330907395-2-14-2023-10-CC-NKIG-CP2UNX-20230214144439

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 330907395
Report Date: 02/14/2023
Date Signed: 02/14/2023 02:44:50 PM

Document Has Been Signed on 02/14/2023 02:44 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME:	ST. JOHN'S LUTHERAN EARLY CHILDHOOD EDUCATION CEN		FACILITY NUMBER:	330907395
ADMINISTRATOR:	NANCY BELLAMY		FACILITY TYPE:	850
ADDRESS:	26410 COLUMBIA STREET		TELEPHONE:	(951) 925-7756
CITY:	HEMET	STATE: CA	ZIP CODE:	92544
CAPACITY:	90	CENSUS: 46	DATE:	02/14/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Nancy Bellamy		TIME COMPLETED:	03:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA), Nasha King conducted an annual inspection as part of a compliance review. This is not a combination childcare center, as this is a preschool site with a toddler component. A tour of the inside and outside of the facility was granted and the following was observed and/or noted: · The following items were posted and updated where necessary: - License - Emergency Disaster Plan (LIC610) and Earthquake Preparedness Checklist (LIC9148) - Parent’s Rights Poster (PUB393) - Personal Rights (LIC613A) - Child Car Seat Law - Menu · The facility is operating within the limits as stated on the license. · Ratios are being met during this inspection. · Classrooms are adequately equipped with age and size appropriate furniture and equipment and free of hazards. · There are no weapons present at the facility as stated by Nancy Bellamy. · There are no accessible bodies of water present. All wading pools or similar product must be emptied immediately after use and stored in an upright position. · Drinking water is provided in the indoor activity space by water pitchers and containers that are filled by the water filter station outside and in the outdoor activity space by a drinking fountain and the children also bring their own water bottles which can be refilled by the water filter station outside. · Hazardous items are stored where inaccessible to children which include: Disinfectants, cleaning solutions. and other items that are dangerous.

SUPERVISOR'S NAME: Carlos Martinez	TELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Nasha King	TELEPHONE: (951) 204-2046
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2023

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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: ST. JOHN'S LUTHERAN EARLY CHILDHOOD EDUCATION CEN	FACILITY NUMBER: 330907395
	VISIT DATE: 02/14/2023

NARRATIVE

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· Poisons and toxins are locked and inaccessible to children.
· All floors were observed to be clean and safe.
· Bathrooms were observed to be safe, sanitary and in operating condition.
· Playgrounds are enclosed by appropriate fences and free of hazards.
· Outdoor activity areas are supplied with age and size appropriate equipment in good condition.
· Food preparation area is clean, free of litter and rubbish and free of rodents and other vermin.
· Food is stored appropriately and protected from contamination.
· All storage containers for solid waste were observed to have tight-fitting covers that are kept on, and in good repair.
· Sign in/Sign out record was reviewed and meets regulation requirements.
· Disaster drills are conducted at least every six months – last drill conducted on 01/12/2023.

A review of staff and children's records were conducted as part of this evaluation.
· Children’s records were found to be complete during this inspection.
· Staff records review indicates that all staff present meet minimum qualifications for the position for which they were hired.
· A staff member is present with current Pediatric CPR/First Aid which expires on 07/2024.
· Opening and closing staff member’s CPR/First Aid expires on 07/2024.
· Director completed Health and Safety Training.
· 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 index clearances or exemptions.

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 items were discussed with the Licensee/Director during inspection:

SUPERVISOR'S NAME: Carlos Martinez	TELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Nasha King	TELEPHONE: (951) 204-2046
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2023

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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: ST. JOHN'S LUTHERAN EARLY CHILDHOOD EDUCATION CEN	FACILITY NUMBER: 330907395
	VISIT DATE: 02/14/2023

NARRATIVE

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· Menus shall be posted at least one week in advance in a place visible by the child’s authorized representative, dated and kept on file for 30 days, and made available upon request.
· The areas around or under high climbing equipment, swings, slides, and similar equipment shall be cushioned with material that absorbs a fall
· The Licensee was informed of their reporting requirements and provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO10@dss.ca.gov
· The Licensee can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations858@dss.ca.gov

LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Licensee [or facility representative] was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

On-line Licensing forms & regulations for a Child Care Center can be obtained on the Department’s website: www.ccld.ca.gov. Additionally, there is a link to “Receive Important Updates” located on the right side of the page, immediately above Quick Links. One can add their email address and choose which program(s) they wish to receive Provider Information Notices (PIN) for.

The Duty Officer is available to answer questions Monday – Friday; 8:00am to 5:00pm at:
1-844-LET-US-NO (1-844-538-8766) and/or 951-782-4200.

The licensee/director was asked to update the following documents, if applicable, and submit to licensing within 30 days:

SUPERVISOR'S NAME: Carlos Martinez	TELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Nasha King	TELEPHONE: (951) 204-2046
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2023

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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: ST. JOHN'S LUTHERAN EARLY CHILDHOOD EDUCATION CEN	FACILITY NUMBER: 330907395
	VISIT DATE: 02/14/2023

NARRATIVE

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1. LIC 500 Personnel Report
2. LIC 610 Emergency & Disaster Plan
3. Parent Handbook/ Program Curriculum/Admission policies and procedures/ fee schedule (only if changes have been made or file copy is more than 2 years old)
4. LIC 309 Administrative Organization (only if changes have been made or file copy is more than 2 years old)
5. LIC 308 Designation of Administrative Responsibility (only if changes have been made& current designation is on file)

See LIC 809D for deficiencies cited.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

An exit interview was conducted, and this report was reviewed with the licensee [or facility representative] Nancy Bellamy. Appeal rights were discussed and provided during the exit interview.

A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Carlos Martinez	TELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Nasha King	TELEPHONE: (951) 204-2046
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/14/2023 02:44 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: ST. JOHN'S LUTHERAN EARLY CHILDHOOD EDUCATION CEN	FACILITY NUMBER: 330907395
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/14/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in that 2 out of 6 staff members did not have current Mandated Reporter Training Certificates on file, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/28/2023
	Plan of Correction
1 2 3 4	S1 and S5 are to complete the Mandated Reporter Trainings (General & AB1207), and the Director will submit proof of completion to LPA via email on or before the Plan of Correction (POC) due date of 02/18/2023.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Carlos Martinez	TELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Nasha King	TELEPHONE: (951) 204-2046
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2023

LIC809 (FAS) - (06/04)

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