334809747-11-29-2021-09-CC-DHOE-C9996X-20211129220616

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334809747
Report Date: 11/23/2021
Date Signed: 11/29/2021 10:06:42 PM

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:	RENU HOPE FOUNDATION		FACILITY NUMBER:	334809747
ADMINISTRATOR:	KRISTIN GILLESPIE		FACILITY TYPE:	850
ADDRESS:	802 BEAUMONT AVENUE		TELEPHONE:	(951) 845-3816
CITY:	BEAUMONT	STATE: CA	ZIP CODE:	92223
CAPACITY:	55	CENSUS: 0	DATE:	11/23/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Site Director, Kristin Gillespie		TIME COMPLETED:	04:30 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 11/23/2021, Licensing Program Analyst (LPA) Destinee Hogue and Licensing Program Manager (LPM) Kimberly Williams conducted a required annual inspection as part of a compliance review. This inspection is also in agreement with, and as a result of a Stipulation, Waiver and Order, effective on January 28, 2021, due to concerns associated with the facility history and previous citations issued. There were no preschool children present at the time of this inspection. A tour of the inside and outside of the facility was granted and the following was observed and discussed with Site Director, Kristin Gillespie: A review of a sampling of the staff records and children records were conducted as part of this evaluation. During observations made throughout this inspection, the facility is preparing to reopen on December 6, 2021 and was reminded to post the following items: Stipulation, Waiver, and Order; License; Emergency Disaster Plan (LIC610); Earthquake Preparedness Checklist (LIC9148); Parent’s Rights Poster (PUB393); Personal Rights (LIC613A); Child Car Seat Law; Menu. - All staff members working at the facility have obtained a Criminal Record Clearance or Criminal Record Exemption. - All staff members working at the facility have a personnel record on file, however CPR and First Aid training is not up to date or completed by all staff employed at the facility. - Poisons, detergents, cleaning compounds and other toxins are locked and stored where inaccessible to children. - Facility roster reviewed and up to date with current children enrolled at the facility. - There were no children present at the time of this inspection to determine if adequate Care and Supervision is being provided during outdoor play activities, classroom, and restroom breaks. - Medications are locked and stored where inaccessible to children. - Facility is clean, safe, sanitary and in good repair at the time of this inspection.

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee Hogue	TELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:	DATE: 11/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/23/2021

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: RENU HOPE FOUNDATION	FACILITY NUMBER: 334809747
	VISIT DATE: 11/23/2021

NARRATIVE

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- Staff training records reviewed. Staff training last conducted on 07/28/2021 and 07/29/2021 regarding Title 22 Regulations. General Health & Safety training was conducted on 11/15/2021.
- LIC309-Administrative Organization and Board Meeting Minutes was previously submitted in February 2021.

- Licensee 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 licensed Family Child Care Home. 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.

- 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.

- The Licensee can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations862@dss.ca.gov

- The Licensee was informed of their reporting requirements and is provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO09@dss.ca.gov

- The Duty Officer is available to answer questions Monday – Friday from 8:00am to 5:00pm at (951)782-4200

Licensee/Site Director agrees to submit pictures prior to the facility reopening date on December 6, 2021. Pictures shall include: facility indoor activity areas and outdoor activity areas set up prior to reopen date and parent board with required postings along with Stipulation, Waiver, and Order shall be posted in a prominent location prior to reopen date.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS. Exit interview conducted and report was reviewed with Site Director Kristin Gilliespie. SEE LIC809D for cited deficiencies.

Based on the above, the facility was found to be in compliance with Title 22, at this time.

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee Hogue	TELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:	DATE: 11/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/23/2021

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: RENU HOPE FOUNDATION	FACILITY NUMBER: 334809747
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/23/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101216(f)

Personnel Requirements

(f) At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on records review, the licensee did not comply with the section cited above in Staff #2 has not completed CPR/First Aid and Staff #3 CPR/First Aid training expired on 11/20/2021 which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/07/2021
	Plan of Correction
1 2 3 4	During this inspection, Licensee/Site Director agreed to have Staff #2 and Staff #3 complete EMSA or AHA CPR/First Aid training by 12/07/2021. Completed CPR/First Aid training can be submitted via email or mail by 12/07/2021.

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) 248-0228
LICENSING EVALUATOR NAME: Destinee Hogue	TELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:	DATE: 11/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/23/2021

LIC809 (FAS) - (06/04)

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