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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334845819
Report Date: 06/26/2020
Date Signed: 06/30/2020 08:52:00 AM

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:HOPE LUTHERAN CHURCHFACILITY NUMBER:
334845819
ADMINISTRATOR:KEVIN FOLEYFACILITY TYPE:
840
ADDRESS:45900 PORTOLA AVENUETELEPHONE:
(760) 346-1273
CITY:PALM DESERTSTATE: CAZIP CODE:
92260
CAPACITY:75CENSUS: 0DATE:
06/26/2020
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Kevin Foley and Virgina PlavicTIME COMPLETED:
09:30 AM
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Due to COVID-19 pandemic, on June 26, 2020, Licensing Program Analyst (LPA) Timeka Reed conducted a Tele-inspection for the purposes of completing a Pre-Licensing inspection. Due to the executive order issued by Governor Newsom on March 16, 2020 regarding COVID-19, this inspection was conducted via FaceTime video application.

LPA Timeka Reed toured proposed School Age center, inside and out via video conference. The days and hours of operation will be: Monday through Friday 6:30 am to 6:00 pm.


Due to executive order issued by Governor Newsom, measurements to determine capacity were obtained from records on file maintained by Riverside Regional Office;

Classroom 1: 20.33 x 26.33 = 535.29
Classroom 2: 20.50 x 26.33 = 539.77
Classroom 3: 20.75 x 26.33 = 546.35
Classroom 4: 20.33 x 26.05 = 529.60
Total indoor activity space for Classrooms # 3 & 4 only: 1075.95 divided by 35 = 31 children
Total indoor activity space for all classrooms: 2151.01 divided by 35 = 61 children

School-Age Indoor Activity Areas
LPA has determined that there is sufficient space to accommodate 60 children.
SUPERVISOR'S NAME: Gilbert SenaTELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Timeka ReedTELEPHONE: (951) 970-1161
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2020
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: HOPE LUTHERAN CHURCH
FACILITY NUMBER: 334845819
VISIT DATE: 06/26/2020
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School-age Bathroom Fixtures
4 toilets x 15 = 60 children
8 sinks x 15 = 120 children

School-Age Outdoor Activity Area:
LPA has determined that there is sufficient space to accommodate 60 children.

Limiting factor for school-age capacity is number of toilets . School-age capacity is limited to 60 children.

The following was observed:
· Classrooms are adequately equipped with age and size appropriate furniture and equipment
· Water fountains supply drinking water in the indoor activity space
· Playground is enclosed by an appropriate fence
· Outdoor activity area is supplied with age and size appropriate equipment
· 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.
· An adequate amount of cushioning material is in place under play equipment
· Adequate shade is provided
· Drinking water is provided in the outdoor play area by water fountain.
· The facility does not prepare food. Snacks will be stored in a cabinet located in the classroom designated as the Green Room.
· The office area is located in between classrooms and will serve as the isolation area for ill children temporarily until parents arrive
· Staff bathroom will also be used as the isolation bathroom and is conveniently located to the isolation area
SUPERVISOR'S NAME: Gilbert SenaTELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Timeka ReedTELEPHONE: (951) 970-1161
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2020
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: HOPE LUTHERAN CHURCH
FACILITY NUMBER: 334845819
VISIT DATE: 06/26/2020
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· Medication will be stored in a locked cabinet in the classroom designated as the Red Room and is inaccessible to children
· Storage area for toxins and poisons is locked.
· Prior to providing any incidental medical services that a written plan must be submitted to the licensing office.
· Sign in/Sign out record was reviewed and meets regulation requirements
· Component II Orientation was completed during this inspection
· A review of staff records on 06/26/2020 indicates that the Licensee or designated individual who is required to have caregiver background checks have received criminal record and child abuse index clearances or exemptions, all other staff have required documentation in their personnel files.
The Licensee can submit transfer forms to associate new individuals or to disassociate someone from your facility at:
Associations_Disassociations862@dss.ca.gov
Associations_Disassociations858@dss.ca.gov
· The "Notification of Parent's Rights" (PUB393 dated [8/02]) poster was posted in all classrooms.
· The applicant is advised that, once licensed, the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided an updated Plan of Operation that includes IMS must be submitted to the Department. 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
SUPERVISOR'S NAME: Gilbert SenaTELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Timeka ReedTELEPHONE: (951) 970-1161
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2020
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: HOPE LUTHERAN CHURCH
FACILITY NUMBER: 334845819
VISIT DATE: 06/26/2020
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The following is provided to the applicant:
v AB 2621 – Public Information effective January 1, 2015 – The Department shall post licensing reports for Child Care Facilities on it’s internet Web site. This information is to be updated at least monthly on the website and will span the preceding five-year period.
v AB 2236 – Civil Penalties, effective July 1, 2015 – Enacts new civil penalties in cases where the Department determines that a violation of licensing standards resulted in the death or serious injury, or constitutes physical abuse of a child in care. The bill establishes an appeal procedure specific to these civil penalties. The bill also expands the scope of the Child Health and Safety Fund in order to assist parents in securing alternative child care when a Child Care Center license has been suspended or revoked. These civil penalty amounts are scaled in relation to the total capacity of all of the licensee’s facilities and not just the specific facility cited or limited to that facility type.
v AB 2386 – Carbon Monoxide Detector Regulations, effective January 1, 2015 – In accordance with California Health and Safety Code Section 1975.543 - Every child care center shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections
v - SB 277 – Immunizations, Personal Beliefs Exemption, effective January 1, 2016 - it eliminates the exemption from existing specified immunization requirements based upon personal beliefs, and only allows an exemption from future immunization requirements deemed appropriate by the State Department of Public Health or a medical professional for medical reasons.
v - AB290 – Child Nutrition, effective January 1, 2016 - In accordance with California Health and Safety Code Section 1596.866 - each child care center shall have at least one person employed who was completed one hour of childhood nutrition training as part of the preventive health practices course or courses.
SUPERVISOR'S NAME: Gilbert SenaTELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Timeka ReedTELEPHONE: (951) 970-1161
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2020
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: HOPE LUTHERAN CHURCH
FACILITY NUMBER: 334845819
VISIT DATE: 06/26/2020
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v - SB792 – Immunization requirements for staff, volunteers, effective September 1, 2016 – In accordance with California Health and Safety Code Section 1596.7995(a)(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. If employees/volunteers are receiving the influenza vaccination they must do so between August 1 and December 1 of each year.
v - AB2231 (2016) – Increased Civil Penalties, effective July 1, 2017 – For failing to correct a violation the civil penalty is increased to $100 per day for EACH violation until corrected; For failing to correct a repeated violation the civil penalty is increased to $250 immediately assessed , and $100 per day afterwards for EACH repeated violation until corrected; For an Immediate Risk violation the civil penalty is increased to $500 immediately assess, and $100 per day for EACH violation after that until corrected; For any repeated Immediate Risk violations the civil penalty is increased to $1,000 immediately assess, and $100 per day afterwards for EACH repeated violation until corrected.
v NOTE: Repeat violations are defined as a violation of a previously cited statutory or regulatory Section and/or subsection within 12 months prior.
v Effective January 1, 2017 – Children under 2 years of age shall ride in a rear-facing car seat unless the child weighs 40 or more pounds OR is 40 or more inches tall. For additional information regarding car seat laws see www.chp.ca.gov

v Access to forms & Regulations for a Child Care Center are online at www.ccld.ca.gov.

v Please subscribe at www.childcareadvocatesprogram to receive Department updates. They will be sent directly to your e-mail account once you have set up an account. This website can also be accessed through www.ccld.ca.gov
v The Duty Officer is available to answer questions Monday – Friday at 1-844-LET-US-NO (1-844-538-8766).
SUPERVISOR'S NAME: Gilbert SenaTELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Timeka ReedTELEPHONE: (951) 970-1161
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2020
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: HOPE LUTHERAN CHURCH
FACILITY NUMBER: 334845819
VISIT DATE: 06/26/2020
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An exit interview was conducted and during the interview, the applicant, Virginia Plavic confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.



Once review is completed, the application will be submitted for approval with a maximum capacity of 60 children. As agreed upon by the applicant.
An exit interview was conducted and a copy of this report was provided to the applicant on this date.

A copy of this report must be made available to the public for 3 years.
SUPERVISOR'S NAME: Gilbert SenaTELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Timeka ReedTELEPHONE: (951) 970-1161
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2020
LIC809 (FAS) - (06/04)
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