376701254-8-25-2022-51-CC-GCUS-CHMVY9-20220825165047

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376701254
Report Date: 08/25/2022
Date Signed: 08/25/2022 04:50:53 PM

Document Has Been Signed on 08/25/2022 04:50 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 GOSNELL		FACILITY NUMBER:	376701254
ADMINISTRATOR:	CLARIBEL ZORRILLA		FACILITY TYPE:	830
ADDRESS:	139 GOSNELL WAY		TELEPHONE:	(760) 736-3066
CITY:	SAN MARCOS	STATE: CA	ZIP CODE:	92069
CAPACITY: 20	TOTAL ENROLLED CHILDREN: 5	CENSUS: 5	DATE:	08/25/2022
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Claribel Zorrilla		TIME COMPLETED:	05:00 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 August 25, 2022 at 2:30 p.m. Licensing Program Analyst (LPA) Leilani Curtis conducted an unannounced case management inspection in reference to the Licensee’s request to have the facility’s newly remodeled playground inspected and approved. Upon arrival LPA met with Director Claribel Zorrilla and proceeded to tour the facility. There were 5 children with 2 staff members present. Appropriate capacity and ratio were observed. Staff members have the required background clearances and are associated to the facility. The total licensed capacity of the facility is for 20 children. LPA measured and inspected the infant playground. The playground measures a total of 2008.22 square feet, which is sufficient space for 26 children. The area is completely fenced and includes age-appropriate play equipment. The director states that a small play structure and covered sand box will be added to the infant play ground. The director will ensure that there will be sufficient cushioning material placed under the play structure to absorb the impact of a fall. Once the structure is installed the director will send Community Care Licensing a picture of the new play structure. The infant playground is physically separate from the preschool playground. There are large shade trees on the playground. Additional shade is provided by awning/canopy. Drinking water is readily accessible via a water jug. The director states that she will have the temporary infant playground located on the patio dismantled Tuesday, 8/30/22. The new playground may be used effective 8/30/22 once the temporary playground has been dismantled.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Grace Curtis
LICENSING EVALUATOR SIGNATURE:	DATE: 08/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2022

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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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 GOSNELL	FACILITY NUMBER: 376701254
	VISIT DATE: 08/25/2022

NARRATIVE

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LPA observed that classroom #4 has been altered and activity space removed. Two floor to ceiling walls have been added to create a separate diaper/hand washing area and a meeting area for families. LPA measured classroom #4. The classroom measures a total of 325.50 square feet which will accommodate 9 children. The current facility enrollment is 8 children. The facility cannot have more than 9 children in the classroom due to space limitations. The director states that the walls were erected on 7/14/22 without windows and on 8/12/22 windows were added completing the walls. The purpose of adding the walls was to create a meeting space for families, to separate the daycare children from the families and to reduce noise. According to Director Zorrilla Community Care Licensing was not notified of the construction or the alteration to the building because the walls are not considered to be structural walls. The director provided LPA with an updated facility sketch at the time of inspection. The director will submit an updated application to request a reduction in capacity by 9/2/22.

See LIC809D for cited deficiency

An exit interview was conducted with the director and appeal rights (LIC 9058 1/16) were discussed. A copy of this report as well as a copy of the appeal rights were given to the director at the conclusion of the inspection. The director’s signature on this form acknowledges receipt of these rights. 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: 08/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 08/25/2022 04:50 PM - It Cannot Be Edited

Created By: Grace Curtis On 08/25/2022 at 04:25 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: MAAC GOSNELL	FACILITY NUMBER: 376701254
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/25/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 09/02/2022 Section Cited CCR 101237(a)	1 2 3 4 5 6 7	101237 Alterations to Existing Buildings or New Facilities: (a) Prior to construction or alterations, the licensee shall notify the Department of the proposed change(s). This requirement was not met as evidenced by:	1 2 3 4 5 6 7	The director states that she will provide a written statement to Community Care Licensing confirming that the department will be notified of any alterations or construction to the building in the future. The letter will be sent to LPA via email by POC due date of 9/2/22.
	8 9 10 11 12 13 14	Based on LPA's observation and the Director's statement two floor to ceiling walls were added to room #4 to create a separate family meeting room and diaper changing/hand washing area. The licensee did not notify the department of this alteration to the building. This poses a potential health and safety risk to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: 08/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2022

LIC809 (FAS) - (06/04)

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