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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 360904908
Report Date: 03/22/2022
Date Signed: 03/22/2022 01:49:19 PM


Document Has Been Signed on 03/22/2022 01:49 PM - 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551



FACILITY NAME:DEL ROSA CHRISTIAN PRE-SCHOOLFACILITY NUMBER:
360904908
ADMINISTRATOR:CRUZ, SILVIAFACILITY TYPE:
850
ADDRESS:1333 EAST 39TH STREETTELEPHONE:
(909) 886-0802
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92404
CAPACITY:75CENSUS: 17DATE:
03/22/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:38 AM
MET WITH:Administrator Silvia CruzTIME COMPLETED:
02:05 PM
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Licensing Program Analyst (LPA) Zirbes met with the Administrator Silvia Cruz for the purpose of conducting an unannounced required one year inspection. LPA toured and inspected the entire center, which consists of five classrooms, two children restrooms, teachers lounge, directors office, activity room, storage closets and outdoor play space. LPA observed a total of 12 preschool age children and five kindergarten children. The following staff were present: Director and three teachers. The facility operates from 6:30am until 6:00pm Monday through Friday. This program offers full and half day programs.
Indoor/Children’s Area:
Child care center is clean, safe, sanitary and in good repair; all outdoor and indoor passageways, stair ways, incline, ramps, open porches and other areas of potential hazard are kept free of obstruction; floors of all rooms have a surface that is safe and clean, cleaning compounds were inaccessible, poisons locked, furniture/equipment is good condition, free of flies, other insects, rodents; tables/chairs provided to meet children’s needs; all play equipment and materials used by children are age-appropriate, each child has an individual permanent or portable storage space (cubby, located in each classroom) for his/her clothing, personal belongings and or bedding. Trash cans for solid waste have tight fitting lids, drinking water is readily available indoors and outdoors. All materials and surfaces are toxic free. No fireplaces were present. There is a working carbon monoxide detector, smoke detector and Fire Extinguishers (2A10BC) located in each classroom and throughout the Center. The Center had working telephone service on the premises. If child becomes ill during the course of the day, the child remains in the directors office. The facility maintains a comfortable temperature at all times. LPA observed complete first aid supplies (thermometer, bandages, scissors, ect) located in each classroom and the kitchen. Sign in/out sheets were available and are completed each day. Each child has a individual cup in each classroom that is filled with water.

Report continued on page two
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:
DATE: 03/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/22/2022
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: DEL ROSA CHRISTIAN PRE-SCHOOL
FACILITY NUMBER: 360904908
VISIT DATE: 03/22/2022
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Report continued from page one
When the children are outside, they have access to their individual water cups. Smoking prohibited on the premises, daily inspection for illness is completed. LPA did not observe prohibited child care items at this time. Firearms/weapons are not allowed or stored on premises. There are no bodies of water on the premises. The Center provides morning and afternoon snack to the children. Meals are provided by the parents.
Napping
Mats are utilized for the napping. LPA and Director observed all the mats had tears or rips in the vinyl material. LPA observed tape placed over the tears/rips however the tape was also ripped on a few of the mats. Tears in the vinyl material prevents the mats from being wiped cleaned and being maintained in a safe condition. Based on LPAs observation the mats were not maintained in safe condition when the majority of the mats had more than one tear or rip in the vinyl material. This poses a potential risk to the children in care. Refer to LIC 809D. Based on LPAs conversation with the Director, the linens are individually stored so that each child's bedding is identifiable, and no child's used bedding comes into contact with other bedding.
Restrooms
There are two children's restrooms, one for the girls and one for the boys at the Center. The restrooms are located between the Director office and the teacher lounge. The girls restroom had two sinks and two toilets. The boys restroom, had one sink and two toilets. All restrooms areas were in safe and sanitary operating condition at the time of this inspection. The children's restrooms only deliver cold water. Per LPA's conversation with the Director, paper towels and soap are dispensed to the children individually when needed.
Outdoor
The Center has a large outdoor play area. The outdoor play area, had a shaded rest area with five tables, dramatic play houses, three swings, and a climbing structure with one slide. The cushioning material under the play structure and swings was sand. The large play structure and swings were securely anchored to the ground. LPA and Director observed the plastic material on one of the three swings had a 3 inch rip. In addition, approximately one foot from the exit of the slide there was a hole. The hole was approximately five inches long and two to three inches wide. This poses a potential risk to the children in care. Refer to LIC 809D. A fence surrounds the outdoor area that is at least 5 feet high. No bodies of water were observed.
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SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: DEL ROSA CHRISTIAN PRE-SCHOOL
FACILITY NUMBER: 360904908
VISIT DATE: 03/22/2022
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Health Related Services
A review of medication policy indicated that only prescription medication is administered and only with parent's written permission. Incidental Medical Services were discussed. At the time of this inspection, medications are being administered and stored on the premises. The medications are stored in on a high cabinet shelf in the kitchen. The medications were labeled with the children's names and prescription label. The parents permission slips and the log of when the medication was administered was in a binder stored near the medications. Refrigerated medications are stored in the refrigerator in the kitchen.

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

Staff/Personnel Records
LPA reviewed 10 child records and four staff files during this inspection. Records were complete and contained the required documentation.

Facility Records


LPA and Facility representative reviewed the LIC 311A Records To Be Maintained At The Facility. LPA observed a current roster, disaster drill log, current CPR/First Aid with expiration date of 03/19/2024 and current mandated reporter training.

Posting Requirements
Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
The following were observed posted as required: facility license, Personal Rights (LIC613A), Parent’s Rights Poster (PUB 393L), car seat law (PUB 269), emergency disaster plan, earthquake preparedness checklist. Report continued on page four
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022
LIC809 (FAS) - (06/04)
Page: 3 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: DEL ROSA CHRISTIAN PRE-SCHOOL
FACILITY NUMBER: 360904908
VISIT DATE: 03/22/2022
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Other: Electrical outlets are inaccessible, there are no recalled and or prohibited toys or sleep/play equipment observed on the premises. Window cords were inaccessible to children

Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, shall inspect the facility. The Director shall permit the Department to inspect the center, and to privately interview children or staff, to determine compliance with or to prevent violations of laws or regulations, also enter and inspect any place providing personal care, supervision and services at any time, with or without advance notice, to secure compliance with, or to prevent a violation.

Facility representative was advised of the requirement to report Unusual Incidents. Facility representative informed to utilize the Unusual Incident Report/Injury Report LIC624 when submitting the report to the department (email address on the website: www.unusualincidentreport@dss.ca.gov). A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of center. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above. The On-Duty Worker is available for questions at (661) 202-3318 Monday through Friday 8am-5pm.



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.

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.

Report continued on page five

SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022
LIC809 (FAS) - (06/04)
Page: 4 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: DEL ROSA CHRISTIAN PRE-SCHOOL
FACILITY NUMBER: 360904908
VISIT DATE: 03/22/2022
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Report continued from page four

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important license related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

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/inspection-process

The following deficiencies were observed during the inspection today:

LPA and Director observed all the mats had tears or rips in the vinyl material. Tears in the vinyl material prevents the mats from being completely wiped cleaned and being maintained in a safe condition. Based on LPAs observation the mats were not maintained in safe condition when the majority of the mats had more than one tear or rip in the vinyl material. This poses a potential risk to the children in care. Refer to LIC 809D



LPA and Director observed the plastic material on one of the three swings had a 3 inch rip. In addition, approximately one foot from the exit of the slide there was a hole in the slide. The hole was approximately five inches long and two to three inches wide. This poses a potential risk to the children in care.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative Silvia Cruz.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022
LIC809 (FAS) - (06/04)
Page: 5 of 7
Document Has Been Signed on 03/22/2022 01:49 PM - 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551


FACILITY NAME: DEL ROSA CHRISTIAN PRE-SCHOOL
FACILITY NUMBER: 360904908

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/22/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101239.1(b)(5)
Napping Equipment
(b) Floor mats used for napping shall be: (5) Maintained in a safe condition with no exposed foam.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interviews, the licensee did not comply with the section cited above when all mats used during nap time had more than one tear or hole in the vinyl material which prevents the mat from being cleaned thoroughly and being maintained in a safe condition which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/14/2022
Plan of Correction
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Per Director, mats will be ordered. Receipt will be submitted to CCL
Type B
Section Cited
CCR
101239(o)(1)
Fixtures, Furniture, Equipment and Supplies
(o) Playground equipment shall be securely anchored to the ground unless it is portable by design. (1) Equipment shall be maintained in a safe condition, free of sharp, loose or pointed parts.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA observation, the licensee did not comply with the section cited above in one of three swings had a three inch rip in the plastic seating material and one hole approximately fives inches in length and two to three inches in width was present on the bottom of slide approximately one foot from the exit. This poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/23/2022
Plan of Correction
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Per Director, the slide will be covered and made inaccessible to the children until a replacement part can be ordered. The swing was made inaccessible during this inspection and will be removed completely by 3/28/22. Director will send CCL a picture of the correction by the above date.

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: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:
DATE: 03/22/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/22/2022
LIC809 (FAS) - (06/04)
Page: 6 of 7