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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334830483
Report Date: 07/08/2021
Date Signed: 07/08/2021 08:25:36 PM

Document Has Been Signed on 07/08/2021 08:25 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:CHILDRENS LIGHTHOUSE OF RIVERSIDE, CAFACILITY NUMBER:
334830483
ADMINISTRATOR:JANICE WILSONFACILITY TYPE:
830
ADDRESS:19743 LURIN AVENUETELEPHONE:
(951) 653-6688
CITY:RIVERSIDESTATE: CAZIP CODE:
92508
CAPACITY: 24TOTAL ENROLLED CHILDREN: 0CENSUS: 4DATE:
07/08/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Director Janice WilsonTIME COMPLETED:
03:30 PM
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On 07/08/2021 at 08:50am, Licensing Program Analyst (LPA) Destinee Hogue 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 discussed with Director, Janice Wilson:

A review of the staff records and a sampling of the children's records was conducted as part of this evaluation.
· ZERO TOLERANCE - 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.
· ZERO TOLERANCE - No weapons stored at the facility
· Hazards are stored where inaccessible to children which include: disinfectants, cleaning solutions and other items that are dangerous to children.
· Poisons and toxins are locked
· Medications are stored where inaccessible to children
· Classrooms are equipped with age appropriate furniture and equipment in good condition. The facility shall have age appropriate furniture and equipment including, but not limited to, cribs, cots or mats; changing tables, and feeding chair
· The facility shall have sufficient infant napping equipment
· The facility shall have indoor and outdoor activity space for infants that is physically separate from space used by child care center/school-age components
· Each crib, mat or cot shall be occupied by only one infant at a time.
· Cribs shall be free from all loose articles and objects, including blankets and pillows.
· There shall be no objects hanging above or attached to the side of the crib.
· Outdoor activity areas are supplied with age and size appropriate equipment in good condition
· Playgrounds are enclosed by appropriate fences and free of hazards
· The surface of the outdoor activity space is free of hazards. LPA observed wood chips surrounding the outdoor play area.
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Destinee Hogue
LICENSING EVALUATOR SIGNATURE: DATE: 07/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/08/2021
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: CHILDRENS LIGHTHOUSE OF RIVERSIDE, CA
FACILITY NUMBER: 334830483
VISIT DATE: 07/08/2021
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· All toilets, handwashing, and bathing facilities are in safe and operating condition, at this time.
· All floors were observed to be clean and free from hazards
· Food preparation area is clean and free of vermin
· Food is stored appropriately and protected from contamination
· All storage containers for solid waste, including moveable bins have tight-fitting covers that were on and in good repair, at this time.
· Uncontaminated drinking water shall be readily available both indoors and out. Drinking water is supplied by filtered waters with disposable cups.
· The areas around or under high climbing equipment, swings, slides, and similar equipment shall be cushioned with material that absorbs a fall.
· The Licensee shall ensure the facility is free of flies, other insects and rodents.
· Outdoor activity space surfaces shall be free of hazards.
· Appropriate carbon monoxide detector is present and was tested by the Director during this inspection.
· Licensee/Director understands the Child Care Center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.
· ZERO TOLERANCE - The Department has inspection authority as specified in Health & Safety Code sections 1596.852, 1596.853, and 1596.8535.
· The Department shall notify a Licensee to immediately terminate the employment of, or to remove/bar any person with specified convictions or for other reasons. The Licensee shall comply with the notice.
· The facility is operating within the terms of the license.
· A review of staff records on 07/08/2021 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
· A Staff member is present with current Pediatric CPR/First Aid which expires on 04/2022
· Licensee understand the name of the Child Care Center Director or fully qualified teacher(s) designated to act in the Director's absence shall be reported to the Department within 10 days of a change.
· Sign in/Sign out record was reviewed and meets regulation requirements, at this time.
· Each Staff’s files contain the required health screening as specified in section 101216(g). Licensee/Director understands all personnel, including the Licensee, Administrator and Volunteers, shall be in good health and shall be physically and mentally capable of performing assigned tasks.
· Personnel that pose a threat to the health and safety of children shall be relieved of their duties.
· All personnel shall be given on-the-job training…or shall have related experience that demonstrates knowledge of and skill in…housekeeping and sanitation principles, including universal health precautions.
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Destinee Hogue
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2021
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: CHILDRENS LIGHTHOUSE OF RIVERSIDE, CA
FACILITY NUMBER: 334830483
VISIT DATE: 07/08/2021
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· The Licensee/Director shall not exceed the conditions, limitations and capacity specified on the license.
· ZERO TOLERANCE - Appropriate supervision was provided during this inspection. Licensee/Director understands the facility shall ensure that each infant is never left unattended, and under the direct visual supervision of a staff person at all times.
· Ratios were met during this inspection. Licensee/Director understands there shall be a ratio of one Teacher for every four infants in attendance. An Aide may be substituted for a Teacher when all of the
following conditions are met: There is a fully qualified Teacher directly supervising no more than
12 infants; and each Aide is responsible for the direct care and supervision of a group of no
more than four infants.
· Staff shall physically check on sleeping infant(s) every 15 minutes and document the following: labored breathing; signs of distress; flushed skin color; increase in body temperature and restlessness.
· Staff shall document and update the infant's Individual Infant Sleeping Plan [LIC 9227 (3/20)] and if Section C is not complete, then staff shall return the infant to their back for sleeping.
· Infants up to 12 months of age shall have a completed Individual Infant Sleeping Plan (LIC9227). Documentation shall include the following: Date; Infant's name; Time of each 15-minute check; Initials of person who conducted each check.
· If staff observes labored breathing or signs of distress…staff shall obtain emergency medical treatment and immediately notify the infant's authorized representative.
· In the event a separately walled room is used as a designated sleeping area, staff must adhere to the staff-infant ratio requirements, as specified in Section 101416.5(d), unless there is a half-wall or transparent wall that allows for constant audial and visual supervision.
· Staff shall place infants up to 12-months of age on their backs for sleeping.
· An infant shall not be swaddled while in care.
· The facility shall have an individual feeding plan for each infant.
· The facility shall ensure that each infant has an Infant Needs and Services Plan
· The facility shall ensure that staff being utilized as infant teachers during the compliance review meet the qualification requirements.
· Licensee/Director shall ensure that each child is accorded a safe, healthful and comfortable accommodations, furnishings and equipment to meet the child's needs.
· The Licensee/Director is responsible for ensuring that children with obvious symptoms of illness including, but not limited to, fever or vomiting, are not accepted.
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Destinee Hogue
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2021
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: CHILDRENS LIGHTHOUSE OF RIVERSIDE, CA
FACILITY NUMBER: 334830483
VISIT DATE: 07/08/2021
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· The facility is equipped to isolate and care for any child who becomes ill during the day. The Directors office will be utilized to isolate and care for ill children.
· Each child’s file contains the required identification and emergency information and medical assessment.
· Menus shall be posted at least one week in advance in a place visible by the child’s authorized
· AB1207 Mandated Child Abuse Reporter training expires on 07/07/2023
· Review of staff records contains proof staff are immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year or provide a statement denying the influenza vaccination.

· Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided an updated Plan of Operation that includes 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: http://www.ada.gov/childqanda.htm

· The Licensee can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations862@dss.ca.gov

· 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

· The Duty Officer is available to answer questions Monday – Friday from 8:00am to 5:00pm at (951)782-4200

· Access to forms & Regulations for a Child Care Center are online at www.cdss.ca.gov.

An exit interview was conducted and during the interview, Director, Janice Wilson 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. Appeal rights were provided and discussed. This report must be available for review, upon request, for the next 3 years.
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Destinee Hogue
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2021
LIC809 (FAS) - (06/04)
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