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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700797
Report Date: 04/23/2024
Date Signed: 04/23/2024 03:25:50 PM

Document Has Been Signed on 04/23/2024 03:25 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:MISSION HILLS CHURCH PRESCHOOLFACILITY NUMBER:
376700797
ADMINISTRATOR/
DIRECTOR:		SHANNON FARRELLFACILITY TYPE:
850
ADDRESS:400 EAST MISSION HILLS COURTTELEPHONE:
(760) 759-2164
CITY:SAN MARCOSSTATE: CAZIP CODE:
92069
CAPACITY: 100TOTAL ENROLLED CHILDREN: 53CENSUS: 34DATE:
04/23/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:10 PM
MET WITH:Director, Shannon FarrellTIME VISIT/
INSPECTION COMPLETED:
03:35 PM
NARRATIVE
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On 4/23/24, an unannounced case management inspection was made by Licensing Program Analyst (LPA) Saraliz Velando to follow up on an incident that occurred on 4/12/24 at approximately 9:30am. Upon arrival, LPA met with Director, Shannon Farrell. There were 34 preschool children and 4 staff members.

The facility self-reported the incident to the department on 4/15/24 and was reported in a timely manner. During the incident on 4/12/24, the staff ratio in the Koala Room was 10 children to 1 staff member. The incident was regarding a staff member that grabbed a child by both arms. The child was not injured and the staff member was immediately removed from the classroom. The staff member is no longer employed at the facility. LPA determined that the facility did what was reasonable and has taken precautions by conducting a meeting with current staff to avoid this type of incident in the future. Based on the evidence from staff interviews and file review, there is proof to support a violation of personal rights to a child.

Refer to the next page LIC 809D for deficiency citation. Facility was provided a copy of the appeal rights.
Exit interview conducted and report was reviewed with the Director, Shannon Farrell.

A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Saraliz Velando
LICENSING EVALUATOR SIGNATURE: DATE: 04/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/23/2024
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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Document Has Been Signed on 04/23/2024 03:25 PM - It Cannot Be Edited


Created By: Saraliz Velando On 04/23/2024 at 02:28 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: 04/23/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/23/2024
Section Cited
CCR
101223(a)(3)

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Personal Rights - (a) The licensee shall ensure that each child is accorded the following personal rights: (3) To be free from corporal or unusual punishment... or other actions of a punitive nature including but not limited to: interference with functions of daily living including eating, sleeping or toileting... This requirement was not met as evidenced by:
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Facility immediately removed staff from the classroom and staff member was ultimately terminated. Director conducted a staff meeting that covered how to deal with challenging behaviors and the school policy that covers staff behavior towards children on 4/16/24.
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A child’s personal rights were violated by a Staff member that grabbed a child by the arms to remove him from one area to another. This posed a potential Health and Safety risk to the clients in care.
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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:Joelle Redding
LICENSING EVALUATOR NAME:Saraliz Velando
LICENSING EVALUATOR SIGNATURE:
DATE: 04/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/23/2024


LIC809 (FAS) - (06/04)
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