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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370805460
Report Date: 05/05/2023
Date Signed: 05/17/2023 12:11:33 PM


Document Has Been Signed on 05/17/2023 12:11 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108



FACILITY NAME:ALPINE COUNTRY CARE CLUBFACILITY NUMBER:
370805460
ADMINISTRATOR:MICHELLE MARKSFACILITY TYPE:
840
ADDRESS:8770 HARBISON CANYON ROADTELEPHONE:
(619) 445-3553
CITY:ALPINESTATE: CAZIP CODE:
91901
CAPACITY:65CENSUS: 25DATE:
05/05/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Leanne TaladaTIME COMPLETED:
04:45 PM
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On 05/05/2023 at 02:00 PM, Licensing Program Analyst (LPA) Dana Stevens made an unannounced visit for the purpose of Annual Required Inspection. LPA met with Director Leanne Talada, as Michelle Marks was on vacation. There were 8 children (TK-K) present with 1 staff in Room A, 9 children (Grades 1-2) present with one staff in Room B, and 6 children (Grades 3-8) present with 2 staff in Room C, at time of inspection. Program operates Monday thru Friday from 6:30 AM. to 9:00 AM. and 2:30 PM. to 5:30 PM. Early release days are Wednesdays with TK and K released at 1:35 PM and Grades 1- 8 released at 2:05 PM.

LPA toured classrooms A, B and C and the playground. The furniture, toys and play equipment, both inside and out, are safe, age-appropriate and in good repair. The rooms have adequate heating, lighting and ventilation, is clean and orderly, and are free of hazards. Bathrooms and hand washing areas are in a safe, sanitary and operating condition. Food service area consists of a kitchen which is clean and sanitary with food stored per regulation. Facility provides am and pm snacks. All hazardous items are stored where they are inaccessible to children. The outdoor play areas have sufficient cushioning and adequate shade. The carbon monoxide detector and smoke detectors are operational. Sign in/out sheets were reviewed. Children and staff records were reviewed and found complete.

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.

SUPERVISOR'S NAME: Cynthia GrayTELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Dana StevensTELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:
DATE: 05/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/05/2023
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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: ALPINE COUNTRY CARE CLUB
FACILITY NUMBER: 370805460
VISIT DATE: 05/05/2023
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Staff 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 improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process

No deficiencies cited.

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

SUPERVISOR'S NAME: Cynthia GrayTELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Dana StevensTELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:

DATE: 05/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2023
LIC809 (FAS) - (06/04)
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