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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701118
Report Date: 03/28/2023
Date Signed: 03/28/2023 03:39:31 PM

Document Has Been Signed on 03/28/2023 03:39 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:MAAC EARLY HEAD START - WESTLAKEFACILITY NUMBER:
376701118
ADMINISTRATOR:LEILA EBTEKARIFACILITY TYPE:
830
ADDRESS:415 AUTUMN DRIVETELEPHONE:
(760) 631-2695
CITY:SAN MARCOSSTATE: CAZIP CODE:
92069
CAPACITY: 18TOTAL ENROLLED CHILDREN: 10CENSUS: 7DATE:
03/28/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:35 PM
MET WITH:Leila EbtekariTIME COMPLETED:
03:50 PM
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On March 28, 2023 at 12:35 p.m. Licensing Program Analyst (LPA) Leilani Curtis visited the facility to conduct an annual inspection. Upon arrival LPA met with Director Leila Ebtekari and proceeded to tour the facility. LPA provided the LIC 125, Entrance Checklist to the director. Also present were a total of 7 children with 4 staff members.
Appropriate ratios and capacity were observed. Staff members have the required background clearances and are associated to the facility. No excluded individuals are present.

There are no bodies of water or weapons at this facility. There is an operational carbon monoxide detector. Toys are safe and do not have sharp points, edges or splinters, or made of small parts that can be pulled off. There is sufficient infant napping equipment. Infant changing tables have a padded surface no less than one inch thick, covered with washable vinyl, and raised sides at least 3 inches high. The changing table is within the reach of a sink. There are no walkers, bouncy seats, exersaucers or jumpers in the facility. All infants are under visual observation at all times. Rooms have adequate heating, lighting, and ventilation. Solid waste storage vessels, including moveable bins, have tight-fitting covers on, and are in good repair. Disinfectants, hazardous items and medications are inaccessible to children through latches and locks. The infant indoor and outdoor activity space is physically separate from the space used by other day care children. The outdoor play area is fenced with sufficient material for cushioning. The area has canopies used for shade. This facility does not provide care to infants under the age of 12 months and operates a toddler option. The food preparation area is clean, food and beverages are stored in covered containers at 45 degrees F or less if required. Drinking water is readily accessible inside and outside the classroom. Menus are posted. Admission agreement, emergency information and medical assessment forms were reviewed for some children. Individual Feeding and Needs and Services Plans were reviewed for some infants. Nap documentation is maintained that included: infant’s name, date, time of each 15-minute check and the initials of the person who conducted each check.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Grace Curtis
LICENSING EVALUATOR SIGNATURE: DATE: 03/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/28/2023
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: MAAC EARLY HEAD START - WESTLAKE
FACILITY NUMBER: 376701118
VISIT DATE: 03/28/2023
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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.

Personnel records were reviewed for qualifications. Staff records contain documentation of education, training, and/or experience. Staff utilized as infant teachers have three child development units in infant/toddler care. Pediatric CPR/First Aid certifications were reviewed and are in compliance. Sign in/sign out sheets are well maintained. LPA reviewed the following with Director Ebtekari: Recently Approved Safe Sleep Regulations in Effect, PIN 20-24-CCP dated 9/15/20. LPA obtained a copy of the children's roster-LIC9040, Administrative Organization-LIC309, Parent Handbook and Lead Water Assessment.



No deficiencies cited.

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.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Grace Curtis
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023
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: MAAC EARLY HEAD START - WESTLAKE
FACILITY NUMBER: 376701118
VISIT DATE: 03/28/2023
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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.

Director Ebtekari 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.

LPA discussed the safe sleep regulations with Director Ebtekari and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/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.

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

Exit interview conducted and report was reviewed with Director Ebtekari.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Grace Curtis
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023
LIC809 (FAS) - (06/04)
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