Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701046
Report Date: 11/02/2015
Date Signed 11/02/2015 10:12:16 AM

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:KIDS ON THE GOFACILITY NUMBER:
376701046
ADMINISTRATOR:EMLYN MARTINEZFACILITY TYPE:
840
ADDRESS:2015 BIRCH ROAD, UNIT 1703TELEPHONE:
(619) 407-7756
CITY:CHULA VISTASTATE: CAZIP CODE:
91915
CAPACITY:53CENSUS: 0DATE:
11/02/2015
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:39 AM
MET WITH:Emlyn MartinezTIME COMPLETED:
10:25 AM
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(3) LPA Iman Kayyali visited the facility to conduct an Annual Random site inspection. Upon arrival LPA met with Director, Emlyn Martinez and proceeded to tour the facility. All required notices, forms and license were posted. There were zero children in care as the program operates from 6 - 8am and 3-6pm. Minimum days are Fridays. Children arrive at 1:30pm. Owner Lynn Twork later arrived.

Furniture and age appropriate equipment is in good condition. Floors are clean and safe. Backpack storage is available. Bathrooms are safe and sanitary, maintained with operational toilets and faucets with appropriate temperature. Paper towels and toilet paper are available. Bathroom is lighted and has ventilation. Trash cans have tight fitting covers in good repair. Food service area consists of a kitchen which is clean and free of hazards. Children are provided drinking water from an operational water fountain. Adequate food is available for meals and snacks. Cleaning supplies are kept locked and are inaccessible to children. Medication is stored in the kitchen inaccessible to children. There is at least one staff present with a current CPR and First Aid certification. Outdoor play area is a fenced playground with sufficient wood chips for cushioning. Playground equipment is in safe condition and large play equipment is securely fixed to the ground. Area has a canopies used for shade. Last fire drill was conducted on July 24, 2015. This facility is currently providing Incidental Medical Services and has a plan of operation in place.

LPA reviewed sign in sheets. Personnel records were reviewed for health screening forms. Client records were reviewed for LIC 700 (Identification and Emergency Information) and Medical Assessment. All personnel have required criminal record and child abuse index clearances or exemptions.

No deficiencies were observed or cited during today's visit.
SUPERVISOR'S NAME: Debbie HanesTELEPHONE: (619) 767-2205
LICENSING EVALUATOR NAME: Iman KayyaliTELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2015
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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