334844170-11-4-2021-10-CC-JDOO-C8FUQD-20211104154657

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334844170
Report Date: 11/04/2021
Date Signed: 11/04/2021 05:50:42 PM

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:	STORYBOOK PRESCHOOL		FACILITY NUMBER:	334844170
ADMINISTRATOR:	CYNTHIA ROSA		FACILITY TYPE:	850
ADDRESS:	31910 MISSION TRAIL		TELEPHONE:	(951) 387-5895
CITY:	LAKE ELSINORE	STATE: CA	ZIP CODE:	92530
CAPACITY:	156	CENSUS: 69	DATE:	11/04/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Cynthia Rosa		TIME COMPLETED:	04:00 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 Analyst (LPA), Joanne Domingo conducted an 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: · The following items were posted and 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 within the limits as stated on the license. YES · Ratios are being met during this inspection YES · Classrooms are adequately equipped with age and size appropriate furniture and equipment and free of hazards YES · There are no weapons present at the facility as stated by DIRECTOR, CYNTHIA ROSA · 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. NONE OBSERVED DURING THIS VISIT · Drinking water is provided in the indoor activity space and in the outdoor activity space by WATER PITCHERS AND CUPS · Medications are stored where inaccessible to children LOCATED IN LOCKED BOX IN KITCHEN · Hazardous items are stored where inaccessible to children which include: Disinfectants, cleaning solutions and other items that are dangerous YES · Poisons and toxins are locked and inaccessible to children YES · All floors were observed to be clean and safe YES · Bathrooms were observed to be safe, sanitary and in operating condition YES · Playgrounds are enclosed by appropriate fences and free of hazards YES

SUPERVISOR'S NAME: Stephanie Hudak	TELEPHONE: (951) 320-2021
LICENSING EVALUATOR NAME: Joanne Domingo	TELEPHONE: (951) 233-9356
LICENSING EVALUATOR SIGNATURE:	DATE: 11/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2021

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 STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: STORYBOOK PRESCHOOL	FACILITY NUMBER: 334844170
	VISIT DATE: 11/04/2021

NARRATIVE

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· Outdoor activity areas are supplied with age and size appropriate equipment in good condition YES
· Food preparation area is clean, free of litter and rubbish and free of rodents and other vermin YES
· Food is stored appropriately and protected from contamination YES
· All storage containers for solid waste were observed to have tight-fitting covers that are kept on, and in good repair YES
· Sign in/Sign out record was reviewed and meets regulation requirements YES
· Disaster drills are conducted at least every six months – last drill conducted on 10/21/21

A review of staff and children's records were conducted as part of this evaluation.
· Children’s records were found to be complete during this inspection. YES
· Staff records review indicates that all staff present meet minimum qualifications for the position for which they were hired. YES
· A staff member is present with current Pediatric CPR/First Aid which expires on 10/23 (AC, DC, XA, BM, RR, CR, KS & EV)
· Opening and closing staff member’s CPR/First Aid expires on 10/23
· Director completed Health and Safety Training CR - SPRING 1997
· A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. YES

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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 following items were discussed with the Director during inspection:

· 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.
· The areas around or under high climbing equipment, swings, slides, and similar equipment shall be cushioned with material that absorbs a fall

SUPERVISOR'S NAME: Stephanie Hudak	TELEPHONE: (951) 320-2021
LICENSING EVALUATOR NAME: Joanne Domingo	TELEPHONE: (951) 233-9356
LICENSING EVALUATOR SIGNATURE:	DATE: 11/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2021

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 STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: STORYBOOK PRESCHOOL	FACILITY NUMBER: 334844170
	VISIT DATE: 11/04/2021

NARRATIVE

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· The Licensee was informed of their reporting requirements and provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO10@dss.ca.gov
· The Licensee can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations858@dss.ca.gov

LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [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.

DIRECTOR, CYNTHIA ROSA 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 Child 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.

On-line Licensing forms & regulations for a Child Care Center can be obtained on the Department’s website: www.ccld.ca.gov. Additionally, there is a link to “Receive Important Updates” located on the right side of the page, immediately above Quick Links. One can add their email address and choose which program(s) they wish to receive Provider Information Notices (PIN) for.

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

There are no deficiencies being cited at this time.

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/process.

An exit interview was conducted, and this report was reviewed with DIRECTOR, CYNTHIA ROSA. Appeal rights were discussed and provided during the exit interview.

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

SUPERVISOR'S NAME: Stephanie Hudak	TELEPHONE: (951) 320-2021
LICENSING EVALUATOR NAME: Joanne Domingo	TELEPHONE: (951) 233-9356
LICENSING EVALUATOR SIGNATURE:	DATE: 11/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2021

LIC809 (FAS) - (06/04)

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