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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198014650
Report Date: 08/20/2021
Date Signed: 08/20/2021 03:12:11 PM

Document Has Been Signed on 08/20/2021 03:12 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:RANCH HILLS CHILD DEVELOPMENT CENTERFACILITY NUMBER:
198014650
ADMINISTRATOR:MR. KYM ALLENFACILITY TYPE:
850
ADDRESS:2 TRABUCO PLACETELEPHONE:
(909) 397-4740
CITY:POMONASTATE: CAZIP CODE:
91766
CAPACITY: 24TOTAL ENROLLED CHILDREN: 0CENSUS: 8DATE:
08/20/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Licensing & Facilties Planner Kym AllenTIME COMPLETED:
03:15 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
An unannounced Annual/Required-1 year inspection was conducted on this date by Licensing Program Analyst (LPA) Emiko Bell. File review was conducted first at the Pomona Unified School District's Child Development Program's Administrative offices located at 1460 E. Holt Ave., Suite 174, Pomona, 91767. Once file review was completed, a physical inspection of the Center was conducted. Upon arrival to the administrative offices, LPA was greeted by Licensing & Facilities Planner Kym Allen and the purpose of the inspection was announced to him. During both the file review and the physical inspection, LPA and all Pomona Unified School District staff and children in attendance wore face coverings due to COVID-19 precautionary measures.

File review was conducted from 08:40-12:15 and the physical inspection was conducted from 12:50-01:15.

Census was taken at 12:40, during the pm session: There were two staff and eight children present.

The Center operates as a State Preschool. The Center is a one room portable located on the west side of Ranch Hills Elementary. It is located directly behind the chain link fence which separates the parking lot from the school grounds. There are two half day sessions, which run Monday-Friday. The A.M. session is from 7:30-10:30 and the P.M. session is from 12:15-3:15. The Center serves children ages 3-5.

Physical Plant: There is one door which leads into the portable. The portable appeared to be clean, safe, sanitary and in good repair. There is a bathroom and a kitchenette in the portable. The bathroom consists of two toilets and two sinks, both of which are operable; the bathroom appeared to be in safe and sanitary operating condition. There is an additional sink outside of the restroom which also has a drinking faucet. (Due to COVID, the drinking faucet has currently been rendered inoperable.) Drinking water is provided by a Brita water filter, which was observed in the refrigerator; plastic individual drinking cups were observed on the microwave. When asked about how drinking water is provided, Teacher Van Gordon stated that children are
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Betty Bell
LICENSING EVALUATOR SIGNATURE: DATE: 08/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/20/2021
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 5
Document Has Been Signed on 08/20/2021 03:12 PM - It Cannot Be Edited


Created By: Betty Bell On 08/20/2021 at 11:33 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: RANCH HILLS CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 198014650

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/20/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/19/2021
Section Cited
CCR
110216(f)

1
2
3
4
5
6
7
PERSONNEL REQUIREMENTS
At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities.
1
2
3
4
5
6
7
Per HR Specialist Renee Smith, she will ensure that at least one of the two staff complete the required training. Verification will be provided to LPA by the COB on the POC due date of 11/19/21.
8
9
10
11
12
13
14
-This requirement is not met as evidenced by:
Of the two staff files reviewed, neither file contained verification of current Pediatric First aid/CPR training. (Both had expired cards.) *This poses a potential health, safety, or personal rights risk to the children in care.*
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Claudia Guangorena
LICENSING EVALUATOR NAME:Betty Bell
LICENSING EVALUATOR SIGNATURE:
DATE: 08/20/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/20/2021


LIC809 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: RANCH HILLS CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 198014650
VISIT DATE: 08/20/2021
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
26
27
28
29
30
31
32
 Page 2/4

offered water during snack (in addition to the juice given) and after they come in from outdoor play time; otherwise, all children know how to say "water" or "drink." The kitchenette has an adult-size sink and a refrigerator. It appeared to be clean, free of litter, rubbish and free of rodents and other vermin. The portable was inspected for safety, comfort, cleanliness, telephone service (there is a landline), heating and ventilation (there is central heating and air-conditioning), inaccessibility to poisons, detergents, cleaning compounds, medicine (which is kept in a backpack which is hung on hook by the entryway) and other hazardous items that can pose a danger to children. There are no bodies of water or weapons on the premises. Furniture and equipment appeared to be in good condition, free of sharp, loose or pointed parts. All floors appeared to be clean and safe. There were no flies, insects or signs of other rodents in the portable.

The outdoor play area is on the north side of the portable, adjacent to the parking lot. It is surrounded on the north and the east side by a wrought iron fence and on the west and the south side by a chain link fence. On the south side is the elementary school playground. The playground has a blacktop and there is foam rubber cushioning under the playground equipment. The surface of the activity space was in safe condition and free of hazards. The sign for the playground equipment states that it is recommended for use by children ages 2-12. The playground equipment was in safe condition, free of sharp, loose or pointed parts. Shade is provided by a canopy which is permanently mounted in the ground. Though there are two drinking faucets which provide access to drinking water, during outdoor playtime, per Teacher Van Gordon, the Brita water filter and cups are taken outside on a tray since the two drinking faucets outdoors have also been disabled due to COVID.

Toys and napping equipment: There are age-appropriate toys on the premises. As the children don't nap, there is only one mat is on the premises in case a child were to become ill during school hours. In addition, if necessary, an ill child may be taken to the Nurse's office where a staff member will stay with them until they are picked up.

Parent Board: The Parent Board is posted on the wall directly left of the entryway. All required postings were observed (the license, Notification of Parents Rights, the Emergency Disaster Plan and the Child Passenger Safety Law).
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Betty Bell
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2021
LIC809 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: RANCH HILLS CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 198014650
VISIT DATE: 08/20/2021
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
26
27
28
29
30
31
32
 Page 3/4

Fire safety: There is a fire extinguisher, size 3-A:40-B:C, which is mounted in the wall next to the entryway. It was last serviced 12/20. There is a carbon monoxide detector hung on the wall above the thermostat, which is located on the back wall; it was tested and is operable. There is a smoke detector mounted on a wall; it was tested and is operable.

Incidental Medical Services: 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 Section 102417. 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

There is one First Aid Kit, which is mounted above the fire extinguisher in the hallway closet. LPA inspected it to ensure that the required items were contained within.

Paperwork: There are currently 25 children enrolled (15 in the am session and 10 in the pm session.) Three children's files from the am session and two children's files from the pm session were chosen at random for review. Of the five children's files reviewed, all five contained both the name, address and telephone number of the child's authorized representative and others who can assume the responsibility for the child if the authorized representative cannot be reached as well as a medical assessment. Of the two staff files reviewed, both contained a health screening, verification of completion of mandated reporter training and verification that both employees are immune to pertussis and the measles. Of the two staff files reviewed, zero contained current Pediatric First Aid/CPR cards.

Please see 809D for documentation of deficiencies cited.

The Notice of Site Visit was posted by Licensing & Facilities Planner Kym Allen in LPA's presence. The Notice of Site Visit shall be posted for 30 consecutive days. Failure to maintain posting as required will result in the issuance of a citation.
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Betty Bell
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2021
LIC809 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: RANCH HILLS CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 198014650
VISIT DATE: 08/20/2021
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
26
27
28
29
30
31
32
 Page 4/4

An exit interview has been conducted with and a copy of this report has been signed by and provided to Licensing & Facilities Planner Kym Allen. Appeal Rights have been provided and explained to Mr. Allen as well.
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Betty Bell
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2021
LIC809 (FAS) - (06/04)
Page: 5 of 5