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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334842464
Report Date: 07/02/2024
Date Signed: 07/02/2024 01:46:18 PM

Document Has Been Signed on 07/02/2024 01:46 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:RENU HOPE FOUNDATIONFACILITY NUMBER:
334842464
ADMINISTRATOR/
DIRECTOR:		DENISE DICKSONFACILITY TYPE:
830
ADDRESS:235 N. 2ND STREETTELEPHONE:
(951) 845-3816
CITY:BANNINGSTATE: CAZIP CODE:
92220
CAPACITY: 18TOTAL ENROLLED CHILDREN: 18CENSUS: 13DATE:
07/02/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Site Supervisor Denise DicksonTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
NARRATIVE
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On the date and time listed, Licensing Program Analysts (LPAs) Perla Ordones and Taityana Benson arrived at the facility to conduct an inspection regarding a separate matter. During the visit, LPAs observed three sleeping infants in sleep sacks in the Infant 1 classroom.

Based on observation, this is a violation of Title 22 regulations. See LIC809-D for cited deficiency.

LPAs Perla Ordones and Taityana Benson informed Site Supervisor Denise Dickson that this report dated 07/02/2024 document(s) one Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPAs Perla Ordones and Taityana Benson informed the licensee Site Supervisor Denise Dickson to provide a copy of this licensing report dated 07/02/2024 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

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

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Site Supervisor Denise Dickson.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Perla Ordones
LICENSING EVALUATOR SIGNATURE: DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/02/2024
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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Document Has Been Signed on 07/02/2024 01:46 PM - It Cannot Be Edited


Created By: Perla Ordones On 07/02/2024 at 01:03 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: RENU HOPE FOUNDATION
FACILITY NUMBER: 334842464

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/02/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/03/2024
Section Cited
CCR
101430(a)(3)(C)

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(C) An infant shall not be swaddled while in care.

This requirement is not met as evidenced by:
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Licensee agrees to submit a written plan of action on how compliance will be maintained regarding the cited regulation. Licensee agrees to submit proof of the Plan of Correction (POC) to Community Care Licensing (CCL) by the end of the business day on the POC due date of 07/03/2024.
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Based on observation, the licensee did not comply with the section cited above as LPAs observed three sleeping infants in sleep sacks in the Infant 1 classroom which poses an immediate health, safety or personal rights risk to persons 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:Aaron Ross
LICENSING EVALUATOR NAME:Perla Ordones
LICENSING EVALUATOR SIGNATURE:
DATE: 07/02/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/02/2024


LIC809 (FAS) - (06/04)
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