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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334843054
Report Date: 02/01/2022
Date Signed: 02/01/2022 03:50:22 PM

Document Has Been Signed on 02/01/2022 03:50 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 STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:RENU HOPE FOUNDATIONFACILITY NUMBER:
334843054
ADMINISTRATOR:SULTANA AHMADFACILITY TYPE:
850
ADDRESS:21091 RIDER STREETTELEPHONE:
(951) 940-7600
CITY:PERRISSTATE: CAZIP CODE:
92570
CAPACITY: 72TOTAL ENROLLED CHILDREN: 44CENSUS: 28DATE:
02/01/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Kristin Gillespie - Acting DirectorTIME COMPLETED:
04:00 PM
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On 01/20/2021, Licensing Program Analyst (LPA) Rachel Zeron conducted a required annual inspection as part of a compliance review. This inspection is also in agreement with, and as a result of a Stipulation, Waiver and Order, effective on January 28, 2021, due to concerns associated with the facility history and previous citations issued. There were 28 children in care. A tour of the inside and outside of the facility was granted and the following was observed and discussed with the acting Site Director:

A review of a sampling of the staff records and children records were conducted as part of this evaluation.

During observations made throughout this inspection, the following items were posted: Stipulation Waiver, and Order; License; Emergency Disaster Plan (LIC610); Earthquake Preparedness Checklist (LIC9148); Parent’s Rights Poster (PUB393); Personal Rights (LIC613A); Child Car Seat Law; Menu.

- All staff members working at the facility have obtained a Criminal Record Clearance or Criminal Record Exemption.
- All staff members working at the facility have a personnel record on file, CPR and First Aid training are up to date or completed by all staff employed at the facility.
- Poisons, detergents, cleaning compounds and other toxins are locked and stored where inaccessible to children.
- Facility roster reviewed, All children present are currently enrolled in care.
- There is adequate Care and Supervision being provided during outdoor play activities, classroom, and restroom breaks.
- Currently, there is no children requiring medications at this time.
- Facility is clean, safe, sanitary and in good repair at the time of this inspection.
SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Rachel Zeron
LICENSING EVALUATOR SIGNATURE: DATE: 02/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/01/2022
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 STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: RENU HOPE FOUNDATION
FACILITY NUMBER: 334843054
VISIT DATE: 02/01/2022
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- Staff training records reviewed. Staff training last conducted on 07/28/2021 and 07/29/2021 regarding Title 22 Regulations. General Health & Safety training was conducted on 11/15/2021.
- LIC309 Administrative Organization and Board Meeting Minutes was previously submitted for February 2022.
- Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Day Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

- To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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.

- The Licensee can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations858@dss.ca.gov



- The Licensee was informed of their reporting requirements and is provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO10@dss.ca.gov

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

No deficiencies were cited on today's visit. the facility was found to be in compliance with Title 22, at this time.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS. Exit interview conducted and report was reviewed with Kristin Gillespie, acting Site Director.

SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Rachel Zeron
LICENSING EVALUATOR SIGNATURE:

DATE: 02/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2022
LIC809 (FAS) - (06/04)
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