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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191598776
Report Date: 05/21/2019
Date Signed: 05/21/2019 11:48:20 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:SO RANCHITO ELEM SCHOOL SITE (ROOM K2)FACILITY NUMBER:
191598776
ADMINISTRATOR:JULIA GAVILANESFACILITY TYPE:
850
ADDRESS:5241 S PASSONS BL RM 20TELEPHONE:
(562) 801-5117
CITY:PICO RIVERASTATE: CAZIP CODE:
90660
CAPACITY:48CENSUS: 32DATE:
05/21/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Melba Schefres, Resource TeacherTIME COMPLETED:
12:00 PM
NARRATIVE
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An unannounced Annual Random Inspection was conducted on this day by Licensing Program Analyst (LPA) Jacqueline Martinez. Facility is currently licensed for a capacity of 48 children. LPA met with Melba Schefres, Resource Teacher, who guided analyst on a tour of the facility. This is a State preschool program which is operated by El Rancho Unified School District and is located on the premises of South Ranchito Elementary School. The program consists of an AM part-time day Session in Room 20 from 9:00am to 12:00pm and an AM and PM Session in Room 41 from 9:00am to 12:00pm and from 1:00pm to 4:00pm, Monday through Friday.

The indoors and outdoors of the facility were inspected. LPA observed 15 children with 3 Staff Members in Room 20 and 17 children with 3 Staff in Room 41. Teacher child ratios were observed and staff names recorded. Sign in sheets were reviewed.

Furniture and equipment was inspected for age appropriateness, good repair and free of sharp, loose, or pointed parts. Telephone service, heating, lighting and ventilation were evaluated. Storage for children's belongings and isolation area were inspected. LPA observed that in both rooms children's sweaters are hanging on hooks and in contact with each other. LPA advised that children's sweaters and jackets can not be in contact with each other. Ill isolation area is in the Schools Main Office. Drinking water was readily available in Room 41 for children to drink freely via a water fountain. LPA observed that the water fountain in Room 20 has a very low water pressure, making it difficult for children to drink water freely. LPA inquired to find out if a work order had been submitted to fix the indoor water fountain. A work order was not provided during this inspection: A Type B deficiency is being cited on the LIC 809-D page.

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SUPERVISOR'S NAME: Katherine HarewoodTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Jacqueline MartinezTELEPHONE: 323 981-3384
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: SO RANCHITO ELEM SCHOOL SITE (ROOM K2)
FACILITY NUMBER: 191598776
VISIT DATE: 05/21/2019
NARRATIVE
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Age appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, area safety and sanitation. There are restrooms located in Room 41. However, Room 20 uses the outside elementary restroom. LPA inquired if the facility had a waiver to use the elementary restrooms which are approximately 117 feet from Room 20. LPA will review the facility file. If there is no waiver in place and the facility continues to use Room 20, the facility may need to submit a waiver to use the elementary restroom. First Aid supplies were reviewed and inventoried.

The facility provides an AM and PM snack through the School District Cafeteria. Food menus were posted in a place that is visible by the child’s authorized representative. All storage containers for solid waste, including moveable bins had tight-fitting covers that are kept on, and in good repair. All floors were observed to be clean and safe. Disinfectants, cleaning solutions, medications and other items that are dangerous to children, were inaccessible.

The facility shares yard with the elementary Kindergarten classrooms. LPA inquired to find out if there is a waiver to use the Kindergarten play area. Ms. Schefres stated that there may not be a waiver in place. LPA will review the file. If there is no waiver in place the facility may need to submit a waiver to share the outdoor yard with the Kindergarten classes. Outdoor play equipment was inspected for safety, free of sharp, loose pointed parts, good repair and age appropriateness. The surface of the outdoor activity area was observed to be maintained in a safe condition, and free of hazards. All areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with material that absorbs a fall. Required shade, drinking water and fencing were inspected. LPA observed that the drinking fountain outdoors had very low water pressure (video taken of the water pressure) making it difficult for children to drink water outdoors. A Type B deficiency is being cited on the LIC 809-D page. Play area was inspected for hazards and inaccessibility to bodies of water; no bodies of water or hazards were observed.

Children's records were reviewed as well as a sampling of children’s emergency information. Staff files were also reviewed. All staff is fingerprint cleared, as a condition of employment through the school district. Staff 2 and Staff 5 provided proof of current Pediatric First Aid and CPR certification.

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SUPERVISOR'S NAME: Katherine HarewoodTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Jacqueline MartinezTELEPHONE: 323 981-3384
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2019
LIC809 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: SO RANCHITO ELEM SCHOOL SITE (ROOM K2)
FACILITY NUMBER: 191598776
VISIT DATE: 05/21/2019
NARRATIVE
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Incidental Medical Services (IMS). Incidental Medical Services (IMS) policy was discussed. During this inspection there were no children requiring Incidental Medical Services. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A Plan of Operation that includes IMS must be submitted to the Department. 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.

AB1207: The following was is a reminder: As of January 1, 2018, Health & Safety Code 1596.8662 requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. New employees shall have 90 days from date of employment to complete training as required. The training may be met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules at: http://www.mandatedreporterca.com/.

Deficiencies The following deficiencies listed on the attached deficiency page are being cited and need to be cleared to protect the children’s health & safety.



An exit interview was conducted with Melba Schefres, Resource Teacher. A copy of this report and Notice of Site Visit was provided. Appeal rights were issued and discussed.


The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.


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SUPERVISOR'S NAME: Katherine HarewoodTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Jacqueline MartinezTELEPHONE: 323 981-3384
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: SO RANCHITO ELEM SCHOOL SITE (ROOM K2)
FACILITY NUMBER: 191598776
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/21/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/04/2019
Section Cited
CCR
101239.2(a)
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Drinking Water: Drinking water from a noncontaminating fixture or container shall be readily available both indoors and in the outdoor activity area.
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Ms. Schefres states that proof of the use of a water jug to use indoors and outdoors will be provided to the Department. As well, a work order will be submitted for the water fountain in Room 20 and the water fountains located in the play yard by the due date.
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This regulation was not met by evidence of the following: LPA took video of the water fountain in Room 20 and the water fountains in the outdoor play yard with very low water pressure, making it difficult for children to drink water indoors and outdoors. This poses a potential health risk to the children in care.
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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: Katherine HarewoodTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Jacqueline MartinezTELEPHONE: 323 981-3384
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4