Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700329
Report Date: 03/08/2016
Date Signed 03/08/2016 05:41:17 PM

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:SAY-EINSTEIN EXTENDED DAY PROGRAMFACILITY NUMBER:
376700329
ADMINISTRATOR:GRAY ANNE MATUNDANFACILITY TYPE:
840
ADDRESS:3035 ASH STREETTELEPHONE:
(858) 380-8726
CITY:SAN DIEGOSTATE: CAZIP CODE:
92102
CAPACITY:84CENSUS: 32DATE:
03/08/2016
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
03:25 PM
MET WITH:Donna Wilson/Program SupervisorTIME COMPLETED:
05:40 PM
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(3)Licensing Program Analyst Selina Siao visited the facility to conduct an unannounced annual random visit and to include room B37 as part of the licensed room. Upon arrival there were 32 children supervised by Assistant Site Supervisor Michelle Ramirez, Teacher Belinda Ceides, teacher aides Maria Rosales, Laurvette Rojas and Danitza Aguirre. The children were observed to be in the multipurpose room. Required notices, forms and license were posted. Furniture and age appropriate equipment is in good condition. Rooms have adequate heating, lighting, ventilation and drinking water from an operational water fountain. Storage bins are readily available and room accommodates class size. Bathrooms are maintained with operational toilets and faucets with appropriate temperature. Paper towels and toilet paper are available. Bathroom is lighted and has ventilation. Snack menu is posted. Adequate snack is available for meals and snacks or food is catered. Cleaning supplies are kept out of reach of children. The program currently uses the outside bench table areas for snack that is located directly at the multipurpose room, grass/dirt area and black top area to play handball and basketball. The program does not use the school climbing structures. There are shade available for the children outside. The campus has operational drinking fountain and grounds are free of debris or potential hazards. LPA reviewed sign in sheets, first aid supplies and reviewed medication policy and storage, all areas are in compliance. Isolation area is the area by the Director's desk or a privacy tent will be set up in the multipurpose room and a staff member will supervise the child. Personnel and client records were reviewed. All personnel have required criminal record and child abuse index
SUPERVISOR'S NAME: Carol AugustTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2016
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: SAY-EINSTEIN EXTENDED DAY PROGRAM
FACILITY NUMBER: 376700329
VISIT DATE: 03/08/2016
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clearances or exemptions. LPA reviewed Emergency Disaster Plan and last fire drill was conducted on 12/16/2015. Reporting requirements and AB633 was also reviewed. The following items were requested to be updated at all times: Personnel Report, Emergency Disaster Plan and Designation of Responsibility. A copy of this report must be maintained at the facility for public review. Facility has at least one staff member that has a valid EMSA approved CPR/FA when children are in care. An operating carbon monoxide is in the multipurpose room.

Facility representative was advised to obtain the child care regulation highlights at www.ccld.ca.gov and register him/her email address on www.myccl.ca.gov to obtain periodic Licensing information.

LPA conducted a tour of room B37 and the room currently has music equipment in the room and all hazardous items were removed during today's visit. Fire clearance was granted to add room B37 on 10/09/2015.

Facility is within substantial A Notice of Site Visit was provided and it was posted during today's visit.

SUPERVISOR'S NAME: Carol AugustTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2016
LIC809 (FAS) - (06/04)
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