334819449-2-23-2021-09-CC-SRON-BYJ2XZ-20210223164757

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334819449
Report Date: 02/23/2021
Date Signed: 02/23/2021 04:48:40 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:	GROVE COMMUNITY CHURCH PRESCHOOL		FACILITY NUMBER:	334819449
ADMINISTRATOR:	CATHY HARMON		FACILITY TYPE:	850
ADDRESS:	19900 GROVE COMMUNITY DRIVE		TELEPHONE:	(951) 571-9080
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92508
CAPACITY:	192	CENSUS: 50	DATE:	02/23/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Cathy Harmon, Director		TIME COMPLETED:	03:30 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	February 23, 2021 Due to COVID-19, Licensing Program Analyst (LPA) Sharleen Robinson conducted a Licensee initiated Case Management Tele-inspection with Director Cathy Harmon. LPA met with the Director via FaceTime. The facility has requested to increase the capacity from 192 to 210. The facility has also requested to add rooms #A5 and room #A6 and two additional toilets and two additional sinks. A waiver has also been requested for scheduled rotated playground(s) use. Fire clearance received 2/23/21. COVID-19 technical assistance provided during the inspection. Measurements for additional rooms are as follows: Measurements for room #A5: 21.6 x 24= 518.4 - 11.6 =506.8/ 35= 14 children Measurements for room #A6: 22.2 x 24= 532.8 -11.6= 521.2/35= 14 children - 11.6 (encumbered space) built in cabinets Room #A5 - 11.6 (encumbered space) built in cabinets Room #A6 The facility has added 2 additional bathrooms 2 additional toilets x 15= 30 2 additional sinks x 15= 30 *Total facility toilets and sinks including the additions 14 toilets X 15= 210 14 sinks X 15= 210 Playgrounds previously measured as follows: Playground 1 3720 sq. ft divided by 75 = 49 children Playground 2 8004.64 sq. ft. divided by 75 = 106 children

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Sharleen Robinson	TELEPHONE: (951) 233-7183
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2021

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: GROVE COMMUNITY CHURCH PRESCHOOL	FACILITY NUMBER: 334819449
	VISIT DATE: 02/23/2021

NARRATIVE

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* Previous facility measurements on file for the entire facility.
The facility is operating within the terms of the license during the inspection
· Ratios/Cohorts were met during this inspection
· 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
· All floors shall be kept clean and safe
· 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.
· Hazards are stored where inaccessible to children which includes: disinfectants, cleaning solutions and other items that are dangerous to children
· Poisons and toxins are locked
· 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 clean, free of litter, rubbish and free of rodents and other vermin
· 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.
· Uncontaminated drinking water is readily available both indoors and out
· The areas around or under high climbing equipment, swings, slides, and similar equipment shall be cushioned with material that absorbs a fall
· Menus are posted at least one week in advance and kept on file for 30 days
· There is a properly rated Fire extinguisher, smoke detector and carbon monoxide detector in good working order
· A Staff member is present with current Pediatric CPR/First Aid which expires on 5/21
· Opening and closing staff member’s CPR/First Aid expires on 5/21
· Director completed Health and Safety Training
· The Director was informed of their reporting requirements and is provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO09@dss.ca.gov, and UnusualIncidentReportsDO10@dss.ca.gov

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Sharleen Robinson	TELEPHONE: (951) 233-7183
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2021

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: GROVE COMMUNITY CHURCH PRESCHOOL	FACILITY NUMBER: 334819449
	VISIT DATE: 02/23/2021

NARRATIVE

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· A review of staff records on 2/23/21 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
The Licensee can submit transfer forms to associate new individuals or to disassociate someone from your facility at:
Associations_Disassociations862@dss.ca.gov
Associations_Disassociations858@dss.ca.gov
· Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided an updated Plan of Operation that includes IMS must be submitted to the Department. 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-Risk-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
v Access to forms & Regulations for a Child Care Center are online at www.ccld.ca.gov.
v Please email the child care advocates 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
v The Duty Officer is available to answer questions Monday – Friday at 1-844-LET-US-NO (1-844-538-8766).

Prior to capacity increase, and usage of rooms #A5 and #A6 and outdoor play areas the following is required:

Obtain a approved waiver for usage of the playgrounds on a rotational bases

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Sharleen Robinson	TELEPHONE: (951) 233-7183
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2021

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: GROVE COMMUNITY CHURCH PRESCHOOL	FACILITY NUMBER: 334819449
	VISIT DATE: 02/23/2021

NARRATIVE

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

An exit interview was conducted via FaceTime, LPA Robinson provided the director with a copy of this report and Notice of Site Visit via email, LPA Asked the director to acknowledge receipt of the email. An electronic “read receipt” was also attached. The electronic read receipt of the emailed report acknowledges receipt of this report. A copy of this report was emailed to director during this Tele-inspection on February 23, 2021.

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Sharleen Robinson	TELEPHONE: (951) 233-7183
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2021

LIC809 (FAS) - (06/04)

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