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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334845630
Report Date: 07/24/2019
Date Signed: 07/24/2019 03:29:44 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:MARIPOSA PARENT CHILD WORKSHOPFACILITY NUMBER:
334845630
ADMINISTRATOR:WHITLOW,JOANNE BOLESFACILITY TYPE:
840
ADDRESS:47192 MONROE STTELEPHONE:
(805) 570-3725
CITY:INDIOSTATE: CAZIP CODE:
92201
CAPACITY:14CENSUS: DATE:
07/24/2019
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Joanne Boles Whitlow, Maria LaraTIME COMPLETED:
03:45 PM
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Licensing Program Analysts (LPAs), Blanca Ruiz-Silva and Kim Leung conducted a prelicensing evaluation at this proposed school age day care center this date on 7/24/2019. Applicant is running a preschool program at this location, facility #334845132. LPAs met with Director, Joanne Boles Whitlow and Site Director Maria Lara during the inspection. Applicant has requested to operate the school-age program in Classrooms A and B. During inspection, LPAs toured the facility, took census and review records. Present during the inspection, LPAs toured the proposed facility indoor and outdoor. Measurements were taken. It was determined that there is sufficient indoor activity space to accommodate the requested capacity of 14 children.

Classrooms A and B have not been furnished at this time. Applicant agreed to fully furnish the rooms with sufficient age-appropriate and safe furniture, equipment and supplies. Drinking water would be provided by use of igloo, cups and water bottles.

Currently, Classroom B is licensed to the preschool program. Applicant would submit a written request for waiver for shared use of Classroom B between the preschool and school-age programs on an alternate schedule.

There is a restroom in Classroom A with one toilet and one sink. There is an additional sink in Classroom B.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Blanca Ruiz-SilvaTELEPHONE: (951) 233-5594
LICENSING EVALUATOR SIGNATURE:

DATE: 07/24/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2019
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: MARIPOSA PARENT CHILD WORKSHOP
FACILITY NUMBER: 334845630
VISIT DATE: 07/24/2019
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The following items need to be completed/corrected prior to a license being issued:
1. Waiver to allow shared use of the playground between the preschool program and school-age program on alternate schedule.
2. Waiver to allow shared use of Classroom A&B between the preschool-age program and school-age program on alternate schedule.
3. Fully furnish the activity rooms with sufficient furniture, equipment and supplies.
4. Place a sign at the restroom door specifying it is for exclusive use by school-age children.

Once all corrections have been made, with proof sent to licensing, the application will be submitted for approval with a maximum capacity of 14 children, ages 5 to 12 years of age. Days and hours of operation: Monday through Friday, 1:00 p.m. to 5:30 p.m. when local schools are in session 8:00 a.m. to 5:30 p.m. when local schools are on summer break. As agreed upon by the applicant, all corrections are due within 30 days. If not received within 30 days from the date of this report, the application will be denied. An exit interview was conducted and a copy of this report was provided to the applicant on this date.

A copy of this report must be made available to the public for 3 years.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Blanca Ruiz-SilvaTELEPHONE: (951) 233-5594
LICENSING EVALUATOR SIGNATURE:

DATE: 07/24/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2019
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: MARIPOSA PARENT CHILD WORKSHOP
FACILITY NUMBER: 334845630
VISIT DATE: 07/24/2019
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AB2231 (2016) – Increased Civil Penalties, effective July 1, 2017 – For failing to correct a violation the civil penalty is increased to $100 per day for EACH violation until corrected; For failing to correct a repeated violation the civil penalty is increased to $250 immediately assessed , and $100 per day afterwards for EACH repeated violation until corrected; For a Zero Tolerance violation the civil penalty is increased to $500 immediately assess, and $100 per day for EACH violation after that until corrected; For any repeated Zero Tolerance violation the civil penalty is increased to $1,000 immediately assess, and $100 per day afterwards for EACH repeated violation until corrected.
NOTE: Repeat violations are defined as a violation of a previously cited statutory or regulatory Section and/or subsection within 12 months prior.

Effective January 1, 2017 – Children under 2 years of age shall ride in a rear-facing car seat unless the child weighs 40 or more pounds OR is 40 or more inches tall. For additional information regarding car seat laws see www.chp.ca.gov
Access to forms & Regulations for a Child Care Center are online at www.ccld.ca.gov.
Please subscribe at www.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

The Duty Officer is available to answer questions Monday – Friday at 1-844-LET-US-NO (1-844-538-8766).
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Blanca Ruiz-SilvaTELEPHONE: (951) 233-5594
LICENSING EVALUATOR SIGNATURE:

DATE: 07/24/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2019
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: MARIPOSA PARENT CHILD WORKSHOP
FACILITY NUMBER: 334845630
VISIT DATE: 07/24/2019
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Applicant would submit written request for waiver for shared use of the preschool playground by school-age on an alternate schedule. It was determined that the playground could accommodate the requested capacity of 14 children. Balls, jumping ropes would be provided to the children for outdoor activities.

Limiting factor for school-age capacity is fire clearance. School-age capacity is limited to 14 per applicant's request .

New Fire Clearance requested on 05/29/19 and granted on 06/04/2019 for capacity of 14 children. The days and hours of operation are: Monday to Friday 7:30 a.m.-5:30 p.m., for school age children ages ( all year).

This facility plans to provide Incidental Medical Services – IMS. Written plan of operation including IMS is on file. 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.

The following was also reviewed and discussed:
AB 2621 – Public Information effective January 1, 2015 – The Department shall post licensing reports for Child Care Facilities on it’s internet Web site. This information is to be updated at least monthly on the website and will span the preceding five-year period.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Blanca Ruiz-SilvaTELEPHONE: (951) 233-5594
LICENSING EVALUATOR SIGNATURE:

DATE: 07/24/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2019
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: MARIPOSA PARENT CHILD WORKSHOP
FACILITY NUMBER: 334845630
VISIT DATE: 07/24/2019
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AB 2236 – Civil Penalties, effective July 1, 2015 – Enacts new civil penalties in cases where the Department determines that a violation of licensing standards resulted in the death or serious injury, or constitutes physical abuse of a child in care. The bill establishes an appeal procedure specific to these civil penalties. The bill also expands the scope of the Child Health and Safety Fund in order to assist parents in securing alternative child care when a Child Care Center license has been suspended or revoked. These civil penalty amounts are scaled in relation to the total capacity of all of the licensee’s facilities and not just the specific facility cited or limited to that facility type.
AB 2386 – Carbon Monoxide Detector Regulations, effective January 1, 2015 – In accordance with California Health and Safety Code Section 1975.543 - Every child care center shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections
SB 277 – Immunizations, Personal Beliefs Exemption, effective January 1, 2016 - it eliminates the exemption from existing specified immunization requirements based upon personal beliefs, and only allows an exemption from future immunization requirements deemed appropriate by the State Department of Public Health or a medical professional for medical reasons.
AB290 – Child Nutrition, effective January 1, 2016 - In accordance with California Health and Safety Code Section 1596.866 - each child care center shall have at least one person employed who was completed one hour of childhood nutrition training as part of the preventive health practices course or courses.
SB792 – Immunization requirements for staff, volunteers, effective September 1, 2016 – In accordance with California Health and Safety Code Section 1596.7995(a)(1) - Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. If employees/volunteers are receiving the influenza vaccination they must do so between August 1 and December 1 of each year.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Blanca Ruiz-SilvaTELEPHONE: (951) 233-5594
LICENSING EVALUATOR SIGNATURE:

DATE: 07/24/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2019
LIC809 (FAS) - (06/04)
Page: 3 of 5