364806342-9-14-2022-09-CC-RZEN-CJ9PKF-20220914112305

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364806342
Report Date: 09/14/2022
Date Signed: 09/14/2022 03:14:15 PM

Document Has Been Signed on 09/14/2022 03:14 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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	SBCSS MARSHALL STATE PRESCHOOL		FACILITY NUMBER:	364806342
ADMINISTRATOR:	ROSIO GONZLAEZ		FACILITY TYPE:	850
ADDRESS:	12045 TELEPHONE AVENUE, RM. 33		TELEPHONE:	(909) 627-9741
CITY:	CHINO	STATE: CA	ZIP CODE:	91710
CAPACITY:	21	CENSUS: 14	DATE:	09/14/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Rosio Gonzalez		TIME COMPLETED:	11:45 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	Licensing Program Analyst (LPA), Rachel Zeron conducted an annual inspection as part of a compliance review. A tour of the inside and outside of the facility was granted and the following was observed and/or noted: · The following items were posted and 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 limits as stated on the license. · Ratios are being met during this inspection · Classrooms are adequately equipped with age and size appropriate furniture and equipment and free of hazards · There are no weapons present at the facility as stated by the Site Supervisor · 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. · Drinking water is provided in the indoor and outdoor activity space by filter water and water bottles brought by children · Hazardous items are stored where inaccessible to children which include: Disinfectants, cleaning solutions and other items that are dangerous · Poisons and toxins are locked and inaccessible to children · All floors were observed to be clean and safe · Bathrooms were observed to be safe, sanitary and in operating condition

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951)320-2023
LICENSING EVALUATOR NAME: Rachel Zeron	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2022

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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: SBCSS MARSHALL STATE PRESCHOOL	FACILITY NUMBER: 364806342
	VISIT DATE: 09/14/2022

NARRATIVE

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· Playgrounds are enclosed by appropriate fences and free of hazards
· Outdoor activity areas are supplied with age and size appropriate equipment in good condition
· All storage containers for solid waste were observed to have tight-fitting covers that are kept on, and in good repair
· Sign in/Sign out record was reviewed and meets regulation requirements
· Disaster drills are conducted at least every six months – last drill conducted on 08/26/2022

A review of staff and children's records were conducted as part of this evaluation.
· Children’s records were found to be complete during this inspection.
· Staff records review indicates that all staff present meet minimum qualifications for the position for which they were hired.
· A staff member is present with current Pediatric CPR/First Aid which expires on 02/2024
· Opening and closing staff member’s CPR/First Aid expires on 02/2024
· Director completed Health and Safety Training
· A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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 items were discussed with the Site Supervisor during inspection:

· 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.

· The areas around or under high climbing equipment, swings, slides, and similar equipment shall be cushioned with material that absorbs a fall

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951)320-2023
LICENSING EVALUATOR NAME: Rachel Zeron	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2022

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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: SBCSS MARSHALL STATE PRESCHOOL	FACILITY NUMBER: 364806342
	VISIT DATE: 09/14/2022

NARRATIVE

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· The Site Supervisor was informed of their reporting requirements and provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO09@dss.ca.gov
· The Licensee can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations862@dss.ca.gov

The Site Supervisor 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.

On-line Licensing forms & regulations for a Child Care Center can be obtained on the Department’s website: www.ccld.ca.gov. Additionally, there is a link to “Receive Important Updates” located on the right side of the page, immediately above Quick Links. One can add their email address and choose which program(s) they wish to receive Provider Information Notices (PIN) for.

The Duty Officer is available to answer questions Monday – Friday; 8:00am to 5:00pm at:
1-844-LET-US-NO (1-844-538-8766) and/or 951-782-4200.

The Site Supervisor was asked to update the following documents, if applicable, and submit to licensing within 30 days:
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 or file copy is more than 2 years old)
4. LIC 309 Administrative Organization (only if changes have been made or file copy is more than 2 years old)
5. LIC 308 Designation of Administrative Responsibility (only if changes have been made& current designation is on file)

There are no deficiencies being cited at this time.

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951)320-2023
LICENSING EVALUATOR NAME: Rachel Zeron	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2022

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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: SBCSS MARSHALL STATE PRESCHOOL	FACILITY NUMBER: 364806342
	VISIT DATE: 09/14/2022

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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.

An exit interview was conducted and during the interview, Ms. Gonzalez confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.

A NOTICE OF SITE VISIT WAS ISSUED AND IS TO BE POSTED IN A PROMINENT LOCATION AT THE FACILITY FOR THE NEXT 30 DAYS. This report must be available for review, upon request, for the next 3 years.

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951)320-2023
LICENSING EVALUATOR NAME: Rachel Zeron	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2022

LIC809 (FAS) - (06/04)

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