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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700569
Report Date: 05/17/2023
Date Signed: 05/17/2023 04:08:24 PM

Document Has Been Signed on 05/17/2023 04:08 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:WILLOW GROVE PRESCHOOLFACILITY NUMBER:
376700569
ADMINISTRATOR:SUSAN CAMPIONFACILITY TYPE:
850
ADDRESS:14727 VIA AZULTELEPHONE:
(858) 673-6526
CITY:SAN DIEGOSTATE: CAZIP CODE:
92127
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 39DATE:
05/17/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:58 PM
MET WITH:Susan Campion and Kristie Spillane/Preschool Operations SupervisorTIME COMPLETED:
04:20 PM
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On 05/12/2023 at 2:58pm, Licensing Program Analyst (LPA) Selina Siao conduct an annual inspection. Upon arrival, LPA met with Director Susan Campion and teacher Xochitl Gonzalez in classroom E17. Teacher Irina Olevnichenko was at the playground with 8 children. Room A22 had 20 children supervised by teachers Adrina Galindo-Diaz and Mini Menom. Most of the children were getting up from nap in both classrooms. The facility currently operates Mon-Fri from 7:30am-5;30pm. Facility is within staffing ratio. All required notices, forms and license were posted. Furniture and age appropriate equipment is in good condition. Rooms have adequate heating, lighting, ventilation and drinking water from an operational water fountain. Storage cubbies are readily available, and room accommodates class size. Napping equipment consists of mats in room E17 and cots in room A22. The napping mats and cots are kept in the classrooms, and each cot/mat has its own sheet or covering. Bathrooms are maintained with operational toilets and faucets with appropriate temperature. Paper towels and toilet paper are available. Bathroom is lighted and has ventilation. Food service area consists of a kitchen which is clean and free of hazards. Menu is posted. Adequate food is available for meals and snacks or food is catered. Cleaning supplies are not accessible to children. Outdoor play area is a fenced playground with sufficient rubber cushioning. Climbing structure and slide are securely fixed to the ground. Area has two shade structures for the children. Equipment is age appropriate for preschool children. The children has there own water bottles when they are inside and out at the playground. The grounds are free of debris or potential hazards. LPA reviewed sign in sheets, first aid supplies and reviewed medication policy and storage, all areas are within compliance. Isolation area is the teacher's desk area in each classroom or at the playground. Personnel and client records were reviewed, and staff members have the required immunizations and completed the online mandated reporter training. Reporting requirements was also reviewed. All personnel have required criminal record and child abuse index clearances or exemptions and are associated to the PUSD Rolling Hills Administrative Site. LPA reviewed Emergency Disaster Plan and last fire drill was conducted on 05/08/2023. Facility has an operating carbon monoxide detector located in room E17 located behind the computer. Facility has multiple staff member that has a valid EMSA approved CPR/FA when children are in care.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE: DATE: 05/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/17/2023
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: WILLOW GROVE PRESCHOOL
FACILITY NUMBER: 376700569
VISIT DATE: 05/17/2023
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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

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/process.

Facility representative 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.

No citation issue. An exit interview was conducted, and appeal rights were provided.

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.

All unusual incident reports shall be submitted to Licensing office via email at SDIncidentReports@dss.ca.gov or via fax at (619)767-2203.

Exit interview conducted and report was reviewed with the facility representative Kristie Spillane.

SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE:

DATE: 05/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2023
LIC809 (FAS) - (06/04)
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