Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700374
Report Date: 05/11/2017
Date Signed 05/11/2017 03:30:10 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:CARLSBAD EDUCATIONAL FOUNDATION-POINSETTIAFACILITY NUMBER:
376700374
ADMINISTRATOR:VICTORIA ALVAREZFACILITY TYPE:
840
ADDRESS:2445 MICA ROADTELEPHONE:
(760) 331-6580
CITY:CARLSBADSTATE: CAZIP CODE:
92010
CAPACITY:100CENSUS: 44DATE:
05/11/2017
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Teacher Sonia RamosTIME COMPLETED:
03:40 PM
NARRATIVE
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Licensing Program Analyst, Joelle Redding, made an unannounced visit for the purpose of a random annual inspection. . During this visit there were 44 children with four staff in the Library and Room 208. Room 201 is not currently in use. Facility is within ratio and capacity. Program operates Monday thru Friday 7 a.m. to 10 a.m. and 11 a.m. to 6:25 p.m.

The furniture, games, books and equipment, both inside and out, are safe, age-appropriate and in good repair. Both rooms have adequate heating, lighting and ventilation, are clean and orderly, and are free of hazards. All storage containers and trashes have tight fitting covers are in good repair. Snack is provided, food stored per regulation and the menu is posted. All hazardous items are stored where they are inaccessible to children. The outdoor play area is fenced, has sufficient cushioning and adequate shade. Kindergarteners are not allowed to use the monkey bars. The carbon monoxide detector is operational. There is no evidence of rodent or insect activity. All staff present have current CPR and First Aid certification. Electronic sign in/out sheets were reviewed. LPA reviewed personnel records and a sample of children's records. LPA discussed SB 792 (staff immunizations) and requirements have been met. This facility provides Incidental Medical Services – IMS. Services are in place. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.See LIC 809D for Type B deficiency (Potential risk to children in care if not corrected). Appeal Rights (1/16) were discussed and provided. Signature at the bottom of this report confirms receipt. NOTICE OF SITE VISIT WAS POSTED DURING THIS VISIT AND WILL REMAIN POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Carl SheltonTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2017
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: CARLSBAD EDUCATIONAL FOUNDATION-POINSETTIA
FACILITY NUMBER: 376700374
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/11/2017
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/08/2017
Section Cited
101226(e)(3)(A)
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Health Related Services- Prescription medications may be administered if all of the following conditions are met: Prescription medications shall be administered in accordance with the label directions as prescribed by the child's physician.
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Teacher Sonia Ramos states that she will provide this information to Site Director Victoria Alvarez for correction when she returns on Monday and have Ms. Alvarez contact Licensing to verify the dates and plan for correction.
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LPA observed that the Epi-Pen for Child #1 had expired 2/17 and was not in the original box with a prescription label, for Child #2, the Epi-Pen expired 2/17 and for Child #3, the prescription label was altered without verification, the box indicates a 4/14 expiration but the Epi Pen inside matches the altered expiration date of 12/16.
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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: Carl SheltonTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2017
LIC809 (FAS) - (06/04)
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