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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334812642
Report Date: 07/09/2021
Date Signed: 07/09/2021 03:39:23 PM

Document Has Been Signed on 07/09/2021 03:39 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:MAGNOLIA PRESCHOOL AND KINDERGARTENFACILITY NUMBER:
334812642
ADMINISTRATOR:ARLIDA ESPINOZAFACILITY TYPE:
830
ADDRESS:13130 MAGNOLIA AVENUETELEPHONE:
(951) 272-0977
CITY:CORONASTATE: CAZIP CODE:
92879
CAPACITY: 20TOTAL ENROLLED CHILDREN: 0CENSUS: 4DATE:
07/09/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Arilda Espinoza, DirectorTIME COMPLETED:
11:00 AM
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(1) A Required – 1 year inspection is being conducted as a compliance review. Licensing Program Analysts (LPAs) Giselle Carbullido and Sumayya Habeebulla toured the infant center, inside and out. The following was observed:

· A review of the staff records and a sampling of the children's records was conducted as part of this evaluation.
· The licensee is asked to update the following documents, if applicable, and submit to licensing within 30 days if changes have been made:
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
· 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: Yes
· Facility is clean, safe and sanitary and in good repair.
· Ratios were met during this inspection: Yes- LPA observed 1 teacher to 4 infants
· Appropriate supervision was provided during this inspection Yes
· Rooms are physically separated from other components: Yes
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE: DATE: 07/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/09/2021
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: MAGNOLIA PRESCHOOL AND KINDERGARTEN
FACILITY NUMBER: 334812642
VISIT DATE: 07/09/2021
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· Rooms are equipped with age appropriate furniture and equipment in good condition
· Activity areas are physically separated from all other components at this center- Yes
· Uncontaminated drinking water is provided in both the indoor and outdoor activity areas by Public water supply
· Napping equipment is sufficient for capacity and meets licensing requirements.
· Rooms are clean and free of hazards
· Materials and surfaces accessible to children are toxic free
· No weapons stored at the facility
· There are no 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 infants: Located in Director's office
· Center is equipped to isolate and care for any child who becomes ill during the day.
· Hazards are stored where inaccessible to infants
· Toxins are locked- Yes
· Toileting area was observed to be safe, sanitary and in operating condition
· Outdoor play area is physically separated by appropriate fencing and free of hazards- Yes
· Outdoor activity areas are supplied with age and size appropriate equipment in good condition
· There is sufficient cushioning material under high climbing equipment, swings, slides and similar equipment: Wood chips, grass
· Measures are taken to keep the facility free of flies, other insects and rodents
· Food preparation area is clean and free of vermin-
· Food is stored appropriately and protected from contamination- Yes
· All storage containers for solid waste have tight-fitting covers that are kept on, and in good repair
· Individual feeding Infant needs and service plans were reviewed; there is an individual feeding and needs and service plan for each infant as required Yes
· Infants up to 12 months shall have a sleeping plan as required with documentation of date, name, time of 15 minute check and staff initials. Yes- LPA observed tracking sheets
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2021
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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: MAGNOLIA PRESCHOOL AND KINDERGARTEN
FACILITY NUMBER: 334812642
VISIT DATE: 07/09/2021
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· Sign in/Sign out record was reviewed and meets regulation requirements: Yes
· A Staff member is present with current Pediatric CPR/First Aid which expires on 1/22
· Opening and closing staff member’s CPR/First Aid expires on Director-1/22
· Director completed Health and Safety Training on 01/1997
· Staff qualifications were reviewed – health screening is on file and all staff meet educational requirements and health requirements for performing assigned tasks.
· Staff have received on the job training for house keeping, sanitation and universal health precautions
· Children’s files were reviewed – Identification and Emergency contact information and a medical assessment is file
· The Licensee 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 07/08/21 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
· Licensee shall comply with Department notifications to terminate or remove specified persons with specified convictions or for other reasons.
· Licensee was informed of the Department has inspection authority per Health and Safety Codes sections: 1596.852, 1596.853 and 1596.8535
The Licensee can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations862@dss.ca.gov

· Facility is providing IMS at this time. 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.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2021
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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: MAGNOLIA PRESCHOOL AND KINDERGARTEN
FACILITY NUMBER: 334812642
VISIT DATE: 07/09/2021
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· For more information on SIDS and Safe Sleep Environments, please visit:
California Department of Public Health – California SIDS Program: http://www.cdph.ca.gov/programs/SIDS/pages/default.aspx
AAP – Safe Sleep Campaign: http://www.healthychildcare.org/sids/html
AAP-Free Training: Reducing the Risk of SIDS in Early Education and Child Care: http://shop.aap.org/Reducing-the-Risk-of-SIDS-in-Early-Education-and-Child-Care
And Caring for our Children, Safe Sleep Practices and SIDS/Suffocation Risk Reduction: http://cfoc/nrckids/org/standardview/spccol/safe_sleep
· Licensee was informed of Infant Safe Sleep regulations and provided Departmental PIN: www.cdss.ca.gov/Portals/9/CCLD/PINs/2020/CCP/PIN%2020-24-CCP.pdf

See LIC 809D for deficiencies cited.

The following was also reviewed and discussed:
SB 277 – Immunizations, Personal Beliefs Exemption, effective January 1, 2016 - it eliminates the exemption from existing specified immunization requirements based upon personal beliefs, and only allows an exemption from future immunization by a medical professional for medical reasons.
vAB290 – Child Nutrition, effective January 1, 2016 - Each child care center shall have at least one person employed who was completed one hour of childhood nutrition training as part of the preventive health practices course(s).
SB 792 – Immunization requirements for staff, volunteers: Health and Safety Code Section 1596.7995(a)(1) - a person shall not be employed or volunteer at a child care center if he or she has not been immunized against influenza, pertussis, and measles or may provide a statement declining the vaccination. If employees/volunteers are receiving the influenza vaccination, they must do so between August 1 and December 1 of each year.
v AB2231 (2016) – Increased Civil Penalties, effective July 1, 2017 – For failing to correct a violation the civil penalty is increased to $100 per day for EACH violation until corrected; For failing to correct a repeated violation the civil penalty is increased to $250 immediately assessed, and $100 per day afterwards for EACH repeated violation until corrected; For an Immediate Risk violation the civil
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2021
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: MAGNOLIA PRESCHOOL AND KINDERGARTEN
FACILITY NUMBER: 334812642
VISIT DATE: 07/09/2021
NARRATIVE
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penalty is increased to $500 immediately assess, and $100 per day for EACH violation after that until corrected; For any repeated Immediate Risk violations the civil penalty is increased to $1,000 immediately assess, and $100 per day afterwards for EACH repeated violation until corrected.
vNOTE: Repeat violations are defined as a violation of a previously cited statutory or regulatory Section and/or subsection within 12 months prior.
vEffective January 1, 2017 – Children under 2 years of age shall ride in a rear-facing car seat unless the child weighs 40 or more pounds OR is 40 or more inches tall. For additional information regarding car seat laws see www.chp.ca.gov
vAB2370 – Lead Exposure, day care facilities, effective January 1, 2019 - An act amending Sections 1596.866 and 1596.8661 and adding Sections 1596.7996 and 1597.16 to the Health and Safety Code for the education of risks and effects of lead exposure in child care facilities and for the testing of drinking water in licensed child care centers. Licensed providers have access to a document regarding lead toxicity prevention created in partnership with the California Department of Public Health (CDPH) to provide to parents/guardians of newly enrolled or reenrolled children with information on the following:
· Risks and effects of lead exposure
· Blood lead testing recommendations and requirements
· Options for obtaining blood lead testing, including any programs that offer free or discounted tests
The bill also requires that that the Department add instruction on the prevention of lead exposure to the Preventative Health and Safety Training curriculum for providers licensed on or after July 1, 2020. Finally, it 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. The Department must adopt regulations in consultation with the State Water Resources Control Board for the implementation of the requirements for the testing of drinking water for lead in Child Care Centers by January 1, 2021. The regulations shall include requirements to ensure the collection and submission of valid water samples.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2021
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: MAGNOLIA PRESCHOOL AND KINDERGARTEN
FACILITY NUMBER: 334812642
VISIT DATE: 07/09/2021
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vAB605 – Child day care facilities, birth to school-age license; Effective January 1, 2021 - An act amending Sections 1596.76, 1596.955 and 1596.956 and adding Section 1596.951 to the Health and Safety Code to address requirements for a single license and extend the period for possible participation in the toddler programs. It requires the California Department of Social Services, in consultation with stakeholders, to adopt regulations on or before January 1, 2021, to create a Child Care Center license to serve infant, toddler, preschool, and school-age children. It also requires, before January 1, 2024, that all Child Care Centers transition to one-center licenses.

vAB2960 – 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.

vPlease subscribe at www.childcareadvocatesprogram to receive Department updates. They will be sent directly to your e-mail account once you have set up an account. Duty Officer is available to answer questions Mon. – Fri. at 1-844-LET-US-NO (1-844-538-8766).

An exit interview was conducted and during the interview, the licensee, Arilda Espinoza confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.


A NOTICE OF SITE VISIT WAS ISSUED AND LPA VERIFIED THAT IT WAS POSTED IN A PROMINENT LOCATION AT THE FACILITY BEFORE LEAVING. THE LICENSEE UNDERSTANDS THAT IT MUST REMAIN POSTED FOR THE NEXT 30 DAYS ALONG WITH A COPY OF ALL TYPE A DEFICIENCIES (LIC809D/9099D) CITED DURING THIS INSPECTION. Appeal rights were provided and discussed. This report must be available for review, upon request, for the next 3 years.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2021
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/09/2021 03:39 PM - It Cannot Be Edited


Created By: Giselle Carbullido On 07/09/2021 at 01:30 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: MAGNOLIA PRESCHOOL AND KINDERGARTEN
FACILITY NUMBER: 334812642

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/09/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/21/2021
Section Cited
HSC
1596.8662(B)(1)

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1596.8662(B)(1) Mandated Reporter : .... employee of a licensed child day care facility shall complete the mandated reporter training … and shall complete renewal mandated reporter training every two years following… initial mandated reporter training. This requirement is not met as evidenced by:
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Facility Director agrees to submit proof of mandated reporter training for S1 to LPA Carbullido by the POC due date of 07/21/2021.
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Based on LPA records review, Facility did not have mandated reporter for S1.This is a potential health and safety risk to children in care.
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Type B
07/21/2021
Section Cited
HSC1596.7995

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Immunizations: SB 792 – Effective September 1, 2016, a person may not be employed or volunteer at a child care center or a family child care home unless he or she has been immunized against influenza, pertussis, and measles.... This requirement is not met as evidenced by:
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Facility Director agrees to submit proof of immuizations for S1 to LPA Carbullido by the POC due date of 07/21/2021.
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Based upon LPA records review, the facility did not have proof of immunizations for S1 per SB792. This poses a potential health and safety risk to children in care.
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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:Gilbert Sena
LICENSING EVALUATOR NAME:Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:
DATE: 07/09/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/09/2021


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