334820096-2-28-2020-09-CC-KLEG-BM8VZU-20200228155319

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334820096
Report Date: 02/28/2020
Date Signed: 02/28/2020 03:53:27 PM

COMPREHENSIVE INSPECTION

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:	MELODY LANE CHILDREN'S CENTER		FACILITY NUMBER:	334820096
ADMINISTRATOR:	JULIE BACA		FACILITY TYPE:	840
ADDRESS:	9191 COLORADO AVENUE		TELEPHONE:	(951) 352-2161
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92503
CAPACITY:	17	CENSUS: 11	DATE:	02/28/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:08 AM
MET WITH:	Janice Randolph, Julie Baca		TIME COMPLETED:	04:10 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	Licensing Program Analyst (LPA) Kim Leung conducted an annual/random inspection as part of a compliance review. A tour of the inside and outside of the facility was granted and the following was observed and/or noted: This is a combination center and the other licensed programs are: Preschool (334819985) and Infant (334820095) which were also inspected on this date A review of a sampling of the staff records and children's records were conducted as part of this evaluation. · The licensee/Director is asked to update the following documents, if applicable, and submit to licensing within 30 days: 1. LIC 500 Personnel Report 2. Parent Handbook/ Program Curriculum/Admission policies and procedures/ fee schedule (only if changes have been made) · 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 with the limits as stated on the license. · Ratios are being met during this inspection. · Classroom is adequately equipped with age and size appropriate furniture and equipment and free of hazards. · There are no weapons present at the facility as stated by director Julie Baca

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Kim Leung	TELEPHONE: (951) 529-4713
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2020

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: MELODY LANE CHILDREN'S CENTER	FACILITY NUMBER: 334820096
	VISIT DATE: 02/28/2020

NARRATIVE

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· There are no accessible bodies of water present. The baptismal pool is located in the sanctuary behind the wall and both entry doors leading directly to the baptismal pool were key-locked at time of the inspection. LPA observed from the opening that the baptismal was not filled with water at the time. Per director, the baptismal is only filled when being used. Director stated that she understood that all wading pools or similar product must be emptied immediately after use and stored in an upright position when not in use.
· Drinking water indoor and outdoor is provided by use of igloo, disposable cups and drinking fountain
· No medication is stored for children at this time as stated by director
· Hazards are stored where inaccessible to children which include: Disinfectants, cleaning solutions 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
· Playgrounds are enclosed by appropriate fences and free of hazards
· Outdoor activity areas are supplied with age and size appropriate equipment in good condition
· Kitchen 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 have tight-fitting covers that are kept on, and in good repair
Menus for the current month February 2020 and March 2020 are posted
· The areas around or under high climbing equipment do not have sufficient cushioning material to absorb falls. LPA observed a thin layer of rubber barks and wood chips with dirt exposing at the fall zones of the climbers.
· Sign in/Sign out record was reviewed and meets regulation requirements
· A Staff member is present with current Pediatric CPR/First Aid which expires in January 2022
· Opening and closing staff member’s CPR/First Aid expires in January 2022 (Teresa Cox who opens and director Julie Baca who closes)
· A review of children’s records was conducted
· Documentation of fire & earthquake drills was reviewed. Last drill was conducted on 2/13/2020 per drill log
· A review of staff records on 2/28/2020 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
· A review of staff records indicates that all staff present meet minimum qualifications for the position for which they were hired.

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Kim Leung	TELEPHONE: (951) 529-4713
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2020

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: MELODY LANE CHILDREN'S CENTER	FACILITY NUMBER: 334820096
	VISIT DATE: 02/28/2020

NARRATIVE

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· The licensee/Director was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809 or LIC9099) must be posted for 30 days.
· Facility is not currently providing IMS 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
v Access to forms & Regulations for a Child Care Center are online at www.ccld.ca.gov.
v Go to the licensing webpage www.ccld.ca.gov, 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 updates for.
v The Duty Officer is available to answer questions Monday – Friday at 1-844-LET-US-NO (1-844-538-8766).

Updated information is provided to the licensee/director on Facility Evaluation Report issued to the infant program, facility #334820095, this dated on 2/28/2020.

A NOTICE OF SITE VISIT WAS ISSUED AND IS TO BE POSTED IN A PROMINENT LOCATION AT THE FACILITY FOR THE NEXT 30 DAYS.

See LIC809D for cited deficiency.

Appeal rights discussed and a copy of this report was provided to the licensee/Director on this date.
A copy of this report must be made available to the public upon request for the next 3 years.

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Kim Leung	TELEPHONE: (951) 529-4713
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2020

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: MELODY LANE CHILDREN'S CENTER	FACILITY NUMBER: 334820096
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/28/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 03/06/2020 Section Cited	1 2 3 4 5 6 7	Outdoor Activity Space. As a condition of licensure, the areas around and under high climbing equipment, swings, slides and other similar equipment shall be cushioned with material that absorbs falls. This requirement was not met as evidenced by: The areas around or under high climbing equipment do
	8 9 10 11 12 13 14	not have sufficient cushioning material to absorb falls. LPA observed a thin layer of rubber barks and wood chips with dirt exposing at the fall zones of the climbers. That presents potential risks to the children's safety.	8 9 10 11 12 13 14
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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: Aaron Ross	TELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Kim Leung	TELEPHONE: (951) 529-4713
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2020

LIC809 (FAS) - (06/04)

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