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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364810041
Report Date: 10/10/2019
Date Signed: 10/31/2019 08:21:25 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:SBCUSD-WARM SPRINGS PRESCHOOLFACILITY NUMBER:
364810041
ADMINISTRATOR:KELLY, LATASHIAFACILITY TYPE:
850
ADDRESS:7497 STERLING AVENUETELEPHONE:
(909) 338-6500
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92410
CAPACITY:23CENSUS: 20DATE:
10/10/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Patti LopezTIME COMPLETED:
11:20 AM
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(1) A random annual inspection is being conducted as part of a compliance review. Licensing Program Analyst (LPA), Taadhimeka Zeigler, toured the center, inside and out.

The following was observed:
• A review of the staff records and review of a sampling of children's records were conducted as part of this evaluation.
• 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.
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Taadhimeka ZeiglerTELEPHONE: (951) 680-6745
LICENSING EVALUATOR SIGNATURE:

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

DATE: 10/10/2019
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: SBCUSD-WARM SPRINGS PRESCHOOL
FACILITY NUMBER: 364810041
VISIT DATE: 10/10/2019
NARRATIVE
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· Medications and hazards are stored where inaccessible to children
· 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
· Uncontaminated drinking water is available inside and outside
· 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 03/01/2021
· Director completed Health and Safety Training on 05/1998
· Required records for staff shall ensure that each personnel record contain a health screening
· Documentation of fire & earthquake drills to be conducted every six months
  • This facility provides Incidental Medical Services – IMS.

The following was also reviewed and discussed:
SB 277 – Immunizations, Personal Beliefs Exemption, effective January 1, 2016
AB290-Child Nutrition, effective January 1, 2016
SB792-Immunizations, Personal Beliefs Exemption, effective 01/01/2016
AB2231 (2016)-Increased Civil Penalties, effective July 1, 2017
AB1207-Mandated Child Abuse Reporting: Child Day Care Personnel Training, beginning 01/01/2018
AB2370-Lead Exposure, day care facilities, effective 01/01/2019

Access to forms & Regulations for a Child Care Center are online at www.ccld.ca.gov
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Taadhimeka ZeiglerTELEPHONE: (951) 680-6745
LICENSING EVALUATOR SIGNATURE:

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

DATE: 10/10/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3
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-WARM SPRINGS PRESCHOOL
FACILITY NUMBER: 364810041
VISIT DATE: 10/10/2019
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The Duty Officer is available to answer questions Monday – Friday at 1-844-LET-US-NO (1-844-538-8766).

A NOTICE OF SITE VISIT WAS ISSUED AND LPA VERIFIED THAT IT WAS POSTED IN A PROMINENT LOCATION AT THE FACILITY BEFORE LEAVING. THE LICENSEE UNDERSTANDS THAT IT MUST REMAIN POSTED FOR THE NEXT 30 DAYS.

An exit interview was conducted with Program Specialist, Patti Lopez, and a copy of this report was left.

This report must be available for review, upon request, for the next 3 years.





This is an electronic version of a manual report. Original signatures on file.
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Taadhimeka ZeiglerTELEPHONE: (951) 680-6745
LICENSING EVALUATOR SIGNATURE:

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

DATE: 10/10/2019
LIC809 (FAS) - (06/04)
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