334845139-2-13-2020-09-CC-DHOE-BLRQED-20200213110610

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334845139
Report Date: 02/13/2020
Date Signed: 02/13/2020 11:06:32 AM

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:	STAVNESS EARLY LEARNING		FACILITY NUMBER:	334845139
ADMINISTRATOR:	STAVNESS, MICHELLE		FACILITY TYPE:	850
ADDRESS:	35275 SINGLETON RD		TELEPHONE:	(909) 226-1048
CITY:	CALIMESA	STATE: CA	ZIP CODE:	92320
CAPACITY:	14	CENSUS: 2	DATE:	02/13/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	07:05 AM
MET WITH:	Licensee Michelle Stavness		TIME COMPLETED:	11:10 AM

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	On 02/13/2020 at 7:05am, Licensing Program Analysts (LPAs) Destinee Hogue, Blanca Ruiz-Silva and Elyse Jones arrived at the facility to conduct a comprehensive annual inspection as part of a compliance review. Licensee/Director Michelle Stavness (Licensee) has applied for a capacity increase from 14 to 36 day care children. LPAs toured the facility inside and outside, reviewed records and met with Licensee Michelle Stavness. Building #1 and Building #2 will be used for day care children. There are two classrooms (Classroom #1 & #2) located in Building #2 and one classroom in Building #1. Days and Hours of Operation are: Monday to Friday from 7:30am to 5:00pm. Building #1 measurements were previously taken and the following measurements were taken for Building #2: Preschool Indoor Activity Areas LPAs have determined that there is sufficient space to accommodate 36 children. Preschool Bathroom Fixtures Building #1) One toilet and one sink to accommodate 15 children Building #2) Two toilets and two sinks to accommodate 30 children There is sufficient toilets and sinks to accommodate 36 children. There is a staff bathroom that is separated from the preschool bathrooms. Preschool Outdoor Activity Area: LPAs have determined that there is sufficient space to accommodate 36 children.

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee Hogue	TELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2020

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 6

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: STAVNESS EARLY LEARNING	FACILITY NUMBER: 334845139
	VISIT DATE: 02/13/2020

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
26
27
28
29
30
31
32

· Playgrounds are enclosed by appropriate fences and free of hazards
· Outdoor activity areas are supplied with age and size appropriate equipment
· Food preparation area is clean, free of litter, rubbish, rodents and other vermin
· Food is stored appropriately and protected from contamination
· All storage containers for solid waste, including moveable bins have a tight-fitting cover that is kept on, and in good repair
· The areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with material that absorbs a fall. Outdoor cushioning is supplied with wood chips. A Technical Violation was issued and discussed with Licensee regarding outdoor cushioning.
· Sign in/Sign out record was reviewed and meets regulation requirements
· A Staff member is present with current Pediatric CPR/First Aid which expires 12/2021
· Opening and closing staff member’s CPR/First Aid expires 07/2020
· AB1207 Mandated Child Abuse Reporter Training completed 07/13/2018
· Documentation of emergency disaster drills on file. Last drill conducted on 01/15/2020
· All facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
· This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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.
· An exit interview was conducted and during the interview, Licensee confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.

The following was reviewed and discussed:
v SB 277 – Immunizations, Personal Beliefs Exemption, effective January 1, 2016 – DEFINITION OF SB277 CAN BE FOUND ON LIC809 (FACILITY EVALUATION REPORT) DATED 06/18/2019

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee Hogue	TELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2020

LIC809 (FAS) - (06/04)

Page: 3 of 6

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: STAVNESS EARLY LEARNING	FACILITY NUMBER: 334845139
	VISIT DATE: 02/13/2020

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
26
27
28
29
30
31
32

v AB290 – Child Nutrition, effective January 1, 2016 - DEFINITION OF AB290 CAN BE FOUND ON LIC809 (FACILITY EVALUATION REPORT) DATED 06/18/2019
v SB792 – Immunization requirements for staff, volunteers, effective September 1, 2016 - DEFINITION OF SB792 CAN BE FOUND ON LIC809 (FACILITY EVALUATION REPORT) DATED 06/18/2019
v AB2231 (2016) – Increased Civil Penalties, effective July 1, 2017 - DEFINITION OF AB2231 CAN BE FOUND ON LIC809 (FACILITY EVALUATION REPORT) DATED 06/18/2019
v AB 1207 – Mandated Child Abuse Reporting: Child Day Care Personnel Training, beginning January 1, 2018 - DEFINITION OF AB1207 CAN BE FOUND ON LIC809 (FACILITY EVALUATION REPORT) DATED 06/18/2019
v AB2370 – Lead Exposure, day care facilities, effective January 1, 2019 - DEFINITION OF AB2370 CAN BE FOUND ON LIC809 (FACILITY EVALUATION REPORT) DATED 06/18/2019
v AB605 – Child day care facilities, birth to school-age license; Effective January 1, 2021 DEFINITION OF AB605 CAN BE FOUND ON LIC809 (FACILITY EVALUATION REPORT) DATED 06/18/2019
v AB2960 – Child Care and development services, online portal – Effective June 20, 2022 - DEFINITION OF AB2960 CAN BE FOUND ON LIC809 (FACILITY EVALUATION REPORT) DATED 06/18/2019
v Receive Department of Social Services updates by subscribing to www.cdss.ca.gov. Click on “RECEIVE IMPORTANT UPDATES”, select Child Care Advocate Program and enter contact information.
v Duty Officer is available to answer questions Monday – Friday (8:00am-5:00pm) a (951)782-4200.

Before capacity increase is granted, the following items need to be corrected/completed in Building #2:
1) Cushioning under swings and high climbing play structures.
2) Electrical cords and outlet in Building #2 (Play Area) shall be made inaccessible.
3) Floor vents with wide blades shall be made inaccessible or covered (Building #2-Classroom #1, Classroom #2, Nap Room and Kitchen area).

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee Hogue	TELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2020

LIC809 (FAS) - (06/04)

Page: 4 of 6

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: STAVNESS EARLY LEARNING	FACILITY NUMBER: 334845139
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/13/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 02/27/2020 Section Cited	1 2 3 4 5 6 7	AB 1207–Mandated Child Abuse Reporting requires all licensed providers and employees of a licensed child day care facility to complete training as specified on their mandated reporter duties and to renew their online training certificate every two (2) years. This requirement was not met as evidenced by:
	8 9 10 11 12 13 14	Based on review of facility records, Licensee did not have proof of completed Mandated Child Abuse Reporting certificate available upon request. This poses a potential health, safety and personal rights risk to children in care.	8 9 10 11 12 13 14
Type B 03/13/2020 Section Cited	1 2 3 4 5 6 7	PERSONNEL REQUIREMENTS. (g) All personnel...shall be in good health and shall be physically and mentally capable of performing assigned tasks. (1)...health shall be verified by a health screening, including a test for tuberculosis, performed by...a physician not more than one year...or seven days after employment...
	8 9 10 11 12 13 14	This requirement was not met as evidenced by: Based on review of facility records, Licensee did not have a Health Screening (LIC503) for staff. This poses a potential health, safety, and personal rights risk to children in care.	8 9 10 11 12 13 14

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: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee Hogue	TELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2020

LIC809 (FAS) - (06/04)

Page: 6 of 6

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: STAVNESS EARLY LEARNING	FACILITY NUMBER: 334845139
	VISIT DATE: 02/13/2020

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
26
27
28
29
30
31
32

4) Lock for garden pit, water heater and water well shed shall be purchased and installed.
5) Sand pit on the side of the building #2 shall be covered, free from hazardous items or made inaccessible to children.
6) Water hose stored in outdoor play area shall be made inaccessible.
7) Type B deficiencies cited on LIC809D

BUILDING #2 CANNOT BE USED TO CARE FOR CHILDREN UNTIL CAPACITY INCREASE IS GRANTED. Deficiencies were cited during this inspection, see LIC 809D for cited deficiencies. Appeal rights were discussed and LPAs provided a copy of this report to Licensee.

Once all corrections have been made, with proof sent to the department, the application for a capacity increase will be submitted for approval with a maximum capacity of 36 day care children. As agreed, upon by the Licensee, all corrections are due within 30 days from today’s inspection. If not received within 30 days, the application may be withdrawn, and the license will remain at a capacity of 14 day care children.

A NOTICE OF SITE VISIT WAS ISSUED AND LPA VERIFIED THAT IT WAS POSTED IN A PROMINENT LOCATION AT THE FACILITY BEFORE LEAVING. THE LICENSEE UNDERSTANDS THAT IT MUST REMAIN POSTED FOR THE NEXT 30 DAYS.

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee Hogue	TELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2020

LIC809 (FAS) - (06/04)

Page: 5 of 6