330910852-6-20-2023-09-CC-SBRR-CSYQTJ-20230620122713

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 330910852
Report Date: 06/20/2023
Date Signed: 06/20/2023 12:27:22 PM

Document Has Been Signed on 06/20/2023 12:27 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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	RUSD/HIGHGROVE HEADSTART STATE PRESCHOOL		FACILITY NUMBER:	330910852
ADMINISTRATOR:	GOSNELL, ELIZABETH		FACILITY TYPE:	850
ADDRESS:	690 CENTER STREET		TELEPHONE:	(951) 788-7296
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92507
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 23	CENSUS: 4	DATE:	06/20/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Program Specialist Luz Romero		TIME COMPLETED:	12:35 PM

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On 06/20/2023 at 8:07 AM Licensing Program Analyst (LPA) Susan Brewer arrived at the facility to conduct a 1 year required annual inspection. LPA was granted entry by Program Specialist Luz Romero. LPA toured the facility, inside and out, reviewed records, and observed and/or discussed the following: The preschool was in summer session. There is a waiver on file for use of the elementary school restroom, shared elementary school playground with Transitional Kindergarten elementary children and sign in/out by staff.

Normal days and hours of operation: Monday- Friday, 7:45 AM – 11:15 AM and 12:00 PM -3:30 PM; In Room K1.

Summer days/hours: Monday – Friday 8:00 AM to 11:00 AM

The inspection consisted of reviews of the following domains: Food Service; Reporting Requirements

Physical Plant; Care and Supervision; Children Records; Staff Records; Staffing Ratio and Capacity and
Personal Rights. The inspection found the facility to be in compliance in these domains, except as noted on the LIC809D.

The licensee is asked to update the following documents, if applicable, and submit to licensing within 30 days:
1. LIC 500 Personnel Report
2. LIC 610 Emergency & Disaster Plan
3. Parent Handbook/ Program Curriculum/Admission policies and procedures/ fee schedule (only if changes have been made)
4. LIC 309 Administrative Organization
5. LIC 308 Designation of Administrative Responsibility

SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Susan Brewer
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2023

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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: RUSD/HIGHGROVE HEADSTART STATE PRESCHOOL	FACILITY NUMBER: 330910852
	VISIT DATE: 06/20/2023

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The following items have been posted and are updated where necessary:
License, Emergency Disaster Plan (LIC610) and Earthquake Preparedness Checklist (LIC9148)
Parent’s Rights Poster (PUB393), Personal Rights (LIC613A); Child Car Seat Law, Menu
· The facility is operating within the terms of the license.
· Ratios are met and appropriate supervision is provided for the state preschool and head start program. A census of 3 staff were observed and supervising 4 children. The total attendance for sign in sheets was 16.
· A fully charged fire extinguisher (2A:10BC) was observed and tagged 06/16/2023. A smoke detector and carbon monoxide detector were present and tested by the Licensee during this inspection on 06/20/2023.
· Classrooms are clean, free of hazards and equipped with age-appropriate furniture and equipment in good condition
· No weapons stored at the facility
· 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.
· Medications are stored where inaccessible to children in the main office and locked.
· Hazards are stored where inaccessible to children which include: Disinfectants, cleaners and other items that are dangerous. Poisons and toxins are locked.
· All floors are clean and safe.
· Bathrooms were observed to be safe, sanitary and in operating condition.
· Outdoor activity areas/playgrounds are enclosed by appropriate fences, free of hazards and are supplied with age and size appropriate equipment in good condition: Yes
· Food preparation area is clean, free of litter, rubbish and free of rodents and other vermin.
· Measures are taken to keep the facility free of flies, other insects and rodents.
· Food is stored appropriately and protected from contamination
· Storage containers for solid waste, including moveable bins-have tight-fitting covers in good repair
· Menus are posted at least one week in advance in a place visible by the child’s authorized representative, dated and kept on file for 30 days, and made available upon request
· Uncontaminated drinking water shall be readily available both indoors and out and provided by tap water and disposable cups and reusable water bottles brought from home.
· The areas around or under high climbing equipment, swings, slides, and similar equipment shall be cushioned with material that absorbs a fall: Facility has rubber turf, wood chips and natural grass under play structures.

SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Susan Brewer
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2023

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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: RUSD/HIGHGROVE HEADSTART STATE PRESCHOOL	FACILITY NUMBER: 330910852
	VISIT DATE: 06/20/2023

NARRATIVE

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· Sign in/Sign out record was reviewed and meets regulation requirements.
· A Staff member is present with current Pediatric CPR/First Aid which expires on 03/2025.
· Opening and closing staff member’s CPR/First Aid expires on 06/2023.
· Director completed Health and Safety Training on 06/05/2023.
· Staff qualifications and files were reviewed and are complete on 06/20/2023.
· Staff have received on the job training for housekeeping, sanitation, and universal health precautions
Licensee was informed the Department has inspection authority per Health and Safety Codes.
Licensee provided the Unusual Incident Reporting email: UnusualIncidentReportsDO09@dss.ca.gov
· Children files were reviewed and are complete on 06/20/2023.
· Documentation of fire & earthquake drills to be conducted every six months: Last drill on 05/16/2023 at 1:30 PM
· Documentation of Lead Testing is on file: 04/15/2023 no action level exceedance reported for the water outlets used in Classroom K1 or the outdoor water fountains used for drinking. However, meals are prepared at the facility kitchen on site. According to Program Specialist Luz Romero, the water outlets utilized in the school kitchen to prepare meals for children, were not included in the initial testing. LPA toured the school kitchen and observed 2 water outlets.
· A review of staff records on 06/20/2023 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
· AB2370 – Lead Exposure, day care facilities, effective January 1, 2019 –
The bill requires that all Child Care Centers, operating in a building constructed before January 1, 2010, shall have their drinking water tested for excessive lead levels, on or after January 1, 2020, but no later than January 1, 2023. Child Care Centers must thereafter test their drinking water every five years after the date of the initial test.
· AB605 – Child day care facilities, birth to school-age license; Effective January 1, 2021
· AB2960 – Child care and development services, online portal – Effective June 20, 2022 - This bill requires the State Superintendent of Public Instruction (SSPI), within the California Department of Education (CDE), to develop and post on CDE's website a comprehensive child care and development services online portal for families and providers by June 30, 2022.
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.

SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Susan Brewer
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2023

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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: RUSD/HIGHGROVE HEADSTART STATE PRESCHOOL	FACILITY NUMBER: 330910852
	VISIT DATE: 06/20/2023

NARRATIVE

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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 CCCs: Incidental Medical Services (IMS) policy was discussed.

Program Specialist Luz Romero; was reminded that all adults 18 and over working at the facility, 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 licensed 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 Licensee can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations862@dss.ca.gov for Riverside Regional Office.

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/inspection-process.

Deficiencies were cited this visit for Type B violation.

Civil Penalties were not issued this visit.

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

Exit interview conducted and report was reviewed with the Program Specialist Luz Romero.

SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Susan Brewer
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 06/20/2023 12:27 PM - It Cannot Be Edited

Created By: Susan Brewer On 06/20/2023 at 12:18 PM

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
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: RUSD/HIGHGROVE HEADSTART STATE PRESCHOOL	FACILITY NUMBER: 330910852
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/20/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, the licensee did not comply with the section cited above in the LPA observed 2 kitchen water outlets used to prepare meals for consumption, that were not included in the initial testing for lead exposure, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/21/2023
	Plan of Correction
1 2 3 4	The licensee agrees to have the identified kitchen water outlets used to prepare meals for preschool children, tested for lead exposure on or before 07/21/2023. The licensee also agrees to sent proof of lead test sampling and the reported results of the lead sampling with the supportive documentation, to the department by fax, mail or e-mail.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Kimberly Williams

LICENSING EVALUATOR NAME:

Susan Brewer

LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2023

LIC809 (FAS) - (06/04)

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