334813807-9-21-2023-09-CC-PORS-CVVRJJ-20230921130402

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334813807
Report Date: 09/21/2023
Date Signed: 09/21/2023 01:04:11 PM

Document Has Been Signed on 09/21/2023 01:04 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:	PSUSD-TWO BUNCH PALMS ELEMENTARY		FACILITY NUMBER:	334813807
ADMINISTRATOR:	DIANA ROMO		FACILITY TYPE:	850
ADDRESS:	14-250 WEST DRIVE		TELEPHONE:	(760) 329-8094
CITY:	DESERT HOT SPRINGS	STATE: CA	ZIP CODE:	92240
CAPACITY: 48	TOTAL ENROLLED CHILDREN: 38	CENSUS: 36	DATE:	09/21/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:57 AM
MET WITH:	ECE Coordinator Linda Rodriguez		TIME COMPLETED:	01:15 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	Licensing Program Analysts (LPAs), Perla Ordones and Samuel Lopez conducted a required/annual inspection as part of a compliance review. A tour of the inside and outside of the facility was granted and the following was observed and/or noted: A review of staff and children's records were conducted as part of this evaluation. The licensee/director is asked to update the following documents, if applicable, and submit to licensing within 30 days: - LIC 500 Personnel Report - LIC 610 Emergency & Disaster Plan - Parent Handbook/ Program Curriculum/Admission policies and procedures/ fee schedule (only if changes have been made) - LIC 309 Administrative Organization (only if changes have been made) - LIC 308 Designation of Administrative Responsibility (only if changes have been made) 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 with the limits as stated on the license. · Ratios are being met during this inspection.

SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Perla Ordones
LICENSING EVALUATOR SIGNATURE:	DATE: 09/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2023

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: PSUSD-TWO BUNCH PALMS ELEMENTARY	FACILITY NUMBER: 334813807
	VISIT DATE: 09/21/2023

NARRATIVE

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· Classrooms are adequately equipped with age and size appropriate furniture and equipment and free of hazards.
· There are no weapons present at the facility as stated by ECE Coordinator Linda Rodriguez.
· 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, medications are stored in the locked kitchenette inside a locked box.
· Hazards are stored where inaccessible to children which include: Disinfectants, cleaning solutions and other items that are dangerous.
· Poisons and toxins are locked.
· All floors shall be clean and safe.
· Bathrooms were observed to be safe, sanitary and in operating condition.
· Playgrounds are enclosed by appropriate fences and free of hazards.
· Outdoor activity areas are supplied with age and size appropriate equipment in good condition.
· Food is prepared and delivered from the Palm Springs Unified School District and onsite staff only serve the food.
· All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair.
· Menus shall be 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 outdoors and provided by water fountains inside and Brita water pitcher with disposable cups outside.
· The areas around or under high climbing equipment, swings, slides, and similar equipment is cushioned with rubber matting material that absorbs a fall.
· 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 06/2025.
· Opening and closing staff member’s CPR/First Aid expires on 06/2025.
· Director completed Health and Safety Training - 08/06/2022.
· A review of children’s records was conducted, and records were found to be complete during this inspection.
· Staff files were not complete as S4 and S6 were missing proof of immunizations on file.
· Disaster drills to be conducted every six months – last drill conducted on 08/14/2023.

SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Perla Ordones
LICENSING EVALUATOR SIGNATURE:	DATE: 09/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2023

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: PSUSD-TWO BUNCH PALMS ELEMENTARY	FACILITY NUMBER: 334813807
	VISIT DATE: 09/21/2023

NARRATIVE

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· 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 09/21/2023 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
· The Licensee can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations862@dss.ca.gov
· A review of staff records indicates that all staff present meet minimum qualifications for the position for which they were hired.

CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES:
Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

LPAs verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

LPAs discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPAs also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

This facility provides Incidental Medical Services – IMS. LPAs reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records.

For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.

SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Perla Ordones
LICENSING EVALUATOR SIGNATURE:	DATE: 09/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2023

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: PSUSD-TWO BUNCH PALMS ELEMENTARY	FACILITY NUMBER: 334813807
	VISIT DATE: 09/21/2023

NARRATIVE

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Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at:
https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

To access on-line Licensing forms & Regulations for a Child Care Center please visit: www.ccld.ca.gov.

The Duty Officer is available to answer questions Monday – Friday; 8:00am to 5:00pm at:
1-844-LET-US-NO (1-844-538-8766) and/or 951-782-4200

See LIC809-D for cited deficiencies.

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

Exit interview conducted and report was reviewed with the ECE Coordinator Linda Rodriguez.

SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Perla Ordones
LICENSING EVALUATOR SIGNATURE:	DATE: 09/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 09/21/2023 01:04 PM - It Cannot Be Edited

Citations on this Visit Report are Under Appeal!

Created By: Perla Ordones On 09/21/2023 at 12:44 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: PSUSD-TWO BUNCH PALMS ELEMENTARY	FACILITY NUMBER: 334813807
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/21/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Under Appeal

Type B

Section Cited

HSC

1596.7995(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above as during record review LPAs observed that S6 was missing proof of the Measles Mumps and Rubella (MMR) and the Pertussis vaccine which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/05/2023
	Plan of Correction
1 2 3 4	Facility Representative agrees to obtain proof of the MMR and Pertussis vaccine for S6. Facility Representative also agrees to submit proof of the MMR and Pertussis vaccine for S6 to Community Care Licensing (CCL) by the end of the business day on the Plan of Correction (POC) due date of 10/05/2023.

Under Appeal

Type B

Section Cited

CCR

101216(g)(1)

Personnel Requirements

(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above as during record review LPAs observed that S4 was missing proof of the Tuberculosis (TB) vaccine which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/05/2023
	Plan of Correction
1 2 3 4	Facility Representative agrees to obtain proof of the TB vaccine for S4. Facility Representative also agrees to submit proof of the MMR and Pertussis vaccine for S6 to Community Care Licensing (CCL) by the end of the business day on the Plan of Correction (POC) due date of 10/05/2023.

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:

Perla Ordones

LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2023

LIC809 (FAS) - (06/04)

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