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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334844856
Report Date: 06/27/2022
Date Signed: 06/27/2022 05:07:42 PM

Document Has Been Signed on 06/27/2022 05:07 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:LEARNING EXPERIENCE, THEFACILITY NUMBER:
334844856
ADMINISTRATOR:BELEN ACOSTAFACILITY TYPE:
850
ADDRESS:515 ALESSANDRO BLVD.TELEPHONE:
(951) 386-2560
CITY:RIVERSIDESTATE: CAZIP CODE:
92508
CAPACITY: 135TOTAL ENROLLED CHILDREN: 135CENSUS: 99DATE:
06/27/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Belen AcostaTIME COMPLETED:
05:15 PM
NARRATIVE
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On 06/27/22 at 1:30PM Licensing Program Analyst (LPA) Giselle Carbullido arrived at the facility to conduct a 1 year required annual inspection. LPA was granted entry by Director Belen Acosta. LPA toured the facility, inside and out, reviewed records and observed and/or discussed the following.

Days and hours of operation are Monday -Friday; 6:30AM -6:30PM.

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. Deficiencies were cited this visit and technical advisory was given.

The licensee is asked to update the following documents, if applicable, and submit to licensing within 30 days:


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)
4. LIC 309 Administrative Organization
5. LIC 308 Designation of Administrative Responsibility
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.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE: DATE: 06/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/27/2022
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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: LEARNING EXPERIENCE, THE
FACILITY NUMBER: 334844856
VISIT DATE: 06/27/2022
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· Ratios were met with appropriate supervision during this inspection: See LIC9102 TV. LPA observed several children up and awake during nap time with 1 teacher present for 20 children in care; additional staff called to assist during this visit.
· Classrooms are clean, free of hazards and equipped with age appropriate furniture
· No weapons stored at the facility
· There are no accessible bodies of water present.
· Medications are stored inaccessible to children in the Front office
· Hazards are stored inaccessible to children which include: Poisons and toxins are locked
· All floors are clean and safe.
· Bathrooms were observed to be safe, sanitary and in operating condition
· Outdoor activity areas/play grounds are enclosed by appropriate fences, free of hazards with age and size appropriate equipment in good condition: Yes
· Food preparation area is clean, free of litter, rubbish and free of rodents and other vermin
· Measures are taken to keep the facility free of flies, other insects and rodents
· Food is stored appropriately and protected from contamination
· Storage containers for solid waste, including moveable bins-have tight-fitting covers in good repair
· Menus are 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
· Uncontaminated drinking water shall be readily available both indoors and out and provided by public water supply (fountains) and water bottles
· The areas around or under high climbing equipment, swings, slides, and similar equipment shall be cushioned with material that absorbs a fall: Facility has rubber foam matting
· Sign in/Sign out record was reviewed and meets regulation requirements: Yes
· A Staff member is present with current Pediatric CPR/First Aid which expires on 06/23
· Opening and closing staff member’s CPR/First Aid expires on 12/22
· Director completed Health and Safety Training on Fall 2018 transcripts
· Staff qualifications and files were reviewed and are complete: No see LIC809D and LIC9102TV
· Staff have received on the job training for housekeeping, sanitation and universal health precautions
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2022
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: LEARNING EXPERIENCE, THE
FACILITY NUMBER: 334844856
VISIT DATE: 06/27/2022
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Licensee was informed the Department has inspection authority per Health and Safety Codes.
Licensee provided the Unusual Incident Reporting email: UnusualIncidentReportsDO09@dss.ca.gov
· Children files were reviewed and are complete. Yes
· Documentation of fire & earthquake drills to be conducted every six months: Last drill on 06/22/2022
· AB2370 – Lead Exposure, day care facilities, effective January 1, 2019 –
The bill requires that all Child Care Centers, operating in a building constructed before January 1, 2010, shall have their drinking water tested for excessive lead levels, on or after January 1, 2020, but no later than January 1, 2023. Child Care Centers must thereafter test their drinking water every five years after the date of the initial test.
· AB605 – Child day care facilities, birth to school-age license; Effective January 1, 2021
· AB2960 – Child care and development services, online portal – Effective June 20, 2022 - This bill requires the State Superintendent of Public Instruction (SSPI), within the California Department of Education (CDE), to develop and post on CDE's website a comprehensive child care and development services online portal for families and providers by June 30, 2022.
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 For CCCs: Incidental Medical Services (IMS) policy was discussed.

Facility Representative was reminded that all adults 18 and over living or working in the home, 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.

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2022
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: LEARNING EXPERIENCE, THE
FACILITY NUMBER: 334844856
VISIT DATE: 06/27/2022
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LPA Carbullido informed facility representative Belen Acosta that this report dated 06/27/2022 document(s) (1) 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, LPA Carbullido informed the facility representative], Belen Acosta to provide a copy of this licensing report dated (06/27/2022) 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.

This citation is a repeat violation and a $250.00 civil penalty was issued.

LPA discussed the safe sleep regulations with 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 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.

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.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Facility Representative, Belen Acosta

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/27/2022 05:07 PM - It Cannot Be Edited


Created By: Giselle Carbullido On 06/27/2022 at 04:26 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: LEARNING EXPERIENCE, THE
FACILITY NUMBER: 334844856

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/27/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
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
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Based on (record review)], the licensee did not comply with the section cited above in [3] out of 7 (persons) which poses an immediate health, safety or personal rights risk to persons in care.This is a repeat violation; a civil penalty has been issued.
POC Due Date: 06/28/2022
Plan of Correction
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Facility will provide copies of LIC503 to S5-S7 and submit proof of scheduled health screen with physician for S5-S7 to LPA Carbullido by POC due date. Facility will also submit poof of completed LIC9224 for all children enrolled in pre school program.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Gilbert Sena
LICENSING EVALUATOR NAME:Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:
DATE: 06/27/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/27/2022


LIC809 (FAS) - (06/04)
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