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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700625
Report Date: 12/02/2022
Date Signed: 12/02/2022 03:11:09 PM

Document Has Been Signed on 12/02/2022 03:11 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:BORREGO SPRINGS STATE PRESCHOOLFACILITY NUMBER:
376700625
ADMINISTRATOR:MARTHA DEICHLERFACILITY TYPE:
850
ADDRESS:1315 PALM CANYON DRIVETELEPHONE:
(760) 767-5333
CITY:BORREGO SPRINGSSTATE: CAZIP CODE:
92004
CAPACITY: 24TOTAL ENROLLED CHILDREN: 21CENSUS: 15DATE:
12/02/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Victoria BaayTIME COMPLETED:
03:30 PM
NARRATIVE
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On 12/2/22 at 10:10AM, Licensing Program Analyst, Patrick Ma, met with Principle Victoria Baay for the purpose of an unannounced annual inspection. There were 15 children present with 3 teachers in one rooms. Facility is within ratio and capacity. Program operates M – F from 8:15 - 12:00pm.

LPA toured the facility. The room was clean, orderly, and a comfortable temperature during this visit. Adequate ventilation and heating are available. The furniture, books, games and toys are safe, age-appropriate and in good repair. There is a variety of activities available throughout the day. All required forms were posted. Principle was advised that solid waste in trash bins need to have tight fitting lids. There is a kitchen which is clean and sanitary. Food is stored in covered containers at 45 degrees or less and there is no expired or contaminated food present. The food meets the nutritional requirements per regulation and is of good quality and proper quantity. The lunch/snack menu is posted, changes are updated on the menu and announced via classroom Dojo app to all parents, and menus are stored for 30 days. Food has been stored separately from any chemicals or cleaning products. Drinking water is readily available. Children do not nap at school due to the early dismissal time.

Hand washing and toileting areas are in a safe, sanitary and operating condition. Principle was reminded if medications is kept on campus they need to be inaccessible to children. Poisons, disinfectants, cleaning solutions and other items that are dangerous to children have been made inaccessible. There is no evidence of rodent or insect activity. (con't pg 2)
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Patrick Ma
LICENSING EVALUATOR SIGNATURE: DATE: 12/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/02/2022
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: BORREGO SPRINGS STATE PRESCHOOL
FACILITY NUMBER: 376700625
VISIT DATE: 12/02/2022
NARRATIVE
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(con't pg 1) Outdoor play area is fully fenced with sufficient cushioning and adequate shade, separate from other programs. Age appropriate playground equipment and outdoor surfaces are in a safe condition with any equipment securely bolted to the ground. Water fountain is available for outdoor use. There are no bodies of water, firearms or ammunition on the property. The facility has a written disaster plan in place that meets regulatory requirement and has been conducting and documenting emergency drills every six months.

LPA reviewed sign in/out sheets, a sample of personnel records and a sample of children's records. There is at least one staff present with current CPR and First Aid certification. Facility is reminded the Mandated Reporter Training is to be retaken every two years and can be accessed at the following website: www.mandatedreporterca.com.

Children are evaluated upon entry and monitored throughout the day for signs of illness. The isolation area for ill children awaiting pick up is the nurses office. The facility understands that current County requirements do not require but strongly recommend state that all children over the age of 2 and staff regardless of vaccination, should wear masks while indoors. Reporting requirements for positive Covid-19 results in children or staff were discussed to include contact with County Department of Public Health for guidance (619-692-8499) and Licensing (619-767-2248) to report the unusual incident.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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
(con't pg 3)
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Patrick Ma
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022
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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: BORREGO SPRINGS STATE PRESCHOOL
FACILITY NUMBER: 376700625
VISIT DATE: 12/02/2022
NARRATIVE
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(con't pg2)
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. 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.

Facility representative is advised to sign up for Quarterly Updates and Provider Information Notices (PINs) for one or more programs on our website: www.ccld.ca.gov. Select “Child Care” then “Quick Links” and Quarterly Updates. Select “Receive Important Updates” then put the email address in and choose which program(s) you would like to subscribe to and select “subscribe.”

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/inspection-process
LPA conducted child care quality management interview with facility representative Victoria Baay.

See LIC 809D for deficiencies cited.

Exit interview conducted and report was reviewed with the Facility representative Victoria Baay. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Patrick Ma
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022
LIC809 (FAS) - (06/04)
Page: 3 of 6
Document Has Been Signed on 12/02/2022 03:11 PM - It Cannot Be Edited


Created By: Patrick Ma On 12/02/2022 at 02:52 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: BORREGO SPRINGS STATE PRESCHOOL
FACILITY NUMBER: 376700625

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/02/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.954
Licensure Requirements
Every licensed child day care center shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, facility was missing carbon monoxide detector which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/09/2022
Plan of Correction
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Principle stated she will provide video proof to the department of an installed carbon monoxide detector in the classroom by 12/9/22.
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on file review, 4 out of 4 file were missing immunizations, LIC 508, LIC 9108, Copy of ID, Mandated reporter, LIC 503, LIC 501, and Teacher evaluation documents/proofs which poses/posed a potential health, safety or personal rights risk to persons in care. Due Title 5 files are often kept at the District office. Principle was only able to provide limited documents to LPA at time of the visit.
POC Due Date: 12/09/2022
Plan of Correction
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Principle stated she will submit proof of all missing personnel documens and proof for the 4 missing staff files to the department by 12/9/22.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Renesha Askew
LICENSING EVALUATOR NAME:Patrick Ma
LICENSING EVALUATOR SIGNATURE:
DATE: 12/02/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/02/2022


LIC809 (FAS) - (06/04)
Page: 4 of 6
Document Has Been Signed on 12/02/2022 03:11 PM - It Cannot Be Edited


Created By: Patrick Ma On 12/02/2022 at 02:52 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: BORREGO SPRINGS STATE PRESCHOOL
FACILITY NUMBER: 376700625

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/02/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101221(b)(8)(C)
Child's Records
(C) A signed consent form for emergency medical treatment unless the child's authorized
representative has signed the statement specified in Section 101220(f).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on file review, 5 of 5 children files reviewed were missing LIC 627 Consent for Emergency Medical Treatment which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/09/2022
Plan of Correction
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Principle stated she will submit proof of signed and completed LIC627 for the five missing children to the department by 12/9/22 and have completed LIC 627 for all children’s files by 12/16/22.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Renesha Askew
LICENSING EVALUATOR NAME:Patrick Ma
LICENSING EVALUATOR SIGNATURE:
DATE: 12/02/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/02/2022


LIC809 (FAS) - (06/04)
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