Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701070
Report Date: 09/19/2016
Date Signed 09/19/2016 11:54:39 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:NATIVITY PRESCHOOL, THEFACILITY NUMBER:
376701070
ADMINISTRATOR:CHRISTINE GRUENFACILITY TYPE:
850
ADDRESS:6309 EL APAJO ROADTELEPHONE:
(858) 756-6763
CITY:RANCHO SANTA FESTATE: CAZIP CODE:
92067
CAPACITY:23CENSUS: 22DATE:
09/19/2016
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:05 AM
MET WITH:Christine GruenTIME COMPLETED:
12:25 PM
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3) LPA Miriam Pennock conducted an annual random visit at The Nativity Preschool in Rancho Santa Fe, CA. Present to assist with the visit is the Director Christine Gruen.
There are no bodies of water or weapons stored on the premises. All children are visually supervised by a teacher at all times. LPA was able to walk into the school area. Ratios are maintained at 2X9 and 2X6. Disinfectants and cleaning solutions are locked in a side cabinet. Facility is cleaned daily using toxic free materials. All medication is stored behind a locked cabinet as well.
There is one bathroom. There are two toilets and one sink and there is a second sink in the mini kitchen area. All toilets and hand washing facilities are in safe and sanitary operating conditions. All floors are clean and safe.
There is one large classroom. Furniture and equipment are in good condition, free of sharp, loose or pointed parts. There is no kitchen area. Parents provide snacks and lunches for the children.
Uncontaminated drinking water is available inside the classroom with water fountain and outside with water and cups, drinking fountains and children do bring their own water bottles to fill. Facility has at least one carbon monoxide detector. Fire Department comes once a year during fire prevention week.
There is a picnic table area with awnings for meals and a large tree which offers shade.
The outside play area was toured. They use rubber shavings for cushioning material with swings, sandbox and play structure. They were playing with a water table. They also have access to tricycles, helmets, and balls on a basketball court along with hula hoops. There is a football field and track and a gym.
Licensee operates the facility within the conditions, limitations and capacity specified on the license. All staff have criminal record clearances on file before they start. All current staff records were reviewed. All are teacher qualified with health screenings and TB test results. All staff are current with Pediatric CPR and First Aid. Classes were taken in August with AB CPR and First Aid. They take one class per year to renew the cards.
Parents sign children in and out using full legal signatures and only those listed on the emergency list may pick up the child. Lists are updated yearly. Children's records were reviewed. All had admission
SUPERVISOR'S NAME: Carol AugustTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Miriam PennockTELEPHONE: (619) 767-2216
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2016
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: NATIVITY PRESCHOOL, THE
FACILITY NUMBER: 376701070
VISIT DATE: 09/19/2016
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agreements, emergency contacts, physician's reports and immunization records on file.
Staff are aware of the new regulations regarding staff immunization records including Measles, Pertussis and Flu vaccines. Incidental medical services were discussed.

At the present time there do not appear to be any deficiencies and this facility appears to be meeting Title 22 and Licensing requirements. This is a public document which must be available at your facility site for a period of three years. Original signature is on original paperwork.
SUPERVISOR'S NAME: Carol AugustTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Miriam PennockTELEPHONE: (619) 767-2216
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2016
LIC809 (FAS) - (06/04)
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