista, conducted an unannounced visit for the purpose of a random inspection. Upon arrival, LPA met with Jennifer Rodriguez, Area Manager. There was a total of 54 children present in care with a total of 6 staff members (5 teachers and 1 aide). Facility is currently licensed to operate in Rooms 707, 804, 805 and auditorium, however, is currently only using 707 due to 804 and 805 being under construction. Auditorium is utilized for overflow. Per Health and Safety Code Sections 1596.806(a), (a)(1), (1)(2) and (d) this program is exempt from square footage, fencing, outdoor activity space, toilet and isolation requirements.

Outdoor play areas include grassy field and blacktop area behind Room 707 bungalow. LPA inspected Room 707. Room was equipped with tables and chairs and age appropriate equipment. Drinking water is readily accessible via water fountains, water jugs and water cups/water bottles. Snacks are provided and prepared in the classroom. Classroom has storage space for food. The program uses four sets of bathrooms (girls and boys) located in 400 building, 200 building, 600 building and auditorium/cafeteria areal, all which afford privacy. There is an operational carbon monoxide detector in Room 707 located on top of the refrigerator. Sign-in/out area is located in front of the Kid’s Care gate. Ms. Rodriguez was reminded to keep anything that reads, “Keep Out of Reach of Children” to be inaccessible to children. Ms. Rodriguez is reminded that any changes to the facility must be reported to and approved by Community Care Licensing. Medications, when present, are stored in a locked cabinet, inaccessible to children. All hazardous items are stored where they are inaccessible to children. Staff and child files were reviewed and observed to be complete. Ms. Rodriguez is reminded the Mandated Reporter Training is to be retaken every two years and can be accessed at the following website: www.mandatedreporterca.com
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Samantha Clenista
LICENSING EVALUATOR SIGNATURE: DATE: 05/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/15/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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
VISIT DATE: 05/15/2023
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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. No services are in place today.

Child Care Providers can now sign up for Quarterly Updates and PINS through the DSS website at https://cdss.ca.gov/inforesources/community-care-licensing/subscribe. LPA discussed California Megan's Law with provider and advised her to go on the website at www.meganslaw.ca.gov.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/ion-process.



Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

The facility appears to be in compliance. No citation issued during time of inspection. A notice of site visit was given and must remain posted for 30 days. Failure to keep notice posted will result in a civil penalty of $100.00. Exit interview conducted and report was reviewed with Ms. Rodriguez. As a reminder, all unusual incident reports shall be submitted to Licensing office via email at SDIncidentReports@dss.ca.gov or via fax at (619) 767-2203.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Samantha Clenista
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2023
LIC809 (FAS) - (06/04)
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