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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334843983
Report Date: 02/11/2021
Date Signed: 02/11/2021 04:38:18 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 STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:STEPPING STONES PRESCHOOL AND CHILD CARE LLCFACILITY NUMBER:
334843983
ADMINISTRATOR:BRITTANY WALKERFACILITY TYPE:
850
ADDRESS:16527 LAKESHORE DRIVETELEPHONE:
(951) 674-5520
CITY:LAKE ELSINORESTATE: CAZIP CODE:
92530
CAPACITY:85CENSUS: 28DATE:
02/11/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Desiree AndrewsTIME COMPLETED:
03:15 PM
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Licensing Program analyst (LPA) Joanne Domingo made an unannounced phone call to Director, Desiree Andrews for the purpose of conducting a follow-up Tele-Visit regarding an Unusual Incident reported on 2/02/21. The tele-visit was conducted via Face-Time video app. On 1/28/21, during outside play, a staff member who was standing next to the play structure had observed a child climb up the chain ladder of a play structure. The child missed stepped the second row of the chain ladder which caused the child to lean forward and bump their forehead on the landing of the structure. The child sustained a cut on the middle of their forehead. First aid was rendered and parent was notified. The parent sought professional medical attention and glue was applied to the cut. The child returned the next day.

Based on the information obtained for this incident, there is no indication that a violation of Title 22 Regulations occurred.

Due to COVID-19 State of Emergency, this report was completed via Tele-Inspections Report Delivery Instructions. Licensee’s signature will be obtained via email. Licensee will receive a copy of this report via email. A NOTICE OF SITE VISIT WAS NOT LEFT AT THE FACILITY DUE TO THIS BEING A TELE-VISIT INSPECTION.

This report must be made available to the public upon request for the next 3 (three) years.
SUPERVISOR'S NAME: Telma SandovalTELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Joanne DomingoTELEPHONE: (951) 233-9356
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2021
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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