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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 360910509
Report Date: 12/10/2019
Date Signed: 12/10/2019 01:02:26 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:CHILDTIME CHILDREN'S CENTERFACILITY NUMBER:
360910509
ADMINISTRATOR:TONI GAVELLFACILITY TYPE:
830
ADDRESS:3656 RIVERSIDE DR.TELEPHONE:
(909) 591-9169
CITY:CHINOSTATE: CAZIP CODE:
91710
CAPACITY:32CENSUS: 18DATE:
12/10/2019
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:05 AM
MET WITH:Toni GavellTIME COMPLETED:
01:15 PM
NARRATIVE
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On December 10, 2019, Licensing Program Analysts (LPAs) Blanca Ruiz-Silva and Samuel Lopez arrived at the facility to conduct a Case Management inspection for a separate purpose. LPA Lopez toured the facility and took a census. During the process the following was observed and noted:

While obtaining a census, LPA Lopez observed Staff#1 providing care and supervision in the infant room. However, no file was available for review and Staff#1 had not been associated to the facility. Further review revealed that staff is associated Child Time Children's Center/-Corporation in Northern, CA but, not at the current location.

Based on all the information obtained and stated above, the following violation was identified: Criminal Record Clearance.

During today's visit, LPA spoke with Director Toni Gavell to discuss the reason for the visit and future plans of corrections associated with the deficiency stated above.

See LIC809D for cited deficiencies of the California Code of Regulations, Title 22, Div. 12.

The Notice of Site Visit must be posted for 30 days. Failure to keep these posted for the entire 30 days will result in an immediate $100 civil penalty for each.



An exit interview was conducted, appeal rights discussed, and a copy of this report was provided to facility staff.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Blanca Ruiz-SilvaTELEPHONE: (951) 233-5594
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2019
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: CHILDTIME CHILDREN'S CENTER
FACILITY NUMBER: 360910509
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/10/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/13/2019
Section Cited

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(2) Request a transfer of a criminal record clearance as specified in Section 101170(f)
This requirement was not being met as evidenced by:
Upon arrival to the facility LPA Lopez observed Staff#1 providing care and supervision in the infant room but staff was not associated to the facility.
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It was determined that the staff had a Criminal Record Clearance and associated to a Childtime facility in Roseville, California. This poses a potential risk to the Health and Safety of the children in care.
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During this inspection, director submitted
All pertinent documents to licensing via fax and confirmation was obtained.

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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: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Blanca Ruiz-SilvaTELEPHONE: (951) 233-5594
LICENSING EVALUATOR SIGNATURE:
DATE: 12/10/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/10/2019
LIC809 (FAS) - (06/04)
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