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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334846061
Report Date: 09/22/2021
Date Signed: 09/22/2021 04:48:38 PM

Document Has Been Signed on 09/22/2021 04:48 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:LA SIERRA ACADEMY CHILDREN'S CENTERFACILITY NUMBER:
334846061
ADMINISTRATOR:MUNOZ, ELIZABETHFACILITY TYPE:
850
ADDRESS:4900 GOLDEN AVENUETELEPHONE:
(951) 351-1445
CITY:RIVERSIDESTATE: CAZIP CODE:
92505
CAPACITY: 60TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
09/22/2021
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
01:12 PM
MET WITH:Datha Tickner, Maritza ArguelloTIME COMPLETED:
04:45 PM
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Licensing Program Analysts (LPAs) Kim Leung and Giselle Carbullido conducted a prelicensing inspection at the facility this date on 9/22/2021. Upon arrival, LPAs met with applicant representative Datha Tickner and facility director Maritza Arguello. LPAs toured proposed Preschool center, inside and out. The days and hours of operation will be: Monday through Friday from 6:30am to 6:00pm. Measurements of the indoor and outdoor activity space were taken during this inspection.

Preschool Indoor Activity Areas
LPA has determined that there is sufficient space to accommodate 60 children, the requested capacity.

Preschool Bathroom Fixtures
5 toilets x 15 = 75 children
9 sinks x 15 = 135 children

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

Limiting factor for preschool capacity is bathroom fixture. Preschool capacity is limited to 60 children as requested by the applicant.

The following was observed:
· There are 3 classrooms, Forest, Rainbow and Jungle. All classrooms are adequately equipped with age and size appropriate furniture and equipment. There are functioning carbon-monoxide detectors in the building.
· The drinking faucets in the Forest Room and Rainbow Room and on playground supply drinking water. During the COVID-19 pandemic, the facility is providing drinking water by using pitchers of water, disposable cups and water bottles. The bottles are filled up by staff throughout the day.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Kim Leung
LICENSING EVALUATOR SIGNATURE: DATE: 09/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/22/2021
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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: LA SIERRA ACADEMY CHILDREN'S CENTER
FACILITY NUMBER: 334846061
VISIT DATE: 09/22/2021
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· Playground is not enclosed by fencing at this time
· Outdoor activity areas are supplied with age and size appropriate equipment for younger preschool children. Applicant is installing sand box and spider climber on the playground.
· There are no accessible bodies of water present at this time. Applicant and director understand that all wading pools or similar product must be emptied immediately after use and stored in an upright position. Applicant representative Datha Tickner states that there is no swimming pool, baptismal or body of water on the premises including the private school territories.
· No high climbing play equipment at this time but applicant agreed to place the spider climber in areas with sufficient cushioning material to absorb falls
· Adequate shade is provided by trees and building overhang. Applicant is putting a portable sand box with canopy in place on the playground to provide additional shade.
· Lunch will be delivered from the cafeteria to the activity rooms by cafeteria staff. The kitchen is equipped with refrigerator, sink with hot and cold running water, storage area, utensils, and adequate amount of food supplies. · The director's office area is located between the Rainbow Room and Jungle Room 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
· Medications are stored in individual classroom and will be secured in a locked box
· The applicant states that they plan to provide Incidental Medical Services (IMS) at this time. Plan of operation including IMS is on file..
· First Aid kit is complete
· Electronic sign in and sign out with unique PIN assigned to each of the authorized representatives of the children.
· Component II Orientation was completed during this inspection
· The was informed of their reporting requirements and is provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO09@dss.ca.gov
· A review of staff records on 9/22/2021 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/applicant can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations862@dss.ca.gov
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Kim Leung
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2021
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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: LA SIERRA ACADEMY CHILDREN'S CENTER
FACILITY NUMBER: 334846061
VISIT DATE: 09/22/2021
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· The applicant has been informed that all employees must be associated to the facility. If the licensee fails to have proof of a fingerprint clearance or fails to associate a previously cleared individual to the facility, a civil penalty of $100.00, per day the person has been present, will be assessed. The first violation is subject to the penalty for up to five days. If there is a subsequent violation in a 12-month period, the fine will continue for up to 30 days.
· The applicant was advised that 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 be posted for 30 days.

The following was also reviewed and discussed:
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 more information on SIDS and Safe Sleep Environments, please visit:
California Department of Public Health – California SIDS Program: http://www.cdph.ca.gov/programs/SIDS/pages/default.aspx
AAP – Safe Sleep Campaign: http://www.healthychildcare.org/sids/html
AAP-Free Training: Reducing the Risk of SIDS in Early Education and Child Care: http://shop.aap.org/Reducing-the-Risk-of-SIDS-in-Early-Education-and-Child-Care
And Caring for our Children, Safe Sleep Practices and SIDS/Suffocation Risk Reduction: http://cfoc/nrckids/org/standardview/spccol/safe_sleep
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.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Kim Leung
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2021
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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: LA SIERRA ACADEMY CHILDREN'S CENTER
FACILITY NUMBER: 334846061
VISIT DATE: 09/22/2021
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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 AB2370 – Lead Exposure, day care facilities, effective January 1, 2019 - An act amending Sections 1596.866 and 1596.8661 and adding Sections 1596.7996 and 1597.16 to the Health and Safety Code for the education of risks and effects of lead exposure in child care facilities and for the testing of drinking water in licensed child care centers. Licensed providers have access to a document regarding lead toxicity prevention created in partnership with the California Department of Public Health (CDPH) to provide to parents/guardians of newly enrolled or reenrolled children with information on the following:
· Risks and effects of lead exposure
· Blood lead testing recommendations and requirements
· Options for obtaining blood lead testing, including any programs that offer free or discounted tests
This printable document (Lead Poisoning Facts) is located here as well as on the Child Care Licensing website. The bill also requires that the Department add instruction on the prevention of lead exposure to the Preventative Health and Safety Training curriculum for providers licensed on or after July 1, 2020. Finally, it 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
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Kim Leung
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2021
LIC809 (FAS) - (06/04)
Page: 4 of 7
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: LA SIERRA ACADEMY CHILDREN'S CENTER
FACILITY NUMBER: 334846061
VISIT DATE: 09/22/2021
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Centers must thereafter test their drinking water every five years after the date of the initial test. The Department must adopt regulations in consultation with the State Water Resources Control Board for the implementation of the requirements for the testing of drinking water for lead in Child Care Centers by January 1, 2021. The regulations shall include requirements to ensure the collection and submission of valid water samples.
v AB605 – Child day care facilities, birth to school-age license; Effective January 1, 2021 - An act amending Sections 1596.76, 1596.955 and 1596.956 and adding Section 1596.951 to the Health and Safety Code to address requirements for a single license and extend the period for possible participation in the toddler programs. It requires the California Department of Social Services, in consultation with stakeholders, to adopt regulations on or before January 1, 2021, to create a Child Care Center license to serve infant, toddler, preschool, and school-age children. It also requires, before January 1, 2024, that all Child Care Centers transition to one-center licenses. Access to forms & Regulations for Child Care Centers online at www.ccld.ca.gov.

v 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. Further, the bill would require the SSPI to submit a report to the Legislature by January 1, 2021, proposing plans for enhancements to the online portal and inclusive of a comprehensive implementation plan, based on recommendations from the workgroup.

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).
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Kim Leung
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2021
LIC809 (FAS) - (06/04)
Page: 5 of 7
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: LA SIERRA ACADEMY CHILDREN'S CENTER
FACILITY NUMBER: 334846061
VISIT DATE: 09/22/2021
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v - AB 1207 – Mandated Child Abuse Reporting: Child Day Care Personnel Training, beginning January 1, 2018 – In accordance with California Health and Safety Code Section 1596.8662 – requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Applicants must meet requirements as a precondition to licensure. Existing licensees must meet requirements by March 30, 2018. New employees shall have 90 days to complete training as required. This training requirement may be directly met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules. The OCAP modules are free of cost and available at: http://www.mandatedreporterca.com/ and are provided in English and Spanish. If no training is made available in a required person’s primary language then those persons shall be exempt from this requirement
v AB2370 – Lead Exposure, day care facilities, effective January 1, 2019 - An act amending Sections 1596.866 and 1596.8661 and adding Sections 1596.7996 and 1597.16 to the Health and Safety Code for the education of risks and effects of lead exposure in child care facilities and for the testing of drinking water in licensed child care centers. Licensed providers have access to a document regarding lead toxicity prevention created in partnership with the California Department of Public Health (CDPH) to provide to parents/guardians of newly enrolled or reenrolled children with information on the following:
· Risks and effects of lead exposure
· Blood lead testing recommendations and requirements
· Options for obtaining blood lead testing, including any programs that offer free or discounted tests
This printable document (Lead Poisoning Facts) is located here as well as on the Child Care Licensing website. The bill also requires that the Department add instruction on the prevention of lead exposure to the Preventative Health and Safety Training curriculum for providers licensed on or after July 1, 2020. Finally, it 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. The Department must adopt regulations in consultation with the State Water Resources Control Board for the implementation of the requirements for the testing of drinking water for lead in Child Care Centers by January 1, 2021. The regulations shall include requirements to ensure the collection and submission of valid water samples.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Kim Leung
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2021
LIC809 (FAS) - (06/04)
Page: 6 of 7
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: LA SIERRA ACADEMY CHILDREN'S CENTER
FACILITY NUMBER: 334846061
VISIT DATE: 09/22/2021
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An exit interview was conducted with facility representatives and during the interview, the applicant representative Datha Tickner confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.

The following items need to be completed/corrected prior to a license being issued:

1. Obtain a fire clearance
2. Complete all work on the playground
3. Enclose the playground with fencing of at least 4 foot tall
4. Submit facility sketch with names of the rooms specified
5. Complete installation of the spider climber in areas cushioned with materials that could absorb falls
6. Make lock boxes available for storage of medications
7. Remove all hazards from the isolation bathroom

Once a fire clearance has been obtained and all the above have been completed, with proof sent to licensing, the application will be submitted for approval with a maximum capacity of 60 children, ages 2 to kindergarten. Applicant agreed to re-address the 2nd temporary relocation site and submit an updated LIC610 Emergency and Disaster Plan with temporary relocation sites in different neighborhoods within two weeks from date of approval of this application. As agreed upon by the applicant, all corrections are due within 30 days. If not received within 30 days from the date of this report, the application will be denied. An exit interview was conducted and a copy of this report was provided to the applicant on this date.

COVID-19 RAST (Rapid Assistance Support Team) inspection was conducted this date during the same visit. Self-Assessment on file.

A copy of this report must be made available to the public for 3 years.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Kim Leung
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2021
LIC809 (FAS) - (06/04)
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