334843392-12-5-2022-10-CC-JSAZ-CLTL8W-20221205073235

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334843392
Report Date: 12/01/2022
Date Signed: 12/05/2022 07:32:58 AM

Document Has Been Signed on 12/05/2022 07:32 AM - 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:	LISA D. STINSON HOMEWORK CLUB		FACILITY NUMBER:	334843392
ADMINISTRATOR:	DORA HAMLETT		FACILITY TYPE:	840
ADDRESS:	77530 ENFIELD LANE-G2		TELEPHONE:	(760) 285-1765
CITY:	PALM DESERT	STATE: CA	ZIP CODE:	92211
CAPACITY:	56	CENSUS: 51	DATE:	12/01/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:05 PM
MET WITH:	Dora Hamlett		TIME COMPLETED:	04:55 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), Jeanette Sanchez conducted an annual inspection as part of a compliance review. This is not a combination center. A tour of the inside and outside of the facility was granted and the following was observed and/or noted: · The following were 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 · Classrooms are 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 Dora Hamlett · 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. · Drinking water is provided in the indoor activity space via drinking fountain and personal water bottles. Outdoor activity space utilizes personal water bottles. · Medications are stored where inaccessible to children, · Hazardous items are stored where inaccessible to children which include: Disinfectants, cleaning solutions and other items that are dangerous · Poisons and toxins are locked

SUPERVISOR'S NAME: Stephanie Hudak	TELEPHONE: (951) 320-2021
LICENSING EVALUATOR NAME: Jeanette Sanchez	TELEPHONE: (951) 255-4577
LICENSING EVALUATOR SIGNATURE:	DATE: 11/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2022

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: LISA D. STINSON HOMEWORK CLUB	FACILITY NUMBER: 334843392
	VISIT DATE: 12/01/2022

NARRATIVE

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·All floors are clean and safe
· Bathrooms were observed to be safe, sanitary and in operating condition
· Waiver in place for use of nearby park
· Food preparation area is clean, free of litter and rubbish and free of rodents and other vermin
· Food is stored appropriately and protected from contamination
· Sign in/Sign out record was reviewed and meets regulation requirements
· Disaster drills are conducted at least every six months – last drill conducted on 8/16/22

A review of staff and children's records were conducted as part of this evaluation.
· Children’s records were found to be complete during this inspection.
· A Staff member is present with current Pediatric CPR/First Aid which expires on 12/29/22
· Opening and closing staff member’s CPR/First Aid expires on 10/19/24
· Director completed Health and Safety Training
· A review of staff records indicates that all staff present meet minimum qualifications for the position for which they were hired.
· A review of staff records on 11/29/22 indicates that not all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

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

The following items were discussed with the Licensee/Director 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.
· 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 their reporting requirements and provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO10@dss.ca.gov

SUPERVISOR'S NAME: Stephanie Hudak	TELEPHONE: (951) 320-2021
LICENSING EVALUATOR NAME: Jeanette Sanchez	TELEPHONE: (951) 255-4577
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2022

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: LISA D. STINSON HOMEWORK CLUB	FACILITY NUMBER: 334843392
	VISIT DATE: 12/01/2022

NARRATIVE

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·The Licensee can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations858@dss.ca.gov or register with Guardian

Facility representative was reminded that all adults 18 and over, 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 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.

On-line Licensing forms & regulations for a Child Care Center can be obtained on the Department’s website: www.ccld.ca.gov. Additionally, there is a link to “Receive Important Updates” located on the right side of the page, immediately above Quick Links. One can add their email address and choose which program(s) they wish to receive Provider Information Notices (PIN) for.

The Duty Officer is available to answer questions Monday – Friday; 8:00am to 5:00pm at:
1-844-LET-US-NO (1-844-538-8766) and/or 951-782-4200

If a civil penalty has been assessed during this inspection, payment is due when billed and the check(s) or money orders shall be made payable to the “California Department of Social Services”. You will receive an invoice in the mail. Do not send money until you receive your invoice. Do not send cash.

See LIC809-D for cited deficiencies

SUPERVISOR'S NAME: Stephanie Hudak	TELEPHONE: (951) 320-2021
LICENSING EVALUATOR NAME: Jeanette Sanchez	TELEPHONE: (951) 255-4577
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2022

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: LISA D. STINSON HOMEWORK CLUB	FACILITY NUMBER: 334843392
	VISIT DATE: 12/01/2022

NARRATIVE

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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.

An exit interview was conducted, and this report was reviewed with the facility representative Dora Hamlett. Appeal rights were discussed during the exit interview. Report and appeal rights to be emailed due to technical issues.

A notice of site visit will be emailed due to technical issues. It must remain posted for 30 days.

SUPERVISOR'S NAME: Stephanie Hudak	TELEPHONE: (951) 320-2021
LICENSING EVALUATOR NAME: Jeanette Sanchez	TELEPHONE: (951) 255-4577
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 12/05/2022 07:32 AM - 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: LISA D. STINSON HOMEWORK CLUB	FACILITY NUMBER: 334843392
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/01/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

101170(e)(1)

Criminal Record Clearance

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department or This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 1 out of 5 records, which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 12/02/2022
	Plan of Correction
1 2 3 4	Licensee will ensure staff does not work on premises until fingerprint cleared. Will send staff for reprinting tomorrow.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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 Hudak	TELEPHONE: (951) 320-2021
LICENSING EVALUATOR NAME: Jeanette Sanchez	TELEPHONE: (951) 255-4577
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2022

LIC809 (FAS) - (06/04)

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