334814630-5-22-2026-09-CC-LMEO-DUBRGB-20260522130027

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334814630
Report Date: 05/22/2026
Date Signed: 05/22/2026 01:00:39 PM

Document Has Been Signed on 05/22/2026 01:00 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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	RUSD/EMERSON ELEMENTARY SCHOOL		FACILITY NUMBER:	334814630
ADMINISTRATOR/ DIRECTOR:	KATHRYN GRIMBLE		FACILITY TYPE:	850
ADDRESS:	4660 OTTAWA AVENUE		TELEPHONE:	(951) 788-7462
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92507
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 22	DATE:	05/22/2026
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:45 AM
MET WITH:	Early Childhood Coordinator Patricia Tran		TIME VISIT/ INSPECTION COMPLETED:	01:10 PM

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On date and time listed above, Licensing Program Analyst (LPA), Laura Mejorado arrived at the facility to conduct annual inspection. LPA was granted entry by Facility Representative Valeria Cuevas-Paz. Early Childhood Coordinator Patricia Tran arrived later in the inspection. LPA toured the facility inside and out, reviewed records, took a census and observed and/or discussed the following.

Days and hours of operation are Monday -Friday; 7:45AM-2:15PM.

The inspection consisted of reviews of the CARE tool domains. The inspection found the facility to be in compliance except as noted on the LIC809D. Deficiencies were not cited this visit.

If updates are made, the facility representative will submit the following documents 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

4. LIC 309 Administrative Organization

5. LIC 308 Designation of Administrative Responsibility

NAME OF LICENSING PROGRAM MANAGER: Ana Noble
NAME OF LICENSING PROGRAM ANALYST: Laura Mejorado
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/22/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2026

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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

FACILITY NAME: RUSD/EMERSON ELEMENTARY SCHOOL	FACILITY NUMBER: 334814630
	VISIT DATE: 05/22/2026

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The following items have been posted and are current: License; Emergency Disaster Plan (LIC610); Facility sketch; Earthquake Preparedness Checklist (LIC9148); Parent’s Rights Poster (PUB393); Personal Rights (LIC613A); Child Car Seat Law, and Menu.

The facility is operating within the scope of license with appropriate ratios and supervision during this inspection.

Medications are stored inaccessible to children in the health office.

Hazardous and dangerous items are stored inaccessible to children. Poisons and toxins are locked.

Classrooms and floors are clean, free of hazards and rooms are equipped with age-appropriate furniture.

Bathrooms were observed to be safe, sanitary and in operating condition.

Per facility representative Patricia Tran, no weapons are stored at the facility.

There are no accessible bodies of water present. All wading pools or similar products must be emptied immediately after use and stored in an upright position.

Outdoor activity areas are enclosed by appropriate fences, free of hazards and have age and size equipment in good condition.

Areas around or under high climbing equipment have material that absorbs a fall. Present was rubber turf.

Food preparation area is clean, free of litter, and vermin. Food is stored appropriately and protected from contamination. Menus are current, posted and visible for authorized representatives and available upon request. Per facility representative food is prepared off site and delivered to the facility.

Measures are taken to keep the facility free of pests and rodents. Storage containers for solid waste have tight-fitting covers in good repair. Uncontaminated drinking water is readily available both indoors and outdoors. Children bring water bottles from home and water fountains are available if needed.

A staff member is present with CPR/First Aid which expires on 3/8/27

Opening and closing staff member’s CPR/First Aid expires on 3/8/27

NAME OF LICENSING PROGRAM MANAGER: Ana Noble
NAME OF LICENSING PROGRAM ANALYST: Laura Mejorado
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/22/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2026

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

FACILITY NAME: RUSD/EMERSON ELEMENTARY SCHOOL	FACILITY NUMBER: 334814630
	VISIT DATE: 05/22/2026

NARRATIVE

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Director completed Health and Safety Training.

Children files are complete.

Staff files are complete.

Fire & earthquake drills are conducted/documented every six months. Yes, last drill on 5/5/26

Facility representative was reminded of the following:

1. Unusual Incident Reporting email: UnusualIncidentReportsDO09@dss.ca.gov

2. Access to forms & Regulations online at www.ccld.ca.gov

3. Facility staff are responsible to know the regulations for providing care.

4. Failure to meet the posting requirements shall result in an immediate civil penalty.

5. 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.

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

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. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

• CCC COMPLETED TESTING ON 7/29/23 AND CURRENTLY THERE ARE NO LEAD EXCEEDANCES

NAME OF LICENSING PROGRAM MANAGER: Ana Noble
NAME OF LICENSING PROGRAM ANALYST: Laura Mejorado
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/22/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2026

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

FACILITY NAME: RUSD/EMERSON ELEMENTARY SCHOOL	FACILITY NUMBER: 334814630
	VISIT DATE: 05/22/2026

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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. 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: https://www.ada.gov/resources/child-care-centers/.

During the exit interview, Early Childhood Coordinator Patricia Tran, confirmed that there are no Registered Sex Offenders present in the facility and LPA completed the RSO profile in FAS.

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.

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

Exit interview conducted and report was reviewed with facility representative Early Childhood Coordinator Patricia Tran.

NAME OF LICENSING PROGRAM MANAGER: Ana Noble
NAME OF LICENSING PROGRAM ANALYST: Laura Mejorado
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/22/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2026

LIC809 (FAS) - (06/04)

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