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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334818397
Report Date: 09/27/2022
Date Signed: 09/27/2022 04:26:43 PM


Document Has Been Signed on 09/27/2022 04:26 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:DISCOVERY ISLE CHILD DEVELOPMENT CENTERFACILITY NUMBER:
334818397
ADMINISTRATOR:KRISTI POLKFACILITY TYPE:
830
ADDRESS:32220 HIGHWAY 79 S.TELEPHONE:
(951) 303-8903
CITY:TEMECULASTATE: CAZIP CODE:
92592
CAPACITY:44CENSUS: 26DATE:
09/27/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Director/Principal Tonia GoldbachTIME COMPLETED:
04:30 PM
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On 09/27/2022 at 2:00 PM a required 1-year inspection is being conducted as a compliance review. Licensing Program Analyst (LPA) Susan Brewer, toured the infant center, inside and out. The following was observed: Present were Directing Principal Tonia Goldbach and Asst. Director Sarah Berwager.

Normal days and hours of operation are: Monday- Friday, 7:00 AM to 6:00 PM; Designated Infant Rooms are Classroom 1 and Classroom 2.

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.
The licensee is asked to update the following documents, if applicable, and submit to licensing within 30 days if changes have been made:

1. LIC 500 Personnel Report, include updates.
2. LIC 610 Emergency & Disaster Plan, to include 2nd relocation site
3. Parent Handbook/ Program Curriculum/Admission policies and procedures/ fee schedule (only if changes have been made)
4. LIC 309 Administrative Organization, with updated owner information.
5. LIC 308 Designation of Administrative Responsibility
6. LIC200A Application form with update to include new Directing Principal.
7. LIC999 Facility and Yard Sketch to include updates.

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
SUPERVISOR'S NAME: Pauline BeschornerTELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Susan BrewerTELEPHONE: (951) 970-0343
LICENSING EVALUATOR SIGNATURE:
DATE: 09/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/27/2022
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: DISCOVERY ISLE CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 334818397
VISIT DATE: 09/27/2022
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· The facility is operating within the terms of the license.
· Facility is clean, safe and sanitary and in good repair.
· Appropriate supervision and Ratios were met during this inspection: A census of 26 children were supervised by 6 staff.
· Rooms and activity areas are physically separated from other components on 09/27/2022.
· Rooms are equipped with age appropriate furniture and equipment in good condition on 09/27/2022.
· Uncontaminated drinking water is provided in both the indoor and outdoor activity areas by public water supply and filtered water tap water.
· Napping equipment is sufficient for capacity and meets licensing requirements.
· Rooms are clean and free of hazards on 09/27/2022.
· Materials and surfaces accessible to children are toxic free on 09/27/2022.
· No weapons stored at the facility on 09/27/2022.
· There are no bodies of water present on 09/27/2022. All wading pools or similar product must be emptied immediately after use and stored in an upright position.
· Medications are stored where inaccessible to infants: Located in Principal’s Office.
· Center is equipped to isolate and care for any child who becomes ill during the day.
· Toxins are locked and Hazards are stored where inaccessible to infants on 09/27/2022.
· Toileting area was observed to be safe, sanitary and in operating condition.
· Outdoor play area is physically separated by appropriate fencing and free of hazards on 09/27/2022.
· Outdoor activity areas are supplied with age and size appropriate equipment in good condition.
· There is sufficient cushioning material under high climbing equipment, swings, slides and similar equipment: Sand boxes under play structures and shade structure outdoors.
· Measures are taken to keep the facility free of flies, other insects and rodents on 09/27/2022.
· Food preparation area is clean and free of vermin Yes.
· Food is stored appropriately and protected from contamination on 09/27/2022.
· All storage containers for solid waste have tight-fitting covers that are kept on, and in good repair
· Individual feeding and Infant needs and service plans were reviewed and are complete for each individual infant: Verified on 09/27/2022.
· Infants up to 12 months shall have a sleeping plan as required with documentation of date, name, time of 15-minute check and staff initials on 09/27/2022.
SUPERVISOR'S NAME: Pauline BeschornerTELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Susan BrewerTELEPHONE: (951) 970-0343
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2022
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: DISCOVERY ISLE CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 334818397
VISIT DATE: 09/27/2022
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· Infant files were reviewed and are complete on 09/27/2022.
· Sign in/Sign out record was reviewed and meets regulation requirements on 09/27/2022.
· A Staff member is present with current Pediatric CPR/First Aid which expires on 09/2023.
· Opening and closing staff member’s CPR/First Aid expires on 08/2024.
· Director completed Health and Safety Training, Nutrition in Fall 2021 transcripts, missing lead component.
· Staff qualifications and files were reviewed and are complete on 09/27/2022.
· Staff have received on the job training for housekeeping, sanitation and universal health precautions.
· Documentation of fire & earthquake drills to be conducted every six months: Last drill on 03/18/2020. The director Tonia Goldbach assumed the position as Principal in 06/2022.
· The Licensee was informed of their reporting requirements and is provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO10@dss.ca.gov,
· Licensee was informed of the Department has inspection authority per Health and Safety Codes.
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.

Please subscribe at www.childcareadvocatesprogram to receive Department updates. They will be sent directly to your e-mail account once you have set up an account.
Duty Officer is available to answer questions Mon. – Fri. at 1-844-LET-US-NO (1-844-538-8766).

This facility provides Incidental Medical Services – IMS. LPA Susan Brewer, reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records.
SUPERVISOR'S NAME: Pauline BeschornerTELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Susan BrewerTELEPHONE: (951) 970-0343
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2022
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: DISCOVERY ISLE CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 334818397
VISIT DATE: 09/27/2022
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 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

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 Susan Brewer, discussed the safe sleep regulations with facility Directing Principal Tonia Goldbach 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.

Deficiencies not cited this visit. No civil penalties issued on 09/27/2022.

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

Exit interview conducted and report was reviewed with the facility Director/Principal Tonia Goldbach.
SUPERVISOR'S NAME: Pauline BeschornerTELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Susan BrewerTELEPHONE: (951) 970-0343
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2022
LIC809 (FAS) - (06/04)
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