334846343-6-1-2023-09-CC-SLOZ-CSDMND-20230601094522

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334846343
Report Date: 06/01/2023
Date Signed: 06/01/2023 09:45:38 AM

Document Has Been Signed on 06/01/2023 09:45 AM - 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:	STOKOE STATE PRESCHOOL		FACILITY NUMBER:	334846343
ADMINISTRATOR:	RYAN, MARY		FACILITY TYPE:	850
ADDRESS:	4501 AMBS DRIVE RM E103		TELEPHONE:	(951) 358-1640
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92505
CAPACITY: 32	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	06/01/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	07:45 AM
MET WITH:	Director Mary Ryan		TIME COMPLETED:	10:10 AM

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), Samuel Lopez, toured proposed Preschool center, inside and out. A Fire Clearance was granted on 1/12/2023. The days and hours of operation will be: Monday through Friday, 7:30am to 4:00pm. Facility will offer an AM Program (8:20am to 11:20am) and a PM Program (12:20pm to 3:20pm) Measurements were taken and the following was determined: Preschool Indoor Activity Areas LPA has determined that there is sufficient space to accommodate 15 children. Preschool Bathroom Fixtures 1 toilets x 15 = 15 children 2 sinks x 15 = 30 children Preschool Outdoor Activity Area: LPA has determined that there is sufficient space to accommodate the requested capacity based on observation. * Playground will be shared with Elementary and Head Start. Waiver is pending* Limiting factor for preschool capacity is the capacity requested by the applicant. Preschool capacity is limited to 15 children. The following was observed: · Classrooms are adequately equipped with age and size appropriate furniture and equipment · Filtered water fountain will supply drinking water in the indoor activity space · Playgrounds are enclosed by appropriate fences

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Samuel Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 06/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2023

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: STOKOE STATE PRESCHOOL	FACILITY NUMBER: 334846343
	VISIT DATE: 06/01/2023

NARRATIVE

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· Outdoor activity areas are 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 (rubber mat) is in place under play equipment structure however, there is a slide that sits on a dirt mound. This slide does not have cushioning material at the bottom landing point
· Adequate shade is provided by trees and shade structure
· Drinking water is provided in the outdoor play areas by filtered water fountains
· Food will be provided by the Alvord Unified School District and staff will only serve
· The office area is located at the entrance as well as the nurse's office and will serve as the isolation area for ill children temporarily until parents arrive
· Toxins are locked
· Medication will be stored in the nurse's office
· Medication administration forms were reviewed upon receiving the application
· First Aid kit is complete
· Sign in/Sign out record was reviewed and meets regulation requirements - will be done electronically via an iPad
· Component II Orientation was completed during this inspection
· The applicant 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 6/1/2023 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Site Supervisor/Director Mary Ryan was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.

The 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: Samuel Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 06/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2023

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: STOKOE STATE PRESCHOOL	FACILITY NUMBER: 334846343
	VISIT DATE: 06/01/2023

NARRATIVE

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Water lead testing documentation was received.

This facility plans to provide Incidental Medical Services (IMS). For IMS information, see PIN 22-02-CCP. A 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

LPA also informed Site Supervisor/Director Mary Ryan 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.

LPA reviewed with Site Supervisor/Director Mary Ryan the LIC 311A, Records to Be Maintained at The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

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

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

1. Roots that are exposed, from the tree, located in the playground need to addressed in a manner where they are not a hazard to children at play
2. Slide that sits on a mound of dirt needs cushioning material to be placed at the landing area
3. On boarding documentation regarding staff hired for up coming school year

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Samuel Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 06/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2023

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: STOKOE STATE PRESCHOOL	FACILITY NUMBER: 334846343
	VISIT DATE: 06/01/2023

NARRATIVE

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Once all corrections have been made, with proof sent to licensing, the application will be submitted for approval with a maximum capacity of 15. 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.

Exit interview conducted and report was reviewed with the Site Supervisor/Director Mary Ryan

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Samuel Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 06/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2023

LIC809 (FAS) - (06/04)

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