Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701103
Report Date: 08/24/2017
Date Signed 08/24/2017 11:52:47 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:SANDBURG STATE PRESCHOOLFACILITY NUMBER:
376701103
ADMINISTRATOR:GEOFFREY MARTINFACILITY TYPE:
850
ADDRESS:11230 AVENIDA DEL GATOTELEPHONE:
(858) 566-0510
CITY:SAN DIEGOSTATE: CAZIP CODE:
92126
CAPACITY:24CENSUS: 0DATE:
08/24/2017
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Walter Shaw, Facility RepresentativeTIME COMPLETED:
11:52 AM
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Licensing Program Analyst (LPA), Marie Hernandez conducted the 3 Year inspection. LPA met with facility representatives, Walter Shaw and Marra Morrow. LPA was given access to inspect the facility. The Representative Ms. Morrow accompanied LPA on the tour of the facility. There were no children present during the inspection. However, there were three staff present in the classroom. The following were observed during today’s visit: There are no bodies of water and/or no fire arms/weapons on the premises. The facility shall ensure that all children are supervised including visual observation, of a teacher at all times. The facility shall ensure that there is a ratio of one teacher supervising no more than 12 children in attendance at all times. The facility is operating within the conditions, limitations and capacity specified on the license during the inspection. The disinfectants, cleaning solutions, poisons and other dangerous items are inaccessible to children the inspection. The storage areas for poisons are locked during the inspection. All materials and surfaces accessible to children are toxic free. The furniture and supplies are age appropriate and are in good condition. The classroom has adequate lighting, and ventilation. The floors are found to be clean and safe. The drinking water is readily accessible, inside and outside. The restrooms are maintained with operational toilets and faucets with appropriate temperature. Hand soap, paper towels and toilet paper are available. The restroom is lighted and ventilated. The food is provided by the school district. The menu is posted. Storage containers for solid waste have tight-fitting covers and are kept in good repair. The facility appears to be free of insects and rodents during the visit. There is an operational carbon monoxide detector. The smoke detectors are hardwired. The facility has maintained the fire extinguisher. The facility has maintained the fire/disaster drills; the last drill was conducted on 04/27/2017.
SUPERVISOR'S NAME: Carolina RamosTELEPHONE: (619) 767-2206
LICENSING EVALUATOR NAME: Marie HernandezTELEPHONE: (619) 767-2224
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2017
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: SANDBURG STATE PRESCHOOL
FACILITY NUMBER: 376701103
VISIT DATE: 08/24/2017
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The outdoor play area is a fenced playground with sufficient cushioning material. Per the approved waiver, the children shall not be allowed to use the play structure present in the yard. The structure is not age-appropriate for preschool children. The Representative
Ms. Morrow stated the children do not use the play yard structure. There is adequate shaded rest area for children. The toys are age appropriate. The grounds are free of debris or potential hazards. LPA was unable to verify the Director's and teacher's personnel records contain documentation of CPR and First Aid certification. The sign-in/out sheets were reviewed. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. LPA was unable to verify if the Director and staff have the required immunization records for pertussis, measles and influenza during the inspection.

Incidental Medical Services were discussed. This facility provides Incidental Medical Services – IMS. 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.

The following deficiencies have been cited today. An exit interview was conducted and a copy of the report, Notice of Site Visit and the Appeal Rights were provided to the Representative. LPA observed the Representative post the Notice of Site Visit in a prominent place. The Representative states it is understood that this notice must be posted for 30 days.
SUPERVISOR'S NAME: Carolina RamosTELEPHONE: (619) 767-2206
LICENSING EVALUATOR NAME: Marie HernandezTELEPHONE: (619) 767-2224
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2017
LIC809 (FAS) - (06/04)
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