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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334818026
Report Date: 03/28/2022
Date Signed: 03/28/2022 04:39:44 PM


Document Has Been Signed on 03/28/2022 04:39 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:KIDS COLLABORATE EARLY LEARNING CENTER, INC.FACILITY NUMBER:
334818026
ADMINISTRATOR:KELLY HERNANDEZFACILITY TYPE:
850
ADDRESS:36555 VAN GAALE LANETELEPHONE:
(951) 926-1600
CITY:WINCHESTERSTATE: CAZIP CODE:
92596
CAPACITY:144CENSUS: 82DATE:
03/28/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Ashley De Villa, Assistant Director TIME COMPLETED:
04:45 PM
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On at 03/28/2022 at 8:15 AM Licensing Program Analyst (LPA) Susan Brewer, arrived unannounced at the facility to conduct a 1 year required annual inspection. LPA was greeted by Assistant Director Ashely De Villa, and granted entry into the facility. LPA toured the facility, inside and out, reviewed records, and observed and discussed the following: Per A. Devilla, the Director Kelly Hernandez, was not scheduled to work. LPA took a census of 82 children present and 12 supervising staff.

Normal days and hours of operation are: Monday- Friday, 6:30 AM to 6:00 PM

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. Deficiencies were not cited this visit.

The licensee is asked to update the following documents, if applicable, and submit to licensing within 30 days or the date indicated below:
1. LIC 500 Personnel Report
2. LIC200A Application update, with changes to facility on or before 04/08/2022.
3. Parent Handbook/ Program Curriculum/Admission policies and procedures/ fee schedule (only if changes have been made)
4. LIC 309 Administrative Organization, on or before 04/15/2022.
5. LIC 308 Designation of Administrative Responsibility
6. Proof of Child Care Center Orientation Training for New Director and Assistant Director.
7. Proof of Immunization record for New Director on or before 04/08/2022.
8. Proof of Health, Safety, Nutrition & Lead, registration for Training for New Director and Assistant Director on or before 04/08/2022.
SUPERVISOR'S NAME: Pauline BeschornerTELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Susan BrewerTELEPHONE: (951) 970-0343
LICENSING EVALUATOR SIGNATURE:
DATE: 03/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/28/2022
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: KIDS COLLABORATE EARLY LEARNING CENTER, INC.
FACILITY NUMBER: 334818026
VISIT DATE: 03/28/2022
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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 on 03/28/2022.
· Ratios were met and appropriate supervision was provided during this inspection on 03/28/2022.
· Classrooms are clean, free of hazards and equipped with age appropriate furniture and equipment in good condition
· No weapons stored at the facility on 03/28/2022
· There are no accessible bodies of water present on 03/28/2022. All wading pools or similar product must be emptied immediately after use and stored in an upright position.
· Medications are stored where inaccessible to children in a key locked medicine cabinet in the Kitchen.
· Hazards are stored where inaccessible to children which include: Disinfectants, cleaners and other items that are dangerous. Poisons and toxins are locked.
· All floors are clean and safe
· Bathrooms were observed to be safe, sanitary and in operating condition
· Outdoor activity areas, playgrounds are enclosed by appropriate fences, free of hazards and are supplied with age and size appropriate equipment in good condition on 03/28/2022
· Food preparation area is clean, free of litter, rubbish and free of rodents and other vermin
· Measures are taken to keep the facility free of flies, other insects and rodents
· Food is stored appropriately and protected from contamination on 03/28/2022.
· Storage containers for solid waste, including moveable bins-have tight-fitting covers in good repair.
· Menus are NOT 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. At 9:24 AM LPA observed a snack menu for the week, without dates or portions listed and 2% milk in the refrigerator.
· Uncontaminated drinking water shall be readily available both indoors by water fountain and out and provided by igloos and disposable dixie cups.
· The areas around or under high climbing equipment, swings, slides, and similar equipment shall be cushioned with material that absorbs a fall: Facility has wood chips and grass.
· Sign in/Sign out record was reviewed and meets regulation requirements: Yes, electronic sign-in’s
· A Staff member is present with current Pediatric CPR/First Aid which expires on 04/2023
SUPERVISOR'S NAME: Pauline BeschornerTELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Susan BrewerTELEPHONE: (951) 970-0343
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2022
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: KIDS COLLABORATE EARLY LEARNING CENTER, INC.
FACILITY NUMBER: 334818026
VISIT DATE: 03/28/2022
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 Opening Staff #3 Child Care Center Orientation-Component 1 & 3 04/20/2006, CPR/1ST Aid expires 04/2023, , and closing staff #4 member’s CPR/First Aid expires on 04/2023.
· Director completed Health and Safety Training on Spring 2003 transcripts, missing Lead component.
· Staff qualifications and files were reviewed and are NOT complete: See LIC 9102TA.
· 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: UnusualIncidentReportsDO10@dss.ca.gov
· Children files were reviewed and are complete on 03/28/2022.
· Documentation of fire & earthquake drills to be conducted every six months: Last drill on 03/02/2022 at 10:30 AM a file drill was conducted with 113 children present, 11 teachers and 2 staff, lasted 10 minutes and the children evacuated to the play yard.
· 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.

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 CCCs: Incidental Medical Services (IMS) policy was discussed and licensee provided a copy of the IMS Plan for review and approval on 03/28/2022.

SUPERVISOR'S NAME: Pauline BeschornerTELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Susan BrewerTELEPHONE: (951) 970-0343
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2022
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: KIDS COLLABORATE EARLY LEARNING CENTER, INC.
FACILITY NUMBER: 334818026
VISIT DATE: 03/28/2022
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Facility Representative was reminded that all adults 18 and over living or working in the home, 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.

LPA discussed the safe sleep regulations with 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 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.

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.

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

Exit interview conducted and report was reviewed with the licensee Facility Representative Assistant Director Ashley De Villa.

SUPERVISOR'S NAME: Pauline BeschornerTELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Susan BrewerTELEPHONE: (951) 970-0343
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2022
LIC809 (FAS) - (06/04)
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