364846189-4-19-2022-09-CC-SLOZ-CDMQKA-20220419121402

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364846189
Report Date: 04/19/2022
Date Signed: 04/19/2022 12:14:07 PM

Document Has Been Signed on 04/19/2022 12:14 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:	KIDDIE ACADEMY OF RANCHO CUCAMONGA		FACILITY NUMBER:	364846189
ADMINISTRATOR:	HOLMES, DAVID & ELIZABETH		FACILITY TYPE:	840
ADDRESS:	7220 VICTORIA PARK LANE		TELEPHONE:	(661) 644-4399
CITY:	RANCHO CUCAMONGA	STATE: CA	ZIP CODE:	91739
CAPACITY:	24	CENSUS: 0	DATE:	04/19/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Applicants David and Elizabeth Holmes and Director Heather Jenkins		TIME COMPLETED:	12:15 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), Samuel Lopez, arrived at the facility to conduct a Pre-licensing inspection, due to a change in ownership. The new ownership will retain the current name of the facility. LPA Lopez toured proposed School Age center, inside and out. A Fire Clearance was granted on 3/17/2022. The days and hours of operation will be: Monday through Friday, 6:30am to 6:00pm. Measurements were taken and the following was determined: School-Age Indoor Activity Areas LPA has determined that there is sufficient space to accommodate 33 children. School-age Bathroom Fixtures 2 toilets x 15 = 30 children 2 sinks x 15 = 30 children School-Age Outdoor Activity Area: LPA has determined that there is sufficient space to accommodate 26 children. Limiting factor for school-age capacity is the Fire Clearance. School-age capacity is limited to 24 children. The following was observed: · Classrooms are adequately equipped with age and size appropriate furniture and equipment · PUR/Brita water pitchers supply drinking water in the indoor activity space · Playground is enclosed by an appropriate fence · Outdoor activity area is supplied with age and size appropriate equipment · There are no accessible bodies of water present. All wading pools or similar product must be emptied immediately after use and stored in an upright position.

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Samuel Lopez	TELEPHONE: (951) 897-2482
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2022

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: KIDDIE ACADEMY OF RANCHO CUCAMONGA	FACILITY NUMBER: 364846189
	VISIT DATE: 04/19/2022

NARRATIVE

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· An adequate amount grass area with play equipment for the children to play
· Adequate shade is provided
· Drinking water is provided in the outdoor play area by Igloos and cups
· Food preparation area 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 entrance and will serve as the isolation area for ill children temporarily until parents arrive
· Toxins are locked
· Medication will be stored in the front reception area and will be secured in a locked box
· Medication administration forms were reviewed
· First Aid kit is complete
· Sign in/Sign out record was reviewed and meets regulation requirements
· 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
· A review of staff records on 4/19/2022 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Director Heather Jenkins was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.

The applicant can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations862@dss.ca.gov

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Samuel Lopez	TELEPHONE: (951) 897-2482
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2022

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: KIDDIE ACADEMY OF RANCHO CUCAMONGA	FACILITY NUMBER: 364846189
	VISIT DATE: 04/19/2022

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This facility plans to provide Incidental Medical Services (IMS). For IMS information, see PIN 22-02-CCP. A Plan of Operation that includes IMS must be submitted to the Department. 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

LPA also informed Director Heather Jenkins of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPA reviewed with Director Heather Jenkins the LIC 311A, Records to Be Maintained at The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

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

The application will be submitted for approval with a maximum capacity of 24.

Exit interview conducted and report was reviewed with the Applicants David and Elizabeth Holmes and Director Heather Jenkins.

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Samuel Lopez	TELEPHONE: (951) 897-2482
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2022

LIC809 (FAS) - (06/04)

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