334844660-8-22-2025-09-CC-SBRR-DKSTCG-20250822143643

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334844660
Report Date: 08/22/2025
Date Signed: 08/22/2025 02:36:57 PM

Document Has Been Signed on 08/22/2025 02:36 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:	KIDSPARK		FACILITY NUMBER:	334844660
ADMINISTRATOR/ DIRECTOR:	JULIE MASON		FACILITY TYPE:	840
ADDRESS:	280 TELLER STREET #170		TELEPHONE:	(951) 520-8900
CITY:	CORONA	STATE: CA	ZIP CODE:	92879
CAPACITY: 30	TOTAL ENROLLED CHILDREN: 368	CENSUS: 3	DATE:	08/22/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:00 PM
MET WITH:	Licensee Julie Mason		TIME VISIT/ INSPECTION COMPLETED:	02:45 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	On 08/22/2025 at 1:00 PM Licensing Program Analyst (LPA) Susan Brewer, arrived at the facility to conduct an annual inspection. LPA was granted entry by Licensee Julie Maston. LPA toured the facility, inside and out, reviewed records, and observed and/or discussed the following: Normal days and hours of operation: Monday to Friday, 7:30 AM to 7:00 PM; and Saturday 10 AM to 9:00 PM. The facility has a waiver on file for Indoor/Outdoor Square Footage; Commingling of Preschool and School Age-Children, Toilets/Sinks and Fluctuating Capacity (not to exceed overall approved capacity). The inspection consisted of reviews of the following domains: Food Service; Reporting Requirements: Physical Plant; Care and Supervision; Children Records; Staff Records; Staffing Ratio and Capacity and Personal Rights. The inspection found the facility to be in compliance in these domains, except as noted on the LIC809D. The facility is operating within the licensed capacity and appropriate ratios. The licensee is asked to update the following documents, if applicable, and submit to licensing within 30 days if changes have been made. 1. LIC 500 Personnel Report 2. LIC 610 Emergency & Disaster Plan. 3. Parent Handbook/ Program Curriculum/Admission policies and procedures/ fee schedule (only if changes have been made).

NAME OF LICENSING PROGRAM MANAGER: Ana Noble
NAME OF LICENSING PROGRAM ANALYST: Susan Brewer
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2025

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: KIDSPARK	FACILITY NUMBER: 334844660
	VISIT DATE: 08/22/2025

NARRATIVE

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4. LIC 309 Administrative Organization
5. LIC 308 Designation of Administrative Responsibility
6. LIC 200A Application for changes.

The following items have been posted and are 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 terms of the license.
· Facility is clean, safe and sanitary and in good repair.
· Ratios met during this inspection with 3 children in care, of 3 staff.
· A fully charged fire extinguisher (2A:10BC) was observed and checked by the fire department. A smoke detector and carbon monoxide detector were present and tested during this inspection. The LPA discussed the some devices sounding off for battery, however the facility has over 10 devices installed in the center.
· Appropriate supervision was provided during this inspection.
· Classrooms are equipped with age-appropriate furniture and equipment in good condition.
· Classrooms are clean and free of hazards.
· All materials and surface accessible to children are toxic free.
· No weapons stored at the facility on 08/22/2025.
· There are no bodies of water present on 08/22/2025. All wading pools or similar product must be emptied immediately after use and stored in an upright position.
· Medications are stored where inaccessible to children.
· Center is equipped to isolate and care for any child who becomes ill during the day.
· Hazards are stored where inaccessible to children which include disinfectants, cleaning solutions and other items that are dangerous to children.
· All floors shall be clean and safe, which were verified on 08/22/2025.
· Measures are taken to keep the facility free of flies, other insects and rodents.
· Toxins are key locked in a storage room.
· Bathrooms were observed to be safe, sanitary and in operating condition.
· The facility does not have an outdoor playground, and a waiver is on file for indoor play area. Indoor activity areas are supplied with age and size appropriate equipment in good condition.

NAME OF LICENSING PROGRAM MANAGER: Ana Noble
NAME OF LICENSING PROGRAM ANALYST: Susan Brewer
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2025

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: KIDSPARK	FACILITY NUMBER: 334844660
	VISIT DATE: 08/22/2025

NARRATIVE

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· Food preparation area is clean and free of vermin on a quarterly basis.
· Food is stored appropriately and protected from contamination.
· All storage containers for solid waste, including movable bins shall have tight-fitting covers that are kept on, and in good repair.
· Uncontaminated drinking water shall be readily available both indoors and out and is provided by tap water. The facility has two drinking fountains, disposable cups and some children bring personal water bottles.
· The areas around or under high climbing equipment, swings, slides, and similar equipment shall be cushioned with material that absorbs a fall. – A waiver is on file for indoor play area, in place of outdoor play area. The LPA observed foam equipment, mats and carpeted materials to cushion a fall.
· 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.
· Sign in/Sign out record was reviewed and meets regulation requirements on Kidpark System (KPC) software application for an electronic sign in/out. In the event of the KPC application not working, the facility has a hardcopy sign in and out sheet.
· A Staff member is present with current Pediatric CPR/First Aid which expires on 04/23/2027
· Opening and closing staff member’s CPR/First Aid expires on 07/27/2027.
· Director completed Health, Safety, Nutrition and Lead Training: Not on file, a staff member present completed H/S/N/L-SP 2025
· Staff qualifications and files were reviewed and are incomplete on 08/22/2025. 2 staff present and working are missing the LIC503 health screening to meet educational requirements and health requirements for performing assigned tasks, proof of Immunizations, Health, Safety, Nutrition and Lead Training, not on file for director, 1 staff present did not have proof of screening for tuberculosis.
· Staff received on the job training for housekeeping, sanitation and universal health precautions.
· Each child’s file is complete on 08/22/2025.
· Licensee was informed of the Department has inspection authority per Health and Safety Codes
· Documentation of fire & earthquake drills to be conducted every six months: Last drill on 06/17/2025 with 1 child and 2 staff.
· Documentation of Lead Testing is on file: Testing completed on 10/23/2022, and 10/25/2022 report indicates no lead exceedances.

NAME OF LICENSING PROGRAM MANAGER: Ana Noble
NAME OF LICENSING PROGRAM ANALYST: Susan Brewer
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2025

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: KIDSPARK	FACILITY NUMBER: 334844660
	VISIT DATE: 08/22/2025

NARRATIVE

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A review of staff records on 08/22/2025 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

The Licensee Representative was informed of their reporting requirements and is provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO09@dss.ca.gov

The Licensee Julie Mason, was reminded that all adults 18 and over working at the facility, 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 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. The
Licensee Julie Mason, can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations862@dss.ca.gov for Riverside Regional Office.

LPA Susan Brewer, also informed Facility Representative of the importance of checking for recalled idevices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all devices with the CPSC to be notified of any recalls on their purchased equipment.

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.

Deficiencies were cited for Type B violations this visit.

Civil Penalties were issued this visit

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

Exit interview conducted and report was reviewed with the licensee Julie Mason.

NAME OF LICENSING PROGRAM MANAGER: Ana Noble
NAME OF LICENSING PROGRAM ANALYST: Susan Brewer
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 08/22/2025 02:36 PM - It Cannot Be Edited

Created By: Susan Brewer On 08/22/2025 at 01:55 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: KIDSPARK	FACILITY NUMBER: 334844660
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/22/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.7995(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, the licensee did not comply with the section cited above in the licensee was unable to provide proof of vaccination for measles and pertussis for a subject staff observed present to supervise children in care, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/22/2025
	Plan of Correction
1 2 3 4	The licensee agrees to ensure a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles, and each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. In addition, the licensee agrees to submit proof of vaccinations for a subject staff, to the department by fax, mail or email.

Type B

Section Cited

CCR

101216(g)(1)

Personnel Requirements

(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, the licensee did not comply with the section cited above in 2 staff present and supervising children did not have proof of the LIC503 health screening, and 1 staff did not have proof of a screening for tuberculosis on file, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/22/2025
	Plan of Correction
1 2 3 4	The licensee agrees to ensure employees are in good physical health shall be verified by a health screening, including a test for tuberculosis (TB), performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure. In addition the licensee agrees to provide proof of health screenings and proof of a TB screening for subject staff, to the department by fax, mail or e-mail.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Ana Noble
NAME OF LICENSING PROGRAM MANAGER:

	Susan Brewer
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2025

LIC809 (FAS) - (06/04)

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