334845704-10-15-2021-09-CC-JGIE-C7TQ3E-20211015114838

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334845704
Report Date: 10/15/2021
Date Signed: 10/15/2021 11:48:53 AM

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:	JUSD SKY COUNTRY ELEMENTARY PRESCHOOL		FACILITY NUMBER:	334845704
ADMINISTRATOR:	BROOKS, KATRINA		FACILITY TYPE:	850
ADDRESS:	5520 LUCRETIA AVENUE		TELEPHONE:	(951) 222-7850
CITY:	JURUPA VALLEY	STATE: CA	ZIP CODE:	91752
CAPACITY:	24	CENSUS: 14	DATE:	10/15/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Katrina Brooks		TIME COMPLETED:	12:10 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	On 10/15/2021 at 9:30am Licensing Program Analyst (LPA) Justin Giese arrived at the facility to conduct a 1 year required annual inspection. LPA was granted entry by Director Katrina Brooks. LPA toured the facility, inside and out, reviewed records, and observed and/or discussed the following: Normal days and hours of operation are: Monday- Friday, 7am- 11am and 12pm-3pm (room 26/27) A review of the staff records and review of a sampling of children's records were conducted as part of this evaluation. The inspection consisted of reviews of the following domains: • Food Service • Reporting Requirements • Physical Plant • Care and Supervision • Children Records • Staff Records • Staffing Ratio and Capacity • Personal Rights The inspection found the facility to be in compliance in these domains: No deficiencies cited The licensee is asked to update the following documents, if applicable, and submit to licensing within 30 days:

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Justin Giese	TELEPHONE: (951) 204-4847
LICENSING EVALUATOR SIGNATURE:	DATE: 10/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2021

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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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: JUSD SKY COUNTRY ELEMENTARY PRESCHOOL	FACILITY NUMBER: 334845704
	VISIT DATE: 10/15/2021

NARRATIVE

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1. LIC 500 Personnel Report
2. LIC 610 Emergency & Disaster Plan
3.Parent Handbook/ Program Curriculum/Admission policies and procedures/ fee schedule (only if changes have been made)
4. LIC 309 Administrative Organization
5. LIC 308 Designation of Administrative Responsibility

• 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 within the terms of the license
• Ratios were met during this inspection
• Appropriate supervision was provided during this inspection
• Classrooms are equipped with age appropriate furniture and equipment in good condition
• Classrooms are clean and free of hazards
• No weapons stored at the facility
• 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.
• Medications are stored where inaccessible to children
• 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 shall be 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

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Justin Giese	TELEPHONE: (951) 204-4847
LICENSING EVALUATOR SIGNATURE:	DATE: 10/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2021

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: JUSD SKY COUNTRY ELEMENTARY PRESCHOOL	FACILITY NUMBER: 334845704
	VISIT DATE: 10/15/2021

NARRATIVE

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Food preparation area is clean, free of litter, rubbish and free of rodents and other vermin
• Measures are taken to keep the facility free of flies, other insects and rodents
• Food is stored appropriately and protected from contamination
• All storage containers for solid waste, including moveable bins-have tight-fitting covers and in good repair
• 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
• Uncontaminated drinking water shall be readily available both indoors and out and provided by Public water supply
• The areas around or under high climbing equipment, swings, slides, and similar equipment shall be cushioned with material that absorbs a fall: Facility rubber foam and grass
• Sign in/Sign out record was reviewed and meets regulation requirements
• A Staff member is present with current Pediatric CPR/First Aid which expires on 04/2023
• Opening and closing staff member’s CPR/First Aid expires on 04/23
• Director completed Health and Safety Training and on file
• Staff qualifications were reviewed – health screening is on file and all staff meet educational requirements and health requirements for performing assigned tasks
• Staff have received on the job training for house keeping, sanitation and universal health precautions
Licensee was informed of the Department has inspection authority per Health and Safety Codes sections: 1596.852, 1596.853 and 1596.8535.
Licensee was informed of Unusual Incident Reporting email UnusualIncidentReportsDO09@dss.ca.gov
• Required records for children shall ensure that each child’s record contain a medical assessment and contain the Identification and Emergency Information
• Documentation of fire & earthquake drills to be conducted every six months: Last drill on 10/12/2021

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Justin Giese	TELEPHONE: (951) 204-4847
LICENSING EVALUATOR SIGNATURE:	DATE: 10/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2021

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: JUSD SKY COUNTRY ELEMENTARY PRESCHOOL	FACILITY NUMBER: 334845704
	VISIT DATE: 10/15/2021

NARRATIVE

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· AB2370 – Lead Exposure, day care facilities, effective January 1, 2019 –
The bill requires that all Child Care Centers, operating in a building constructed before January 1, 2010, shall have their drinking water tested for excessive lead levels, on or after January 1, 2020, but no later than January 1, 2023. Child Care Centers must thereafter test their drinking water every five years after the date of the initial test.

· AB605 – Child day care facilities, birth to school-age license; Effective January 1, 2021

· AB2960 – Child care and development services, online portal – Effective June 20, 2022 - This bill requires the State Superintendent of Public Instruction (SSPI), within the California Department of Education (CDE), to develop and post on CDE's website a comprehensive child care and development services online portal for families and providers by June 30, 2022.

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 For CCCs: Incidental Medical Services (IMS) policy was discussed

Facility representative was reminded that all adults 18 and over living or working in the home, 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 licensed 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.

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Justin Giese	TELEPHONE: (951) 204-4847
LICENSING EVALUATOR SIGNATURE:	DATE: 10/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2021

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: JUSD SKY COUNTRY ELEMENTARY PRESCHOOL	FACILITY NUMBER: 334845704
	VISIT DATE: 10/15/2021

NARRATIVE

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LPA discussed the safe sleep regulations with Facility representative and discussed the Child Care Licensing Safe Sleep webpage at:
https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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.

Exit interview conducted and report was reviewed with the Facility representative, Katrina Brooks.

A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Justin Giese	TELEPHONE: (951) 204-4847
LICENSING EVALUATOR SIGNATURE:	DATE: 10/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2021

LIC809 (FAS) - (06/04)

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