330908480-6-8-2023-09-CC-SBRR-CSKTT2-20230607150000

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 330908480
Report Date: 06/07/2023
Date Signed: 06/08/2023 09:03:21 AM

Document Has Been Signed on 06/08/2023 09:03 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	ISLAMIC ACADEMY OF RIVERSIDE		FACILITY NUMBER:	330908480
ADMINISTRATOR:	KHALIDA ZIAULLAH		FACILITY TYPE:	850
ADDRESS:	1038 W. LINDEN STREET		TELEPHONE:	(951) 682-1202
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92507
CAPACITY:	24	CENSUS: 8	DATE:	06/07/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Nadia Saber, Director		TIME COMPLETED:	03:15 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	On 06/07/2023 at 10:15 AM Licensing Program Analyst (LPA) Susan Brewer arrived at the facility to conduct a 1 year required annual inspection. LPA was granted entry by Director Nadia Saber . LPA toured the facility, inside and out, reviewed records, and observed and/or discussed the following: The outdoor play area is temporarily off - limits, pending the completion of construction for a new restroom. Normal days and hours of operation: Monday- Friday, 7:30 AM – 3:30 PM; Friday 7:30 AM to 2:30 PM The facility follows regular school calendar schedule and is closed for Summer Break The inspection consisted of reviews of the following domains: Food Service. Reporting Requirements Physical Plant; Care and Supervision; Children Records; Staff Records; Staffing Ratio and Capacity and Personal Rights. The inspection found the facility to be in compliance in these domains, except as noted on the LIC809D. The licensee is asked to update the following documents, if applicable, and submit to licensing within 30 days: 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) and Staff handbook. 4. LIC 309 Administrative Organization, Updated Board Resolution/Agreements and Meeting Minutes. 5. LIC 308 Designation of Administrative Responsibility The following items have been posted and are 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 not required. The facility is operating within the terms of the license.

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Susan Brewer	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2023

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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: ISLAMIC ACADEMY OF RIVERSIDE	FACILITY NUMBER: 330908480
	VISIT DATE: 06/07/2023

NARRATIVE

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· Ratios were met and appropriate supervision was provided during this inspection. LPA took a census of 8 children in care and supervised by 2 staff.
· A fully charged fire extinguisher (2A:10BC) was observed. A smoke detector is hardwired to the building and carbon monoxide detector were present and tested by the Licensee during this inspection.
· Classrooms are clean, free of hazards and equipped with age-appropriate furniture and equipment in good condition.
· No weapons stored at the facility.
· There are no accessible bodies of water present on 06/07/2023. All wading pools or similar product must be emptied immediately after use and stored in an upright position.
· Medications are NOT stored at the facility. Per director Nadia Saber, the preschool does not provide Incidental Medical Services to day care children and there is no IMS Plan of Operation.
· Hazards are stored where inaccessible to children in the classrooms which include Disinfectants, cleaners and other items that are dangerous. Poisons and toxins were observed to be locked indoors.
· All floors are clean and safe.
· Bathrooms were observed to be safe, sanitary and in operating condition on 06/07/2023. The licensee is in the process of adding an additional restroom for the preschool, which is still under construction.
· Outdoor activity areas/playgrounds are enclosed by appropriate fences and are supplied with age and size appropriate equipment in good condition. However, at 11:02 AM LPA observed miscellaneous construction materials to include 2 large canisters of Acetona Klean Strip, 2 buckets of an unknown substance, tile, boards; bug or yard spray container, dry grout mixture, electrical wiring laid across and above the sidewalk where the day care entrance to the preschool classrooms are located. No children were present in the outdoor play area at the time of the inspection. The outdoor play area is temporarily off - limits.
· Food preparation is not conducted at the facility.
· Measures are taken to keep the facility free of flies, other insects, and rodents with monthly service.
· Food is stored appropriately and protected from contamination. Only dry snacks and packaged juices are stored for children, should a parent forget to provide a lunch.
· Storage containers for solid waste, including moveable bins-have tight-fitting covers in good repair
· Menus are not posted. The facility does not provide meals for children. Patrons provide lunches and snacks for children while in care.
· Uncontaminated drinking water shall be readily available both indoors and out and provided by purchasing filtered water containers and using a filtered water dispenser.
· The areas around or under high climbing equipment, swings, slides, and similar equipment shall be cushioned with material that absorbs a fall: Facility has rubber turf and artificial grass.

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Susan Brewer	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2023

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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: ISLAMIC ACADEMY OF RIVERSIDE	FACILITY NUMBER: 330908480
	VISIT DATE: 06/07/2023

NARRATIVE

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However, at 11:00 AM, LPA observed a play structure, extending onto the concrete pavement, which would not absorb a fall which was brought to the attention of the director. No children were present and the outdoor play area is temporarily off limit.
· Sign in/Sign out record was reviewed and meets regulation requirements on 06/07/2023.
· A Staff member is present with current Pediatric CPR/First Aid which expires on 11/2024.
· Opening and closing staff member’s CPR/First Aid expires on 09/2024
· Director completed Health and Safety Training: FALL 2000 transcripts for H/S/N only, No lead.
· Staff qualifications and files were reviewed and are NOT complete. Staff 1 file was missing the LIC503 Health Screening form, the MMR, Tdap, and Influenza or letter to decline; Mandated reporter Parts 1 & 2.
· Staff have received on the job training for housekeeping, sanitation, and universal health precautions
Licensee was informed the Department has inspection authority per Health and Safety Codes.
Licensee provided the Unusual Incident Reporting email: UnusualIncidentReportsDO09@dss.ca.gov
· Children files were reviewed and are NOT complete, for Child 2 on Confidential Names list did not have the LIC995 Parents Right’s, LIC610A Personal Rights and LIC627 Medical Consent, however the subject child is promoting to Kindergarten and will not be returning to school after today's date.
· Documentation of fire & earthquake drills to be conducted every six months: Last fire drill on 05/25/2023 at 10:00 AM on a Thursday.
· Documentation of Lead Testing is on file: Not on file. The licensee uses only filtered water for children at the preschool. No food preparation is conducted at the facility.
· A review of staff records on 06/01/2023 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
· AB2370 – Lead Exposure, day care facilities, effective January 1, 2019 –
The bill requires that all Child Care Centers, operating in a building constructed before January 1, 2010, shall have their drinking water tested for excessive lead levels, on or after January 1, 2020, but no later than January 1, 2023. Child Care Centers must thereafter test their drinking water every five years after the date of the initial test.
· AB605 – Child day care facilities, birth to school-age license; Effective January 1, 2021
· AB2960 – Child care and development services, online portal – Effective June 20, 2022 - This bill requires the State Superintendent of Public Instruction (SSPI), within the California Department of Education (CDE), to develop and post on CDE's website a comprehensive child care and development services online portal for families and providers by June 30, 2022.

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Susan Brewer	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2023

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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: ISLAMIC ACADEMY OF RIVERSIDE	FACILITY NUMBER: 330908480
	VISIT DATE: 06/07/2023

NARRATIVE

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For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated 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

The director Nadia Saber, was reminded that all adults 18 and over working at the facility, 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 licensed 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. The Licensee can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations862@dss.ca.gov for Riverside Regional Office.

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/inspection-process.

Deficiencies were cited for Type B violations this visit.

Civil Penalties were not issued this visit

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

Exit interview conducted and report was reviewed with the licensee Director Nadia Saber.

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Susan Brewer	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2023

LIC809 (FAS) - (06/04)

Page: 4 of 11

Document Has Been Signed on 06/08/2023 09:03 AM - 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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: ISLAMIC ACADEMY OF RIVERSIDE	FACILITY NUMBER: 330908480
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.7995(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. 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 a file reviewed for a staff present and working did have proof of Measles, Pertussis, Influenza or a letter to decline the influenza, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/07/2023
	Plan of Correction
1 2 3 4	Per director the subect staff will provide proof of Measles, Pertussis, Influenza or a letter to decline the influenza, and the licensee will submit documentation of immunization records for staff to the department by fax, mail or e-mail.

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 review of staff records, the licensee did not comply with the section cited above in staff present did not have certificates for the CA Child Abuse Mandated Reporter Training Parts 1 and 2, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/07/2023
	Plan of Correction
1 2 3 4	The director agrees to provide proof of Training certificates for the CA Child Abuse Mandated Reporter Training Parts 1 and 2, for the subject staff and submit documentation to the department by fax, mail or e-mail.

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: Kimberly Williams	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Susan Brewer	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2023

LIC809 (FAS) - (06/04)

Page: 5 of 11

Document Has Been Signed on 06/08/2023 09:03 AM - 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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: ISLAMIC ACADEMY OF RIVERSIDE	FACILITY NUMBER: 330908480
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101216(g)(2)

Personnel Requirements

(2) Each person specified in (g) above shall have a health-screening report signed by the person performing the screening. This report shall indicate the following: 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 1 staff present did not have proof of a the LIC503 Health Screening, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/07/2023
	Plan of Correction
1 2 3 4	The licensee agrees to submit proof of the LIC503 Health Screening for the subject staff and submit proof of documentation to the department by fax, mail or e-mail.

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: Kimberly Williams	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Susan Brewer	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2023

LIC809 (FAS) - (06/04)

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