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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364810040
Report Date: 08/28/2023
Date Signed: 08/28/2023 02:46:46 PM


Document Has Been Signed on 08/28/2023 02:46 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501



FACILITY NAME:SBCUSD-LANKERSHIM PRESCHOOLFACILITY NUMBER:
364810040
ADMINISTRATOR:KELLY, LATASHIAFACILITY TYPE:
850
ADDRESS:7499 LANKERSHIM STREETTELEPHONE:
(909) 862-4213
CITY:HIGHLANDSTATE: CAZIP CODE:
92346
CAPACITY:23CENSUS: 12DATE:
08/28/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Diane GuzmanTIME COMPLETED:
03:00 PM
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On 08/28/2023 at time listed above Licensing Program Analysts (LPA) Justin Giese arrived at the facility unannounced to conduct a 1 year required annual inspection. LPA was granted entry by Instructional Aide, Diane Guzman. 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; Morning Session: 8:15 AM to 11:15 AM and Afternoon Session: 12:15 AM to 3:15 PM


· 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
SUPERVISOR'S NAME: Gilbert SenaTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Justin GieseTELEPHONE: (951) 204-4847
LICENSING EVALUATOR SIGNATURE:
DATE: 08/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/28/2023
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: SBCUSD-LANKERSHIM PRESCHOOL
FACILITY NUMBER: 364810040
VISIT DATE: 08/28/2023
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The licensee 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)
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 (age requirements met)
· Ratios were met during this inspection (3 staff, 12 children)
· Appropriate supervision was provided during this inspection
· Rooms are equipped with age appropriate furniture and equipment in good condition
· Drinking water is provided in both the indoor and outdoor activity
· Room is clean and free of hazards
· No weapons stored at the facility
· There are no 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 (front office nurse station)
· Hazards are stored where inaccessible to children (off site janitorial closet)
· Toxins are locked
· Toileting area was observed to be safe, sanitary and in operating condition
SUPERVISOR'S NAME: Gilbert SenaTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Justin GieseTELEPHONE: (951) 204-4847
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2023
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: SBCUSD-LANKERSHIM PRESCHOOL
FACILITY NUMBER: 364810040
VISIT DATE: 08/28/2023
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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 filtered water bottles. cups made available if needed for indoor and outdoor use
· The areas around or under high climbing equipment, swings, slides, and similar equipment shall be cushioned with material that absorbs a fall: rubber flooring, 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 10/23/2023
· Opening and closing staff member’s CPR/First Aid expires on 10/23/2023
· Director completed Health and Safety Training and is on file
· Staff qualifications were reviewed – all staff meet educational requirements and 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 reviewed for Children all contained a medical assessment, immunization and Identification and Emergency Information
· Documentation of fire & earthquake drills to be conducted every six months: Last drill on 08/15/2023
SUPERVISOR'S NAME: Gilbert SenaTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Justin GieseTELEPHONE: (951) 204-4847
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2023
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: SBCUSD-LANKERSHIM PRESCHOOL
FACILITY NUMBER: 364810040
VISIT DATE: 08/28/2023
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Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

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 PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers
SUPERVISOR'S NAME: Gilbert SenaTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Justin GieseTELEPHONE: (951) 204-4847
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2023
LIC809 (FAS) - (06/04)
Page: 4 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: SBCUSD-LANKERSHIM PRESCHOOL
FACILITY NUMBER: 364810040
VISIT DATE: 08/28/2023
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To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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


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

Exit interview conducted and report was reviewed with Instructional Aide, Diane Guzman.
SUPERVISOR'S NAME: Gilbert SenaTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Justin GieseTELEPHONE: (951) 204-4847
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2023
LIC809 (FAS) - (06/04)
Page: 5 of 5