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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700376
Report Date: 10/31/2024
Date Signed: 10/31/2024 04:25:34 PM

Document Has Been Signed on 10/31/2024 04:25 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:CENTER FOR CHILDREN & FAMILIES AT CAL STATE SMSFACILITY NUMBER:
376700376
ADMINISTRATOR/
DIRECTOR:		LETISIA FORDFACILITY TYPE:
850
ADDRESS:453 LA MOREE ROADTELEPHONE:
(760) 750-8750
CITY:SAN MARCOSSTATE: CAZIP CODE:
92078
CAPACITY: 176TOTAL ENROLLED CHILDREN: 126CENSUS: 117DATE:
10/31/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:20 PM
MET WITH:Director, Letisia FordTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On 10/31/24 Licensing Program Analyst (LPA) Saraliz Velando, conducted an unannounced inspection to follow up on 3 self-reported unusual incidents. Two incidents occurred on 10/9/24, the third incident occurred on 10/11/24. LPA met with Director Letisia Ford and toured the facility. There were 117 children with 26 staff members present. Appropriate ratio/capacity was observed. Staff members have the required background clearances and are associated to the facility. LPA interviewed the Director, staff #1 (S1), staff #2 (S2), and staff #3 (S3).

On 10/9/24 at approximately 8:15am, child #1 (C1) was having eggs and turkey bacon for breakfast when staff #1 (S1) noticed C1 coughing and possibly choking. S1 being CPR certified, performed a Heimlich maneuver and was able to dislodge a small piece of turkey bacon. C1 appeared normal but taken to the Director for further evaluation. The Director called parents for pickup and C1 returned to school the following day. At the time of the incident, there were two staff supervising 8 children. Appropriate ratio/supervision was in place. The staff members responded to the injury appropriately.

Also on 10/9/24, at approximately 11:15am, child #2 (C2) was on the floor working with a puzzle and started crying while favoring her right elbow area. C2 was unable to move or bend the arm. Staff #2 (S2) did not observe any injury or markings. Parent was called for pick up and stated C2 would be taken to the doctor. C2 returned to school on 10/14/24. The staff members responded to the injury appropriately. Appropriate ratio/supervision was in place. LPA inspected the classroom and found the area where the incident occurred to be safe and free of hazards.
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Saraliz Velando
LICENSING EVALUATOR SIGNATURE: DATE: 10/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/31/2024
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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: CENTER FOR CHILDREN & FAMILIES AT CAL STATE SMS
FACILITY NUMBER: 376700376
VISIT DATE: 10/31/2024
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On 10/11/24, at approximately 3:45pm, child #3 (C3) was climbing up the ladder on playground equipment, missed the top step and fell off sustaining a laceration to the right eyebrow. S3 cleaned the wound, applied an ice pack, and comforted the child. Parents were called and arrived within an hour. Parent stated they would seek medical attention. C3 returned to school on 10/14/24 with no restrictions. Appropriate ratio/supervision was in place. The staff members responded to the injury appropriately. LPA inspected the playground and found the area where the incident occurred to be safe and free of hazards.

All 3 incidents were reported to the Department timely. The director states that she met with staff members to discuss proper supervision and classroom safety.

No deficiencies are cited.

An exit interview was conducted with the Director, Letisia Ford and appeal rights were provided. A notice of site visit was posted and must remain for 30 days.
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Saraliz Velando
LICENSING EVALUATOR SIGNATURE:

DATE: 10/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2024
LIC809 (FAS) - (06/04)
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