360904126-2-5-2025-09-CC-RMOD-DDLS6R-20250205123622

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 360904126
Report Date: 02/05/2025
Date Signed: 02/05/2025 12:36:34 PM

COMPREHENSIVE INSPECTION

Document Has Been Signed on 02/05/2025 12:36 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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	FAITH LUTHERAN DAY CARE CENTER		FACILITY NUMBER:	360904126
ADMINISTRATOR/ DIRECTOR:	JOY KIRBY		FACILITY TYPE:	850
ADDRESS:	12449 CALIFORNIA STREET		TELEPHONE:	(909) 790-1816
CITY:	YUCAIPA	STATE: CA	ZIP CODE:	92399
CAPACITY: 30	TOTAL ENROLLED CHILDREN: 30	CENSUS: 22	DATE:	02/05/2025
TYPE OF VISIT:	Case Management - Annual Continuation	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:15 AM
MET WITH:	Joy Kirby, Director		TIME VISIT/ INSPECTION COMPLETED:	12:45 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 02/05/2025 at 09:15 AM, Licensing Program Analyst (LPA) Raymond Moorehead arrived at the facility to continue and finish a required/annual inspection as part of a compliance review. The initial annual visit was initiated on 01/31/2025. A tour of the inside and outside of the facility was granted and the following was observed and/or noted: This is a combination center, and the other licensed program is 360908889 (infant) which was also inspected on this date/not inspected on this date. A review of staff and children's records were conducted as part of this evaluation. · The licensee/director 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 (only if changes have been made) 5. LIC 308 Designation of Administrative Responsibility (only if changes have been made) · 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 (snacks)

Aaron Ross	TELEPHONE: (951) 782-4200
Raymond Moorehead	TELEPHONE: 951-782-4200
	DATE: 02/05/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2025

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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: FAITH LUTHERAN DAY CARE CENTER	FACILITY NUMBER: 360904126
	VISIT DATE: 02/05/2025

NARRATIVE

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· The facility is operating with the limits as stated on the license.
· Ratios are being met during this inspection.
· Classrooms are adequately equipped with age and size appropriate furniture and equipment and free of hazards.
· There are no weapons present at the facility as stated by Director Joy Kirby
· 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.
· Children bring their own water from home, water is also provided for children in water pitcher that comes from kitchen's sink
· Medications are stored where inaccessible to children, in the front office
· Hazards are stored where inaccessible to children which include disinfectants, cleaning solutions and other items that are dangerous.
· Poisons and toxins are locked or inaccessible to children.
· All floors are clean and safe.
· Bathrooms were observed to be safe, sanitary and in operating condition.
· Playgrounds are enclosed by appropriate fences and free of hazards.
· Outdoor activity areas are supplied with age and size appropriate equipment in good condition.
· Food preparation area is clean, free of litter, rubbish and free of rodents and other vermin.
· Food is stored appropriately and protected from contamination.
· All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair.
· Menus shall be 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 is readily available both indoors and outdoors.
· The areas around or under high climbing equipment, swings, slides, and similar equipment shall be cushioned with material that absorbs a fall.
· Sign in/Sign out record was reviewed and meets regulation requirements.
· A Staff member is present with current Pediatric CPR/First Aid expires on 09/16/2025
· Opening and closing staff member’s CPR/First Aid expires on 09/16/2025
· Director completed Health and Safety Training – completed

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Raymond Moorehead	TELEPHONE: 951-782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 02/05/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2025

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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: FAITH LUTHERAN DAY CARE CENTER	FACILITY NUMBER: 360904126
	VISIT DATE: 02/05/2025

NARRATIVE

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· A review of children’s records was conducted, and records were found to be complete during this inspection.
· Disaster drills to be conducted every six months – last drill conducted on 02/03/2025
· The Licensee 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 02/05/2025 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 can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations862@dss.ca.gov
· A review of staff records indicates that all staff present do meet minimum qualifications for the position for which they were hired.

LPA discussed AB 2370 and provided a copy of PIN 21-21.1-CCP which explains the requirement for lead testing of water. All licensed Child Care Centers operating in buildings constructed before January 1, 2010, shall test their water for lead.
For more information visit:
https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information

LPA also informed Director Joy Kirby of the importance of checking for recalled 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.

- 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 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

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Raymond Moorehead	TELEPHONE: 951-782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 02/05/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2025

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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: FAITH LUTHERAN DAY CARE CENTER	FACILITY NUMBER: 360904126
	VISIT DATE: 02/05/2025

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- Director Joy Kirby was reminded that all adults 18 and over, 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.

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.

- To access on-line Licensing forms & Regulations for a Child Care Center please visit: www.ccld.ca.gov.

- The Duty Officer is available to answer questions Monday – Friday; 8:00am to 5:00pm at:

951-782-4200 and/or 1-844-LET-US-NO (1-844-538-8766)

A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with Director Joy Kirby.

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Raymond Moorehead	TELEPHONE: 951-782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 02/05/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2025

LIC809 (FAS) - (06/04)

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