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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700797
Report Date: 09/13/2022
Date Signed: 09/13/2022 02:32:52 PM

Document Has Been Signed on 09/13/2022 02:32 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:MISSION HILLS CHURCH PRESCHOOLFACILITY NUMBER:
376700797
ADMINISTRATOR:SHANNON FARRELLFACILITY TYPE:
850
ADDRESS:400 EAST MISSION HILLS COURTTELEPHONE:
(760) 759-2164
CITY:SAN MARCOSSTATE: CAZIP CODE:
92069
CAPACITY: 100TOTAL ENROLLED CHILDREN: 57CENSUS: 30DATE:
09/13/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
02:10 PM
MET WITH:Shannon FarrellTIME COMPLETED:
02:45 PM
NARRATIVE
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On September 13, 2022 at 2:10 p.m. Licensing Program Analyst (LPA) Leilani Curtis conducted an unannounced case management inspection. Upon arrival LPA met with Director Shannon Farrell and proceeded to tour the facility. There were 30 children present with 4 staff members. Appropriate ratio/capacity was observed. Staff members have the required background clearances and are associated to the facility.

On 6/27/22 and 7/6/22 LPA reviewed staff records at the facility. At the time of the inspections the director did not have a copy of a teacher’s (S1) transcript/education record. According to the Guardian Background Check System this person was associated to the facility from 5/18/22-6/15/22. The director states that S1 last worked as a teacher on site 6/9/22. On 6/29/22 LPA received an email from the director stating that this staff member is no longer an employee and they do not have a copy of the teacher’s transcript.

See LIC809D for cited deficiency.

An exit interview was conducted with Director Farrell and appeal rights (LIC 9058) were discussed. A copy of this report as well as a copy of the appeal rights were given to Ms. Farrell. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS. LPA observed the director post Notice of Site Visit.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Grace Curtis
LICENSING EVALUATOR SIGNATURE: DATE: 09/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/13/2022
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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Document Has Been Signed on 09/13/2022 02:32 PM - It Cannot Be Edited


Created By: Grace Curtis On 09/13/2022 at 01:24 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: MISSION HILLS CHURCH PRESCHOOL
FACILITY NUMBER: 376700797

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/13/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/20/2022
Section Cited
CCR
101217(a)(6)

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101217 Personnel Records:(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information:(6) Documentation of the educational background, training and/or experience specified in this chapter. This requirement was not met as evidenced by:
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The director states that S1 is no longer employed at the facility. The director states that she will review the applicable regulation and submit a letter stating what information is to be obtained for each employee and how she will ensure that the documentation is maintained. The letter will be submitted to LPA via email by 9/20/22.

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Based on record review and the directors statement, the director does not maintain the transcripts/education qualifications for teacher/staff member, S1. This poses a potential health and safety risk to children in care.
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CCR

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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:Tashima Daniel
LICENSING EVALUATOR NAME:Grace Curtis
LICENSING EVALUATOR SIGNATURE:
DATE: 09/13/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/13/2022


LIC809 (FAS) - (06/04)
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