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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701229
Report Date: 09/13/2024
Date Signed: 09/13/2024 10:24:23 AM

Document Has Been Signed on 09/13/2024 10:24 AM - 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:LM-SV KEMPTON ELEMENTARY PRESCHOOLFACILITY NUMBER:
376701229
ADMINISTRATOR/
DIRECTOR:		WENDY NEWMARKFACILITY TYPE:
850
ADDRESS:740 KEMPTON STREETTELEPHONE:
(619) 668-5870
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY: 23TOTAL ENROLLED CHILDREN: 17CENSUS: 15DATE:
09/13/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Ana GarciaTIME VISIT/
INSPECTION COMPLETED:
10:45 AM
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On 9/13/24 at 9:00 AM, Licensing Program Analyst (LPA) Gloria Gonzalez conducted an unannounced Case Management inspection to follow-up on a self-reported incident that occurred on or about 5/3/24.  LPA disclosed the purpose of the inspection and was granted a tour into the facility by Lead Teacher, Ana Garcia. There were 15 children 2 staff members, and 3 Para Educators at the time of the inspection.

The incident that occurred on or about 5/3/24 was regarding Child #1, (C1) exited campus. Staff #1 (S1) stated that three staff were with C1 to ensure C1s safety until C1's parent #1 (P1) met with C1. Parents were notified. Interviews were conducted with the Principal, 3 staff members, and attempted interview with C1. It has been determined that C1 was under constant supervision during the incident.

At this time, based on information obtained and interviews conducted a licensing violation has not occurred, no deficiencies cited.  The incident investigation may be reopened should further information be obtained.

Ms. Garcia was provided a copy of the report, appeal rights (LIC 9058). LPA provided notice of site visit (LIC 9213) and observed it being posted at the facility. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Gloria Gonzalez
LICENSING EVALUATOR SIGNATURE: DATE: 09/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/13/2024
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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