336300618-12-19-2022-10-CC-LVAA-CM9RAZ-20221219115158

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 336300618
Report Date: 12/19/2022
Date Signed: 12/19/2022 11:52:09 AM

Document Has Been Signed on 12/19/2022 11:52 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 STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME:	I CAN PRESCHOOL AND CHILD CARE		FACILITY NUMBER:	336300618
ADMINISTRATOR:	CABAONG, ATLANTIS		FACILITY TYPE:	850
ADDRESS:	26704 MURRIETA RD		TELEPHONE:	(951) 973-1105
CITY:	MENIFEE	STATE: CA	ZIP CODE:	92585
CAPACITY: 75	TOTAL ENROLLED CHILDREN: 75	CENSUS: 0	DATE:	12/19/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:25 AM
MET WITH:	Atlantis Cabaong		TIME COMPLETED:	12:15 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 12/19/2022, Licensing Program Analysts (LPAs), Ana Noble and Lorena Valenzuela conducted a pre-licensing inspection this date for a proposed preschool program. The days and hours of operation will be: Monday-Friday 7:00 am to 6:00 pm. LPAs met with Atlantis Cabaong, Applicant and Director who led a tour of the facility at 9:55 AM. The facility was toured inside and out, and the following was observed: · Classrooms are adequately equipped with age and size appropriate furniture and equipment. Classroom has been set up with the equipment. · Water will be provided via disposable cups from filtered water from the kitchen in the indoor and outdoor activity spaces · Playground is enclosed by a wrought iron fence and chain link fence · Outdoor activity area is supplied with age and size appropriate equipment. · There are no accessible bodies of water present. If wading pools or similar products are used, they must be emptied immediately after use and stored in an upright position. · There is adequate amount of cushioning material – grass and sand in some areas. Under play equipment there is rubber padding · Adequate shade will be provided by several outdoor shade structures · Food preparation area is equipped with refrigerator, sink with hot and cold running water, storage area, utensils, and adequate amount of food supplies · The office area is located main building near the entrance · Office room will serve as the isolation area for ill children temporarily until parents arrive · There is a working telephone located in the facility. · Medication will be stored in the offic building in a locked cabinet which is inaccessible to children · Storage area for toxins and poisons is locked, located in the staff restroom in Classroom #1 and #2, and in a locked cabinet in classroom #3.

SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Lorena Valenzuela
LICENSING EVALUATOR SIGNATURE:	DATE: 12/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2022

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 STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: I CAN PRESCHOOL AND CHILD CARE	FACILITY NUMBER: 336300618
	VISIT DATE: 12/19/2022

NARRATIVE

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- Medication administration forms were reviewed
· First Aid kit was available during this visit.
Sign in/Sign out record was reviewed and meets regulation requirements
· Parent Board located entrance of the office with all required forms.
· Carbon Monoxide Detector located in each building and were test and operable.

Measurements were taken and the following was determined:

Preschool Indoor Activity Areas-
LPA has determined that there is sufficient space to accommodate 51 children.

Preschool Bathroom Fixtures
6 toilets x15 = 90 children
9 sinks x 15 = 135 children (2 sinks in the outside area)

Preschool Outdoor Activity Area:
LPA has determined that there is sufficient space to accommodate 99 children.

Limiting factor for capacity is the indoor space. Fire Clearance granted on 10/28/2022.

Preschool capacity is limited to 51 children.

During the inspection, the following was reviewed with Facility Representative, Atlanis Cabaong:
· Component II Orientation was completed
· The applicant was informed of their reporting requirements and provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO10@dss.ca.gov
· The importance of checking for recalled infant (children) devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant (children) devices with the CPSC to be notified of any recalls on their purchased equipment.
· Provider Information Notice (PIN) 22-20-CCP: Resources and Requirements on Lead Testing in Child Care

SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Lorena Valenzuela
LICENSING EVALUATOR SIGNATURE:	DATE: 12/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2022

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 STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: I CAN PRESCHOOL AND CHILD CARE	FACILITY NUMBER: 336300618
	VISIT DATE: 12/19/2022

NARRATIVE

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LPA reviewed 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 if the facility will provide the services. 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
· 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.

Facility representative 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. 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.

A review of staff records on indicates that the applicant and/or designated individual who is required to have caregiver background checks have received criminal record and child abuse index clearances or exemptions. The applicant can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations858@dss.ca.gov

LPA discussed the safe sleep regulations with facility representative, Atlantis Cabaong, Director 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 applicant 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 Facility representative 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.

SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Lorena Valenzuela
LICENSING EVALUATOR SIGNATURE:	DATE: 12/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2022

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 STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: I CAN PRESCHOOL AND CHILD CARE	FACILITY NUMBER: 336300618
	VISIT DATE: 12/19/2022

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

1. Add a gate to the classroom # 2 for the the storage/ washer and dryer area.
3. Submit an updated admissions agreement to include the required information for Title 22.

Once all corrections have been made, with proof sent to licensing, the application will be submitted for approval with a maximum capacity of 51 children. As agreed upon by facility representative, all corrections are due within 30 days. If not received within 30 days from the date of this report, the application will be denied.

Atlantis Cabaong provided LPA Valenzuela with the lead testing results for the facility's water outlets with no water outlets resulting in action level exceedance. Also provided the Licensing forms LIC 9275 and 9276 with a facility sketch of water outlets tested.
Exit interview conducted and report was reviewed with Facility representative Atlantis Cabaong.

SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Lorena Valenzuela
LICENSING EVALUATOR SIGNATURE:	DATE: 12/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2022

LIC809 (FAS) - (06/04)

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