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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364846092
Report Date: 11/05/2021
Date Signed: 11/05/2021 05:18:11 PM

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:CHILDREN'S COURTYARD, THEFACILITY NUMBER:
364846092
ADMINISTRATOR:BRADSHAW, KRISTIEFACILITY TYPE:
840
ADDRESS:16427 SIERRA LAKES PKWYTELEPHONE:
(909) 401-2955
CITY:FONTANASTATE: CAZIP CODE:
92336
CAPACITY:14CENSUS: 0DATE:
11/05/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Tammi Reliford and Kristie BradshawTIME COMPLETED:
01:50 PM
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This is a change of ownership application. Facility is currently operating. Licensing Program Analyst (LPA) Kim Leung conducted a prelicensing inspection at the facility this date on 11/5/2021. Upon arrival, LPA met with applicant representative Tammi Reliford and facility director Kristie Bradshaw. LPA toured proposed school-age child care center, inside and out. The days and hours of operation will be: Monday through Friday from 6:30am to 6:30pm. Measurements of the indoor and outdoor activity space are on file.

School-Age Indoor Activity Areas
LPA has determined that there is sufficient space to accommodate the requested capacity.

School-Age Bathroom Fixtures
1 toilet x 15 = 15 children
2 sinks x 15 = 30 children

School-Age Outdoor Activity Area:
LPA has determined that there is sufficient space to accommodate the requested capacity

Limiting factor for preschool capacity is indoor activity space. Capacity is limited to 14 children per applicant's request.

The following was observed:
· Classroom is adequately equipped with age and size appropriate furniture and equipment
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Kim LeungTELEPHONE: (951) 529-4713
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2021
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: CHILDREN'S COURTYARD, THE
FACILITY NUMBER: 364846092
VISIT DATE: 11/05/2021
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Drinking water indoor is provided by use of pitchers of and disposable cups. The drinking fountain on the playground provides drinking water during outdoor activities. During the COVID-19 pandemic, the facility is filling up the disposable cups for the children as a safety measure.
· Playground is enclosed by appropriate fences
· Balls will be provided for outdoor activities
· There are no swimming pools or water fountains present at this time. Applicant and director understand that all wading pools or similar product must be emptied immediately after use and stored in an upright position.
· No high climbing play structure at this time
· No shade structures at this time
· Kitchen is equipped with refrigerator, sink with hot and cold running water, storage area, utensils, and adequate amount of food supplies.
· The office area is located at the front and will serve as the isolation area for ill children temporarily until parents arrive
· The employees' bathroom next to the Pre K Room is also used as the isolation bathroom and is conveniently located to the isolation area. Applicant representative agreed to put a sign at the door for identification purposes.
· Medications are stored in the kitchen and director's office and are secured in a locked boxes.
· The applicant states that they plan to provide Incidental Medical Services (IMS) at this time. A written plan including IMS is on file.
· First Aid kit is complete
· Electronic sign in/out that each of the authorized representatives is assigned a unique PIN for checking in and out children. Facility uses paper sign in/out in at the same time.
· Component II Orientation was completed during this inspection
· The applicant was informed of their reporting requirements and is provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO09@dss.ca.gov
· Applicant and director agreed to logon Guardian to associate all staff members to this application.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Kim LeungTELEPHONE: (951) 529-4713
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2021
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: CHILDREN'S COURTYARD, THE
FACILITY NUMBER: 364846092
VISIT DATE: 11/05/2021
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· The applicant has been informed that all employees must be associated to the facility. If the licensee fails to have proof of a fingerprint clearance or fails to associate a previously cleared individual to the facility, a civil penalty of $100.00, per day the person has been present, will be assessed. The first violation is subject to the penalty for up to five days. If there is a subsequent violation in a 12-month period, the fine will continue for up to 30 days.
The Licensee can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations862@dss.ca.gov
· The applicant was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809 or LIC9099) must be posted for 30 days.
The following was also reviewed and discussed:
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 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.
· For more information on SIDS and Safe Sleep Environments, please visit:
California Department of Public Health – California SIDS Program: http://www.cdph.ca.gov/programs/SIDS/pages/default.aspx
AAP – Safe Sleep Campaign: http://www.healthychildcare.org/sids/html
AAP-Free Training: Reducing the Risk of SIDS in Early Education and Child Care: http://shop.aap.org/Reducing-the-Risk-of-SIDS-in-Early-Education-and-Child-Care
And Caring for our Children, Safe Sleep Practices and SIDS/Suffocation Risk Reduction: http://cfoc/nrckids/org/standardview/spccol/safe_sleep
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Kim LeungTELEPHONE: (951) 529-4713
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2021
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: CHILDREN'S COURTYARD, THE
FACILITY NUMBER: 364846092
VISIT DATE: 11/05/2021
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The following items need to be completed/corrected prior to a license being issued:

1. Revised LIC401 Monthly Operating Statement with budgets based on the requested capacity
2. Install a shade structure/canopy to provide shade on the playground

A fire clearance has been obtained. Once all corrections have been made, with proof sent to licensing, and the required documents have been received, the application will be submitted for approval with a maximum capacity of 14 children, ages 6 to 12. As agreed upon by the applicant, all corrections are due within 30 days. If not received within 30 days from the date of this report, the application will be denied. An exit interview was conducted and a copy of this report was provided to the applicant on this date.

COVID-19 RAST (Rapid Assistance Support Team) inspection was conducted this date during the same visit. Self-Assessment on file.

A copy of this report must be made available to the public for 3 years.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Kim LeungTELEPHONE: (951) 529-4713
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2021
LIC809 (FAS) - (06/04)
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