<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701468
Report Date: 10/18/2023
Date Signed: 10/18/2023 05:59:51 PM

Document Has Been Signed on 10/18/2023 05:59 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 CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:KINDERLAND MONTESSORI - INFANTFACILITY NUMBER:
376701468
ADMINISTRATOR:CAROLINA VALENCIAFACILITY TYPE:
830
ADDRESS:625 OTAY LAKES ROADTELEPHONE:
(619) 479-4007
CITY:CHULA VISTASTATE: CAZIP CODE:
91913
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 11DATE:
10/18/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Vanessa Valencia and Liza ValenciaTIME COMPLETED:
01:59 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 10/18/23 at 11:45am, Licensing Program Analyst (LPA), Martha Malane arrived at the facility to conduct a case management inspection for the purpose of a change in the outdoor activity space. Upon arrival, LPA met with Owner, Vanessa Valencia and Administrator, Liza Valencia and was led on a of tour the facility. There were 11 children napping and two (2) staff members present.

At 11:48am, LPA observed sleeping children, Child 1 (C1) to have a pacifier with a string of beads attached, Child 2 (C2) to have a bottle and Child 3 (C3) to have a stuffed toy in the crib; see LIC809D for Type A deficiency cited.

The new outdoor activity space was inspected and measured a total of 1857.10 square feet which is sufficient to accommodate the current capacity. The new outdoor space is located next to the office.

Per California Code of Regulations, (Title 22, Division 12 & Chapter 3) one (1) Type A deficiency is being cited on the attached LIC 809-D.

LPA, Martha Malane informed Owner, Vanessa Valencia and Administrator, Liza Valencia that this report dated 10/18/23 documents one (1) Type A deficiency which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPA, Martha Malane informed Owner, Vanessa Valencia and Administrator Liza Valencia to provide a copy of this licensing report dated 10/18/23 that documents any Type A deficiency to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted with Owner, Vanessa Valencia and Administrator, Liza Valencia. Notice of Site Visit shall be posted for 30 days from today's date. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Martha Malane
LICENSING EVALUATOR SIGNATURE: DATE: 10/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/18/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 10/18/2023 05:59 PM - It Cannot Be Edited


Created By: Martha Malane On 10/18/2023 at 02:53 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: KINDERLAND MONTESSORI - INFANT
FACILITY NUMBER: 376701468

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/18/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/19/2023
Section Cited
CCR
101439.1(f)

1
2
3
4
5
6
7
101439.1(f) Infant Care Center Sleeping Equipment: Cribs shall be free from all loose articles and objects, including blankets and pillows.

This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Owner stated she will train staff on safe sleep regulation utilizing PIN 20-24-CCP. Owner stated she will submit a staff sign-in sheet and summary of the training to the SDRO by COB 10/29/23.
8
9
10
11
12
13
14
Based on LPA's observation, the licensee did not comply with the section cited above in that three (3) out of 11 sleeping infants had objects in their crib which poses an immediate health, safety or personal rights risk to persons 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:Monica Cuddy
LICENSING EVALUATOR NAME:Martha Malane
LICENSING EVALUATOR SIGNATURE:
DATE: 10/18/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/18/2023


LIC809 (FAS) - (06/04)
Page: 2 of 2