<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600956
Report Date: 05/31/2022
Date Signed: 05/31/2022 12:29:02 PM


Document Has Been Signed on 05/31/2022 12:29 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 STREET, STE 700
RIVERSIDE, CA 92501



FACILITY NAME:ALL SAINTS' PRESCHOOLFACILITY NUMBER:
376600956
ADMINISTRATOR:SANDRINE BUNTINFACILITY TYPE:
850
ADDRESS:1940 SHADOWRIDGE DRIVETELEPHONE:
(760) 598-8495
CITY:VISTASTATE: CAZIP CODE:
92081
CAPACITY:144CENSUS: 69DATE:
05/31/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:52 AM
MET WITH:Sandrine BuntinTIME COMPLETED:
10:00 AM
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
On the above date and time, Licensing Program Analysts (LPA) Jessica Rubio and James Wilkerson arrived unannounced to the facility to conduct a case management visit due to an unusual incident report submitted for an incident that occurred on 5/9/2022 involving an injury to a child (C1) due to climbing onto a shelf and falling off. LPA met with Director Sandrine Buntin and conducted a tour of the facility. LPA conducted an interview with the staff (S1) that was present during the incident. It was revealed that C1 climbed onto the top of the shelf by climbing on a sofa that was near the shelf. The sofa has since been removed. After touring and investigating, LPA determined that the facility was not in violation of Title 22 Regulations. There were no citations issued during this visit. An exit interview was conducted, a copy of this report, LIC 811 (Confidential Names List) and appeal rights were reviewed with and provided to Director Sandrine Buntin.
SUPERVISOR'S NAME: Pauline BeschornerTELEPHONE: (951) 255-4093
LICENSING EVALUATOR NAME: Jessica M RubioTELEPHONE: (951) 233-9356
LICENSING EVALUATOR SIGNATURE:
DATE: 05/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/31/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1