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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701490
Report Date: 12/11/2024
Date Signed: 12/11/2024 04:14:43 PM

Document Has Been Signed on 12/11/2024 04:14 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:FAITH CHAPEL INFANT CENTERFACILITY NUMBER:
376701490
ADMINISTRATOR/
DIRECTOR:
AMBER DELUCAFACILITY TYPE:
830
ADDRESS:9400 CAMPO ROADTELEPHONE:
(619) 567-7557
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY: 16TOTAL ENROLLED CHILDREN: 16CENSUS: 7DATE:
12/11/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:20 PM
MET WITH:Samantha DeliaTIME VISIT/
INSPECTION COMPLETED:
04:35 PM
NARRATIVE
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On 12/11/2024 at 1:20 p.m. Licensing Program Analysts (LPAs), Victoria Hernandez and Vicky Williamson conducted an unannounced annual random inspection and met with Assistant Director, Samantha Delia. LPAs disclosed the purpose of the inspection and toured the inside and outside of the facility. This is a full day program that operates year-round. Days and hours of operation are Monday – Friday, 8:00 a.m. – 4:30 p.m. There are two classrooms in operation. There were seven (7) infants, five (5) of whom were napping, and two (2) teachers, and one (1) aide present. LPAs observed Child #1 (C1) napping in the nap room adjacent to Infant Room 102 with the door closed and without staff present.

Furniture and equipment in the classrooms were observed to be in good condition, free of sharp, loose, or pointed parts. The surface of the outdoor activity space and playground equipment is maintained, is in safe condition and is free of hazards. The area under high climbing equipment and slides has rubber cushioning to absorb falls. There is sufficient cushioning to absorb falls under and around play equipment. The playground area includes a shaded rest area for children through the use of canopies and trees.

Potty chairs, toilet and handwashing equipment are in safe and sanitary operating condition. Floors in the facility are clean and safe. Solid waste storage containers have tight-fitting covers and are in good repair. Drinking water is available both indoors and outdoors. Facility has a functioning carbon monoxide detector that meets statutory requirements. The last fire/disaster drill was conducted and documented on 11/7/2024.
Napping equipment consists of cribs for younger infants and napping mats for the older infants and each crib/cot has its own sheet or covering. All changing tables are located next to respective sinks.

Assistant Director stated there are no bodies of water or on the premises and LPAs did not observe any bodies of water. Assistant Director stated there are no firearms, weapons, or ammunition allowed or stored on the premises. Disinfectants, cleaning solutions, medication and other hazardous items are made inaccessible to children. No poisons were observed during the inspection. (CONT 809C...)
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Victoria Hernandez
LICENSING EVALUATOR SIGNATURE: DATE: 12/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/11/2024
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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Document Has Been Signed on 12/11/2024 04:14 PM - It Cannot Be Edited


Created By: Victoria Hernandez On 12/11/2024 at 03:31 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: FAITH CHAPEL INFANT CENTER

FACILITY NUMBER: 376701490

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 12/11/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101429(a)(1)
Responsibility for Providing Care and Supervision for Infants
(1) Each infant shall be constantly supervised and under direct visual observation and supervision by a staff person at all times. Under no circumstances shall ANY infant be left unattended.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above in that C1 was napping in the nap room adjacent to Infant Room 102 without staff present and the door closed which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/11/2024
Plan of Correction
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Assistant Director immediately opened the door to the nap room and stated she will ensure the door will remain opened during napping times.
Type B
Section Cited
CCR
101429(a)(2)(B)
Responsibility for Providing Care and Supervision for Infants
(B) Staff shall physically check on sleeping infant(s) every 15 minutes and document the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above in not documenting every 15 minutes when infants are sleeping which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/19/2024
Plan of Correction
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Assistand Director will submit documentation of 15 minute sleep log for Child #1 (C1) for the period of 12/12-12/19/24 to LPA Hernandez via email no later than 12/19/2024
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:Jason Garay
LICENSING EVALUATOR NAME:Victoria Hernandez
LICENSING EVALUATOR SIGNATURE:
DATE: 12/11/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/11/2024


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Document Has Been Signed on 12/11/2024 04:14 PM - It Cannot Be Edited


Created By: Victoria Hernandez On 12/11/2024 at 03:31 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: FAITH CHAPEL INFANT CENTER

FACILITY NUMBER: 376701490

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 12/11/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101419.3(a)
Modifications to Infant Needs and Services Plan
(a) The written infant needs and services plan shall be updated at least quarterly, or as often as necessary to assure its accuracy.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in that
Infant Needs and Service Plan for Child #4 (C4), Child #5 (C5), and Child #6 (C6) were not updated quarterly which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/19/2024
Plan of Correction
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Assistant Director will submit Infant Needs and Service Plans for Child #4 (C4), Child #5 (C5), and Child #6 (C6)
Type B
Section Cited
CCR
101427(j)
Infant Care Food Service
(j) Bottles, dishes and containers of food brought by the infant's authorized representative shall be labeled with the infant's name and the current date.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above in bottles for Child #1 (C1), Child #2 (C2), and Child #3 (C3) are labeled with the child’s name but did not include the date which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/19/2024
Plan of Correction
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Assistant Director stated she and her staff will review CCR Infant Care Food Service 101427(j) and submit a staff sign in sheet as proof of reviewing section cited
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:Jason Garay
LICENSING EVALUATOR NAME:Victoria Hernandez
LICENSING EVALUATOR SIGNATURE:
DATE: 12/11/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/11/2024


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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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: FAITH CHAPEL INFANT CENTER
FACILITY NUMBER: 376701490
VISIT DATE: 12/11/2024
NARRATIVE
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Food preparation areas are clean and safe. Notation of children’s allergies is accessible. All food is protected against contamination and any contaminated food is discarded immediately. Formula is provided by the parents. LPAs observed bottles for Child #1 (C1), Child #2 (C2), and Child #3 (C3) are labeled with the child’s name but did not include the date. Storage cubbies are readily available, and room accommodates class size. Infant Needs and Service Plan for Child #4 (C4), Child #5 (C5), and Child #6 (C6) were not updated quarterly.
A review of staff records on this date indicates facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions.

Assistant Director, was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.

All required notices, forms and license(s) were posted. Capacity and limitations as specified on the license are being maintained. Facility maintains a ratio of one (1) qualified teacher supervising no more than four (4) children in care. At least one person trained in EMSA approved Pediatric CPR and First Aid is present when children are at the facility or at offsite activities. The name of the childcare center director or fully qualified teacher, designated to act in the director’s absence, has been reported to the Department. Children are under supervision, including visual supervision, of a teacher at all times. The person who signs the child in/out of the facility shall use their full signature and record the time of day. Facility utilizes electronic sign in and sign out procedures. LPAs reviewed sign in/sign out documentation on the Brightwheel App.

LPAs reviewed a sample of children’s files and observed files were complete with contact information for authorized representative and or relatives or others who can assume responsibility for the child and medical assessment. LPAs reviewed a sample of staff files and observed files were complete with health screening, immunization records for influenza, pertussis, and measles, and current documentation of completed mandated reporter training. (CONT 809C...)
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Victoria Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2024
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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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: FAITH CHAPEL INFANT CENTER
FACILITY NUMBER: 376701490
VISIT DATE: 12/11/2024
NARRATIVE
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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 childcare 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).
LPAs verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

LPAs discussed the safe sleep regulations with Assistant Director 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 Facility Representative, 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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-care-centers/.

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

LPAs reviewed with Assistant Director the LIC 311A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.
(CONT 809C...)
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Victoria Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2024
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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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: FAITH CHAPEL INFANT CENTER
FACILITY NUMBER: 376701490
VISIT DATE: 12/11/2024
NARRATIVE
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LPAs and Assistant director discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, Mandated Reporter Training, Forms and Regulations, Safe Sleep in Childcare, Lead Poisoning Facts, Guardian and California Megan’s Law (www.meganslaw.ca.gov).

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, deficiencies were cited; four (4) Type B citations were cited see LIC809D.

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.

Appeal Rights were given. A notice of site visit was given to Assistant Director, Samantha Delia and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Exit interview conducted and report was reviewed with the Assistant Director, Samantha Delia .
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Victoria Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2024
LIC809 (FAS) - (06/04)
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