376700908-9-14-2023-51-CC-GCUS-CVNQHN-20230914121125

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376700908
Report Date: 09/14/2023
Date Signed: 09/14/2023 12:11:34 PM

Document Has Been Signed on 09/14/2023 12:11 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:	PACIFIC PRESCHOOL - SAN ELIJO HILLS, INC		FACILITY NUMBER:	376700908
ADMINISTRATOR:	JESSICA BEEBE		FACILITY TYPE:	850
ADDRESS:	1301 ELFIN FOREST ROAD WEST		TELEPHONE:	(760) 510-0155
CITY:	SAN MARCOS	STATE: CA	ZIP CODE:	92078
CAPACITY: 130	TOTAL ENROLLED CHILDREN: 129	CENSUS: 82	DATE:	09/14/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Jessica Beebe		TIME COMPLETED:	12:20 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 9/14/2023 at 8:40 a.m. Licensing Program Analyst (LPA) Leilani Curtis visited the facility to conduct an annual inspection. Upon arrival LPA met with Assistant Director Aimee Ainsworth and Director Jessica Beebe and proceeded to tour the facility. LPA provided the LIC 125, Entrance Checklist to the assistant director. Also present were a total of 82 children with 17 staff members. Appropriate ratio and capacity were observed. Staff members have the required background clearances and are associated to the facility. No excluded individuals are present. Furniture and age-appropriate equipment is in good condition indoors and outdoors. Children's toilets and hand washing facilities are sanitary. Rooms are safe and clean. The director states that the facility does not provide food for the children. Parents provide all snacks and meals. Nonperishable emergency food supplies are on hand for children who forget their food. The food preparation area is clean. Storage containers for solid waste are covered. Drinking water is readily accessible inside and outside the classroom. Disinfectants, hazardous items and medications are inaccessible to children through latches and locks. The outdoor play area is fenced. Playground equipment is in safe condition, free of sharp, loose or pointed parts. There area under high climbing equipment such as slides, swings or similar equipment is cushioned with material that absorbs the impact of a fall. The outdoor play area has canopies used for shade. The toddler indoor and outdoor activity space is physically separate from the space used by other day care children. There are no bodies of water or weapons at this facility. Fire drills are being conducted every 6 months. There is an operational carbon monoxide detector at the facility. First Aid/CPR certifications were reviewed and are in compliance.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Grace Curtis
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2023

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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Document Has Been Signed on 09/14/2023 12:11 PM - It Cannot Be Edited

Created By: Grace Curtis On 09/14/2023 at 11:05 AM

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: PACIFIC PRESCHOOL - SAN ELIJO HILLS, INC	FACILITY NUMBER: 376700908
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/14/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 2 out of 8 staff files reviewed do not contain current mandated reporter certification. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/20/2023
	Plan of Correction
1 2 3 4	The director states that she will submit current mandated reporter certificates for staff #1 (S1) and staff #2 (S2) to LPA via email by 9/20/23.

Type B

Section Cited

CCR

101216(g)(1)

Personnel Requirements

(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 1 out of 8 staff files reviewed do not contain the results of a tuberculosis test. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/20/2023
	Plan of Correction
1 2 3 4	The director states that she will send LPA verification of staff #3's (S3) tuberculosis clearance (test) via email by 9/20/23

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: 09/14/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2023

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: PACIFIC PRESCHOOL - SAN ELIJO HILLS, INC	FACILITY NUMBER: 376700908
	VISIT DATE: 09/14/2023

NARRATIVE

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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 PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.

Admission agreement, emergency information and medical assessment forms were reviewed for some children. The facility does not maintain 15-minute sleep documentation for the infants/toddlers between the ages of 18-24 months. Sign In/Sign Out sheets are well maintained. Staff records contain documentation of education, training, and/or experience. LPA reviewed the following with Director Beebe: Recently Approved Safe Sleep Regulations PIN 20-24-CCP dated 9/15/20. LPA obtained an updated Emergency Disaster Plan for Child Care Centers- LIC610, Personnel Report-LIC500, Children’s Roster and Parent Handbook.

See LIC809D for cited deficiencies.

Child Care Providers can now sign up for Quarterly Updates and PINS through the DSS website. Please go to www.ccld.ca.gov and click on Child Care, go under Quick Links and Quarterly Updates, click on “Receive Important Updates” then enter your email address and choose which program(s) you would like to subscribe to and click “subscribe”.

Duty Officer: (619) 767- 2248, Monday thru Friday 8am-5pm.

Director Beebe was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Grace Curtis
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2023

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: PACIFIC PRESCHOOL - SAN ELIJO HILLS, INC	FACILITY NUMBER: 376700908
	VISIT DATE: 09/14/2023

NARRATIVE

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The director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

LPA discussed the safe sleep regulations with the director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed the director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP).

LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. Director Beebe states that the facility was constructed in 2012 and is therefore exempt from the requirement to have the facility water tested for lead.

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.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Director Beebe.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Grace Curtis
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2023

LIC809 (FAS) - (06/04)

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