364840979-2-13-2025-09-CC-ALAA-DDURBJ-20250213115249

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364840979
Report Date: 02/13/2025
Date Signed: 02/13/2025 11:52:56 AM

Document Has Been Signed on 02/13/2025 11:52 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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	OMSD/SULTANA ELEMENTARY SCHOOL		FACILITY NUMBER:	364840979
ADMINISTRATOR/ DIRECTOR:	ADRIANA MELGOZA		FACILITY TYPE:	850
ADDRESS:	1845 SOUTH SULTANA AVENUE		TELEPHONE:	(909) 459-1215
CITY:	ONTARIO	STATE: CA	ZIP CODE:	91761
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 23	DATE:	02/13/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Gianna Roca, program administrator		TIME VISIT/ INSPECTION COMPLETED:	12:00 PM

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), Aman Lama conducted an annual inspection. LPA entered through the main office, and was walked to the preschool classroom. Upon arrival, LPA was met with lead teacher, Luz Valdez and later with Gianna Roca, program administrator and site director, Adriana Melgoza. LPA toured inside and outside, and the following was observed and/or noted: There are 2 waivers on file for the facility. One waiver is to share the outdoor playground with the Kindergarten class, but on alternate schedules. The other is to share the restroom with the Elementary school students. Both waivers are granted with conditions. The following documents are requested to be updated if any changes made, and submit to the Riverside Regional Office (RRO) within 30 days of this report: 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.

Gilbert Sena	TELEPHONE: (951) 782-4200
Aman Lama	TELEPHONE: (951) 970-7385
	DATE: 02/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2025

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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: OMSD/SULTANA ELEMENTARY SCHOOL	FACILITY NUMBER: 364840979
	VISIT DATE: 02/13/2025

NARRATIVE

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·The facility is operating within the limits as stated on the license.
· Ratios were met during this inspection.
·Classrooms are adequately equipped with age and size appropriate furniture and free of hazards.
· There are no weapons present at the facility.
· No accessible bodies of water were observed by LPA at the time of this inspection. All wading pools or similar product must be emptied immediately after use and stored in an upright position.
· Children bring their own water bottles/cups from home. Facility also provides re-fillable uncontaminated drinking water through the water fountain near the restroom area of the property.
· Hazards are stored where they were inaccessible 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 to always be kept locked, 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.
· The center shares their playground with the kindergarten class, but are on an alternate schedule with them, to prevent commingling.
· Food is provided by the center. Breakfast and snack for the AM class and lunch and a snack for the PM class.
· All storage containers for solid waste, including moveable bins have tight-fitting covers that were observed on and in good repair.
· Sign in/Sign out record was reviewed and meets regulation requirements.
· There is at least one closing and one opening staff present with a current CPR/First Aid on file.
· 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 01/09/25.
· The facility is 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: Gilbert Sena	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Aman Lama	TELEPHONE: (951) 970-7385
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2025

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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: OMSD/SULTANA ELEMENTARY SCHOOL	FACILITY NUMBER: 364840979
	VISIT DATE: 02/13/2025

NARRATIVE

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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 facility 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.

- The facility is not currently providing Incidental Medical Services (IMS). LPA discussed storage of medications and required documents needed. 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

- The facility 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.

- 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: 951-782-4200

Due to site director being in meetings all day, LPA conducted the exit interview and reviewed report with program administrator, Gianna Roca.

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

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Aman Lama	TELEPHONE: (951) 970-7385
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2025

LIC809 (FAS) - (06/04)

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