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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364818207
Report Date: 12/04/2023
Date Signed: 12/04/2023 11:55:29 AM


Document Has Been Signed on 12/04/2023 11:55 AM - 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:WASHINGTON STATE PRESCHOOLFACILITY NUMBER:
364818207
ADMINISTRATOR:MELISSA MACKFACILITY TYPE:
850
ADDRESS:900 EAST C STREETTELEPHONE:
(909) 876-4240
CITY:COLTONSTATE: CAZIP CODE:
92324
CAPACITY:24CENSUS: 15DATE:
12/04/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Della Sanchez, Lead TeacherTIME COMPLETED:
12:15 PM
NARRATIVE
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Licensing Program Analysts (LPA), Aman Sharma conducted a required annual inspection. LPA was met with lead teacher, Della Sanchez. The inspection tool was not used as part of this evaluation, due to technical difficulties. An inside out tour of the facility was taken, and the following was observed and/or noted:
A review of staff and children's records were reviewed as part of todays evaluation.
· The site director is 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
- Food menu.
· The facility is operating with the limits as stated on the license.
· Ratios were met during this inspection.
· Classrooms are adequately equipped with age and size appropriate furniture and equipment and are free of hazards.
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 805-5718
LICENSING EVALUATOR NAME: Aman SharmaTELEPHONE: (951) 970-7385
LICENSING EVALUATOR SIGNATURE:
DATE: 12/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/04/2023
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: WASHINGTON STATE PRESCHOOL
FACILITY NUMBER: 364818207
VISIT DATE: 12/04/2023
NARRATIVE
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·There are no weapons present at the facility.
· There are no accessible bodies of water on the school property. All wading pools or similar product must be emptied immediately after use and stored in an upright position.
· Children bring their own water bottles to utilize in both, indoor and outdoor activity spaces.
· Uncontaminated drinking water was observed as an option for children via water bottles. The facility has been utilizing the water faucet for drinking water, but agrees to immediately cease operation unless a lead testing result indicates it is safe to utilize.
· Medications are currently being administered at the facility.
· Hazards are also stored where they were accessible to children. These include: Disinfectants, cleaning solutions and other items that are dangerous to the health and safety of children in care.
· Poisons and toxins are kept locked and inaccessible to children, per Title 22 Regulations.
· All floors were observed clean and safe and shall remain so at all times.
· Restrooms were observed to be, sanitary and in operating condition.
· Playgrounds are enclosed by appropriate fences.
· Outdoor activity areas are in good condition and supplied with age/size appropriate equipment.
· The areas around or under high climbing equipment, swings, slides, and similar equipment were cushioned with material that absorbs a fall.
· Food is prepared off-site and delivered into the classroom.
· Menus were posted with date included and were placed in a visible location of children’s authorized representatives. Menus shall be kept on file for 30 days, and made available upon request.
· All storage containers for solid waste, including moveable bins have tight-fitting covers that were observed to be on and in good repair.
· Sign in/Sign out record was reviewed and meets regulation requirements.
· Staff members present had a current Pediatric CPR/First Aid on file and expire in 2025.
· A review of children’s records were found to be complete during this inspection.
· Disaster drills are to be conducted every six months – last drill was conducted on 11/15/23
· The lead teacher was informed of their reporting requirements and is provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO09@dss.ca.gov
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 805-5718
LICENSING EVALUATOR NAME: Aman SharmaTELEPHONE: (951) 970-7385
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2023
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: WASHINGTON STATE PRESCHOOL
FACILITY NUMBER: 364818207
VISIT DATE: 12/04/2023
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·A review of staff records indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
· The Director can submit transfer forms to associate or disassociate someone from their facility at: Associations_Disassociations862@dss.ca.gov
· A review of staff records indicates that staff that were present meet minimum qualifications for the position for which they were hired.
- This facility does currently provide Incidental Medical Services (IMS). LPA reviewed and discussed submission of IMS plan to the department. Facility understands children’s, personnel, and administrative records must be completed as needed. LPA confirmed that all medication and paperwork was complete and meets regulation requirements. 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

- Lead teacher, Della Sanchez 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.

- Go to the licensing webpage www.ccld.ca.gov, and click on the “Receive Important Updates” located on the right side of the page, immediately above the Quick Links. One can add their email address and choose which program(s) they wish to receive Provider Information Notices (PIN) for.

- To access on-line Licensing forms & Regulations for a Child Care Center please visit: www.ccld.ca.gov.

- 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

Exit interview was conducted and this report was reviewed with lead teacher, Della Sanchez.

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

SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 805-5718
LICENSING EVALUATOR NAME: Aman SharmaTELEPHONE: (951) 970-7385
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 12/04/2023 11:55 AM - 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501


FACILITY NAME: WASHINGTON STATE PRESCHOOL
FACILITY NUMBER: 364818207

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/04/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
1597.16(a)(1)


This requirement is not met as evidenced by: A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.
Deficient Practice Statement
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Based on observation of records, the facility did not comply with the section cited above. Staff were unable to confirm if lead testing was done at the facility. LPA also did not see any postings indicating that there was a test done. This poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/01/2024
Plan of Correction
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Facility agrees to schedule a lead testing visit and submit the findings, when available, to licensing no later than the POC due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Kimberly WilliamsTELEPHONE: (951) 805-5718
LICENSING EVALUATOR NAME: Aman SharmaTELEPHONE: (951) 970-7385
LICENSING EVALUATOR SIGNATURE:
DATE: 12/04/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/04/2023
LIC809 (FAS) - (06/04)
Page: 4 of 4