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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700416
Report Date: 02/16/2024
Date Signed: 02/16/2024 04:04:15 PM

Document Has Been Signed on 02/16/2024 04:04 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
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:SKYLINE CHILD DEVELOPMENT CENTERFACILITY NUMBER:
376700416
ADMINISTRATOR:JACQUELINE SERRANOFACILITY TYPE:
850
ADDRESS:11330 CAMPO ROADTELEPHONE:
(619) 415-5485
CITY:LA MESASTATE: CAZIP CODE:
91941
CAPACITY: 72TOTAL ENROLLED CHILDREN: 63CENSUS: 41DATE:
02/16/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Rosa JohnsonTIME COMPLETED:
04:15 PM
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On 2/16/2024 at 2:45pm, Licensing Program Analysts (LPAs), Vicky Williamson and Angela Nguyen conducted an unannounced Plan of Correction (POC) inspection. The purpose of this inspection is to ensure citations issued during a case management inspection on 1/25/2024 were corrected. Upon arrival, LPA met with Assistant Director, Rosa Johnson and was led on a tour of the facility. There were 41 children present with six (6) staff members.

Interviews were conducted with assistant director and staff members. Assistant Director stated that the training provided to staff included scenarios regarding name to face policies. Staff members stated that Director, Jacqueline Serrano and Assistant Director, Rosa Johnson provided a training regarding name to face procedures and supervision best practices on 2/1/2024. Staff members explained and demonstrated to LPAs on how the name to face procedures are utilized at the facility. Staff members stated that the name to face procedures will be conducted before and after transition of each staff member leaving the classroom and before and after leaving the playground with the children.

Director submitted training summary and staff sign in/sign out sheets to SDRO on 2/2/2024. LPA cleared citation during the time of inspection.

An exit interview conducted with Assistant Director, Rosa Johnson. Notice of Site Visit shall be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Vicky Williamson
LICENSING EVALUATOR SIGNATURE: DATE: 02/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/16/2024
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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