330910708-6-5-2019-09-CC-ANOE-BCUPXK-20190605114229

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 330910708
Report Date: 06/05/2019
Date Signed: 06/05/2019 11:42:40 AM

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 ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	CVUSD - JOHN KELLEY HS CENTER		FACILITY NUMBER:	330910708
ADMINISTRATOR:	DELILAH SALADO		FACILITY TYPE:	850
ADDRESS:	87-163 CENTER STREET		TELEPHONE:	(760) 399-1259
CITY:	THERMAL	STATE: CA	ZIP CODE:	92274
CAPACITY:	24	CENSUS: 12	DATE:	06/05/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:02 AM
MET WITH:	Norma Nunez		TIME COMPLETED:	11:51 AM

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	A random annual inspection is being conducted as part of a compliance review. Licensing Program Analysts (LPAs), Ana Noble, toured the center, inside and out. The following was observed: A total of 12 children present with 3 staff members. Children engaged indoor play time. · A review of the staff records and review of a sampling of children's records were conducted as part of this evaluation. · 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) 4. LIC 309 Administrative Organization (only if changes have been made) 5. LIC 308 Designation of Administrative Responsibility (only if changes have been made) · 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 · The facility is operating within the terms of the license · Ratios were met during this inspection

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Ana Noble	TELEPHONE: (951) 782-3278
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2019

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 ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: CVUSD - JOHN KELLEY HS CENTER	FACILITY NUMBER: 330910708
	VISIT DATE: 06/05/2019

NARRATIVE

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· Appropriate supervision was provided during this inspection
· Classrooms are equipped with age appropriate furniture and equipment in good condition
· Classrooms are clean and free of hazards
· No weapons stored at the facility
· 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 when not in use.
· Medications are stored where inaccessible to children
· Hazards are stored where inaccessible to children which include: Disinfectants, cleaning solutions and other items that are dangerous
· Poisons and toxins are locked
· All floors shall be clean and safe
· Bathrooms floor were observed to be safe, but not sanitary-there was a strong odor of urine and visible build up on floor and base board behind and around the toilets-See LIC809-D. Toilet were 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, rubbish and free of rodents and other vermin (Meals are prepared at school cafeteria).
· Food is stored appropriately and protected from contamination
· All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair
· 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
· Uncontaminated drinking water shall be readily available both indoors and out and provided by Water drinking fountain both indoor and outdoors.
· The areas around or under high climbing equipment, swings, slides, and similar equipment shall be cushioned with material that absorbs a fall
· Sign in/Sign out record was reviewed and meets regulation requirements

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Ana Noble	TELEPHONE: (951) 782-3278
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2019

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 ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: CVUSD - JOHN KELLEY HS CENTER	FACILITY NUMBER: 330910708
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/05/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 06/28/2019 Section Cited CCR 101238(a)	1 2 3 4 5 6 7	Buildings and Grounds. The child care center shall be clean, safe, sanitary and in good repair at all times. This requirement was not met by evidence of: In the children restroom there was a strong odor of urine and the vinyl floor covering clearly had visible grime built up. This poses a potential health and safety risk to children if not corrected.	1 2 3 4 5 6 7	Licensee agrees to submit copy of work order with the school district, with an approximately date of completion. Submit proof to the Department by 6/28/2019.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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) 248-0228
LICENSING EVALUATOR NAME: Ana Noble	TELEPHONE: (951) 782-3278
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2019

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 ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: CVUSD - JOHN KELLEY HS CENTER	FACILITY NUMBER: 330910708
	VISIT DATE: 06/05/2019

NARRATIVE

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· A Staff member is present with current Pediatric CPR/First Aid which expires on 11/30/19
· Opening and closing staff member’s CPR/First Aid expires on 11/30/19
· Director completed Health and Safety Training
· Required records for children shall ensure that each child’s record contain a medical assessment and contain the Identification and Emergency Information
· Required records for staff shall ensure that each personnel record contain a health screening
· Documentation of fire & earthquake drills to be conducted every six months
· A review of staff records on 6/5/19 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
· Facility is providing IMS 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.
· For more information on SIDS and Safe Sleep Environments, please visit:
California Department of Public Health – California SIDS Program: http://www.cdph.ca.gov/programs/SIDS/pages/default.aspx
AAP – Safe Sleep Campaign: http://www.healthychildcare.org/sids/html
AAP-Free Training: Reducing the Risk of SIDS in Early Education and Child Care: http://shop.aap.org/Reducing-the-Rick-of-SIDS-in-Early-Education-and-Child-Care
And Caring for our Children, Safe Sleep Practices and SIDS/Suffocation Risk Reduction: http://cfoc/nrckids/org/standardview/spccol/safe_sleep
See LIC 809D for deficiency cited.
The following was also previously reviewed and discussed on 10/8/18:
v AB 2084 - Nutritious Beverages in Child Care Facilities effective January 1, 2012

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Ana Noble	TELEPHONE: (951) 782-3278
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2019

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 ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: CVUSD - JOHN KELLEY HS CENTER	FACILITY NUMBER: 330910708
	VISIT DATE: 06/05/2019

NARRATIVE

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v AB 2621 – Public Information effective January 1, 2015
v AB 2236 – Civil Penalties, effective July 1, 2015
v AB 2386 – Carbon Monoxide Detector Regulations, effective January 1, 2015
v AB 2386 – Carbon Monoxide Detector Regulations, effective January 1, 2015
The child weighs 40 or more pounds OR is 40 or more inches tall. For additional information regarding car seat laws see www.chp.ca.gov
vAccess to forms & Regulations for a Child Care Center are online at www.ccld.ca.gov.
vPlease subscribe at childcareadvocatesprogram@dss.ca.gov to receive Department updates. They will be sent directly to your e-mail account once you have set up an account. This website can also be accessed through www.ccld.ca.gov
vThe Duty Officer is available to answer questions Monday – Friday at 1-844-LET-US-NO (1-844-538-8766).

An exit interview was conducted and during the interview, the Lead Teacher Norma Nunez, confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.

A NOTICE OF SITE VISIT WAS ISSUED AND IS TO BE POSTED IN A PROMINENT LOCATION AT THE FACILITY FOR THE NEXT 30 DAYS. Appeal rights were provide and discussed. This report must be available for review, upon request, for the next 3 years.

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Ana Noble	TELEPHONE: (951) 782-3278
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2019

LIC809 (FAS) - (06/04)

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