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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334819247
Report Date: 01/18/2023
Date Signed: 01/18/2023 12:47:23 PM


Document Has Been Signed on 01/18/2023 12:47 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:DSUSD ADAMS EARLY CHILDHOOD LEARING CENTERFACILITY NUMBER:
334819247
ADMINISTRATOR:ALEJANDRA BAUTISTAFACILITY TYPE:
850
ADDRESS:50-800 DESERT CLUB DRIVETELEPHONE:
(760) 771-8675
CITY:LA QUINTASTATE: CAZIP CODE:
92253
CAPACITY:60CENSUS: 43DATE:
01/18/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Alejandra BautistaTIME COMPLETED:
12:55 PM
NARRATIVE
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On 01/18/2023, Licensing Program Analyst (LPA) Lorena Valenzuela conducted an annual inspection as part of a compliance review. LPA was granted access by Alejandra Bautista. A tour of the inside and outside of the facility was conducted by LPA and the following was observed and/or noted:
· The following items were posted:
- 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 capacity limits as stated on the license.
· Ratios are being met and children in care were supervised at the time of the inspection
· Classroom are adequately equipped with age and size appropriate furniture and equipment and is free of hazards.
· There are no weapons present at the facility as stated by Alejandra Bautista
· 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.
· Water is available through water fountain which is available in indoor and outdoor activity spaces. There is also pitchers of water with paper cups available for children in care.
· Medications are stored where they are inaccessible to children in a locked cabinet
· Hazardous items are stored where inaccessible to children which include: Disinfectants, cleaning solutions and other items that are dangerous
· Poisons and toxins are locked and inaccessible to children
· All floors were observed to be clean and safe
SUPERVISOR'S NAME: Stephanie HudakTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Lorena ValenzuelaTELEPHONE: (951) 233-9356
LICENSING EVALUATOR SIGNATURE:
DATE: 01/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/18/2023
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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Document Has Been Signed on 01/18/2023 12:47 PM - 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
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501


FACILITY NAME: DSUSD ADAMS EARLY CHILDHOOD LEARING CENTER

FACILITY NUMBER: 334819247

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 01/18/2023

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
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Based on record review, the licensee did not comply with the section cited above in that three staff (Staff 3, Staff 4, Staff 5) do not have proof or documenation for immunizations against measles and pertussis, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/17/2023
Plan of Correction
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Facility representative Alejandra Bautista agrees to provide documentation of immunizations for three staff to the Department by due date 02/17/2023.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Stephanie HudakTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Lorena ValenzuelaTELEPHONE: (951) 233-9356
LICENSING EVALUATOR SIGNATURE:
DATE: 01/18/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/18/2023
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
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: DSUSD ADAMS EARLY CHILDHOOD LEARING CENTER
FACILITY NUMBER: 334819247
VISIT DATE: 01/18/2023
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Bathrooms were observed to be safe, sanitary and 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 the school cafeteria and food is delivered by staff to children in classroom
· 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
· The Sign in/Sign out record was reviewed and meets regulation requirements
· Fire and Disaster drills are being conducted, with the last drill conducted on 01/11/2023.

A review of staff and children's records were conducted as part of this inspection, the following was observed:
· Children’s records were found to be complete during this inspection.
· Staff records review indicates that all staff present meet minimum qualifications for the position for which they were hired
· A Staff member is present with current Pediatric Cardiopulmonary Resuscitation (CPR) and First Aid certification which expires on 03/2023
· Opening and closing staff member’s Cardiopulmonary Resuscitation CPR and First Aid certification expires on 07/2024
· Director Jay Rallion completed Health and Safety Training.
· A review of staff records indicates that all facility staff or other individuals who require caregiver background checks have received criminal record, child abuse index clearances and/or exemptions.

The facility provides Incidental Medical Services (IMS). LPA’s reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. The facility was advised to obtain information about IMS to refer to the Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. The following information regarding Americans with Disability Act (ADA) was provided: United States 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, is available at: http://www.ada.gov/childqanda.htm
SUPERVISOR'S NAME: Stephanie HudakTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Lorena ValenzuelaTELEPHONE: (951) 233-9356
LICENSING EVALUATOR SIGNATURE:

DATE: 01/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2023
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
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: DSUSD ADAMS EARLY CHILDHOOD LEARING CENTER
FACILITY NUMBER: 334819247
VISIT DATE: 01/18/2023
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The following items were discussed with the facility representative during inspection:
· 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 outdoors
· The areas around or under high climbing equipment, swings, slides, and similar equipment shall be cushioned with material that absorbs a fall
· The Licensee was informed of the reporting requirements and provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO10@dss.ca.gov
· The Licensee can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations858@dss.ca.gov

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 recalls of 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.
Facility representative Alejandra Bautista was reminded that all individuals, 18 years of age and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to their initial presence at the facility. A civil penalty of one hundred dollars ($100) minimum per violation per day up to a maximum of five hundred dollars ($500) per person will be assessed, if this regulation is violated.

-To access on-line Licensing forms & Regulations for a Child Care Center please visit: www.ccld.ca.gov. Also, go to the licensing webpage and click on the “Receive Important Updates” located on the right side of the page, immediately above the Quick Links. One can add their email address and choose which program(s) they wish to receive Provider Information Notices (PIN) for.
SUPERVISOR'S NAME: Stephanie HudakTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Lorena ValenzuelaTELEPHONE: (951) 233-9356
LICENSING EVALUATOR SIGNATURE:

DATE: 01/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2023
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
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: DSUSD ADAMS EARLY CHILDHOOD LEARING CENTER
FACILITY NUMBER: 334819247
VISIT DATE: 01/18/2023
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The Duty Officer is available to answer questions Monday through Friday; 8:00am to 5:00pm at: 1-844-LET-US-NO (1-844-538-8766) or 951-782-4200.

LPA advised the facility, a new inspection process was conducted using the Compliance and Regulatory Enforcement (CARE) Tool, which aims to improve the quality and value of the inspection process. Facility will be sent a survey to the facility’s e-mail address and asked to please complete the survey and share their inspection experience. Any questions regarding the process or tools, may be sent by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection, its tools and methods, please visit the program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

See deficiency page (LIC 809d) for citation issued. Technical Violation advisory note (LIC 9102TV) was issued.

An exit interview was conducted, and report was reviewed with the facility representative Alejandra Bautista. A copy of this report, appeal rights, Children’s Record Review (LIC 857) and Staff Record Review (LIC 859) was provided to Alejandra Bautista.

A Notice of Site Visit was given to licensee and must remain posted for 30 days.
SUPERVISOR'S NAME: Stephanie HudakTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Lorena ValenzuelaTELEPHONE: (951) 233-9356
LICENSING EVALUATOR SIGNATURE:

DATE: 01/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2023
LIC809 (FAS) - (06/04)
Page: 5 of 5