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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364810159
Report Date: 09/15/2025
Date Signed: 09/15/2025 04:13:10 PM

Document Has Been Signed on 09/15/2025 04:13 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:SBCUSD-ARROYO VALLEY INFANT TODDLER CENTERFACILITY NUMBER:
364810159
ADMINISTRATOR/
DIRECTOR:		KELLY, LATASHIAFACILITY TYPE:
830
ADDRESS:1881 W. BASELINE ROOM #G-107TELEPHONE:
(909) 386-2567
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92411
CAPACITY: 18TOTAL ENROLLED CHILDREN: 19CENSUS: 8DATE:
09/15/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:10 AM
MET WITH:Adriana Mendez, TeacherTIME VISIT/
INSPECTION COMPLETED:
04:25 PM
NARRATIVE
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On the date and time listed, Licensing Program Manager (LPM) Aaron Ross and Licensing Program Analyst (LPA) Taityana Benson conducted an annual inspection as part of a compliance review. A tour of the inside and outside of the facility was granted and the following was observed and/or noted:

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:

- LIC 500 Personnel Report


- LIC 610 Emergency & Disaster Plan
- Parent Handbook/ Program Curriculum/Admission policies and procedures/ fee schedule (only if changes have been made)
- LIC 309 Administrative Organization (only if changes have been made)
- 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)

Report Continued On LIC809-C

NAME OF LICENSING PROGRAM MANAGER: Aaron Ross
NAME OF LICENSING PROGRAM ANALYST: Taityana Benson
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 09/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/15/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 15
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
Page: 2 of 15
Document Has Been Signed on 09/15/2025 04:13 PM - It Cannot Be Edited


Created By: Taityana Benson On 09/15/2025 at 01:31 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: SBCUSD-ARROYO VALLEY INFANT TODDLER CENTER
FACILITY NUMBER: 364810159

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/15/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101429(a)(1)
Responsibility for Providing Care and Supervision for Infants
(1) Each infant shall be constantly supervised and under direct visual observation and supervision by a staff person at all times. Under no circumstances shall ANY infant be left unattended.

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on observation, interview and record review, the licensee did not comply with the section cited above. S3 placed C2 in a crib in the napping area at 10:40 a.m. and at 10:44 a.m. S3 departed the napping area and entered into the infant room, leaving C2 unattended, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 09/16/2025
Plan of Correction
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2
3
4
Licensee agrees to (part 1) establish a written plan of action on marinating supervision of infants at all times, and submit a copy to CCLD by the end of the business day on the POC due date of 09/16/2025, (part 2) conduct a in-service training with staff on maintaining supervision at all times, including proof of staff participation and submit a copy to CCLD by the end of the business day on the POC due date of 09/29/2025.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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4
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Aaron Ross
NAME OF LICENSING PROGRAM MANAGER:
Taityana Benson
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/15/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 09/15/2025 04:13 PM - It Cannot Be Edited


Created By: Taityana Benson On 09/15/2025 at 01:31 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: SBCUSD-ARROYO VALLEY INFANT TODDLER CENTER
FACILITY NUMBER: 364810159

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/15/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101174(d)(2)
Disaster and Mass Casualty Plan
(d) Disaster drills shall be conducted at least every six months. (2) The drills shall be documented. This documentation shall be kept in the child care center for at least one year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above. During the visit, the last fire/disaster drill documented was 01/21/2025. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/29/2025
Plan of Correction
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Licensee agrees to document the last fire/disaster drill that includes the date and time on the fire/disaster drill log and provide proof to Community Care Licensing by the end of the business day on the POC due date of 09/29/2025.
Type B
Section Cited
CCR
101238(a)
Buildings and Grounds
(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above, outdoor play equipment/furniture bird droppings and cobwebs, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/29/2025
Plan of Correction
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Licensee agrees to make outdoor play equipment/furniture free from bird droppings and cobwebs and submit a copy of the outdoor play equipment/furniture to CCLD by POC due of 09/29/2025.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Aaron Ross
NAME OF LICENSING PROGRAM MANAGER:
Taityana Benson
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/15/2025


LIC809 (FAS) - (06/04)
Page: 4 of 15
Document Has Been Signed on 09/15/2025 04:13 PM - It Cannot Be Edited


Created By: Taityana Benson On 09/15/2025 at 01:31 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: SBCUSD-ARROYO VALLEY INFANT TODDLER CENTER
FACILITY NUMBER: 364810159

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/15/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(g)(2)
Personnel Requirements
(2) Each person specified in (g) above shall have a health-screening report signed by the person performing the screening. This report shall indicate the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on record review, the licensee did not comply with the section cited above. Staff 1, 2, 3, 4, and 5 (S1, S2, S3, S4, and S5) LIC 503 Health Screening Report is not available for review during this visit, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/29/2025
Plan of Correction
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2
3
4
Licensee agrees to have S1, S2, S3, S4, and S5 obtain a LIC 503: Health Screening Report and maintain proof at the facility. Licensee agrees to provide proof of S1, S2, S3, S4, and S5 completed LIC 503: Health Screening Report to Community Care Licensing by the end of the business day on the POC due date of 09/29/2025.
Type B
Section Cited
CCR
101216(l)(1)(B)
Personnel Requirements
(B) A copy of the signed LIC 9052 (11/94) shall be kept in the employee's personnel record.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above. Staff 3 (S3) LIC 9052: Employee Rights is not available for review during this visit, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/29/2025
Plan of Correction
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Licensee agrees to have S3 complete a LIC 9052: Employee Rights and maintain proof at the facility. Licensee agrees to provide proof of S3 completed LIC 9052: Employee Rights to Community Care Licensing by the end of the business day on the POC due date of 09/29/2025.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Aaron Ross
NAME OF LICENSING PROGRAM MANAGER:
Taityana Benson
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/15/2025


LIC809 (FAS) - (06/04)
Page: 5 of 15
Document Has Been Signed on 09/15/2025 04:13 PM - It Cannot Be Edited


Created By: Taityana Benson On 09/15/2025 at 01:31 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: SBCUSD-ARROYO VALLEY INFANT TODDLER CENTER
FACILITY NUMBER: 364810159

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/15/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on record review, the licensee did not comply with the section cited above, Staff 3 and 4 (S3 and S4) Mandated Reporter Child Care Providers Training (AB1207) was not available for review, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/29/2025
Plan of Correction
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2
3
4
Licensee agrees to have S3 and S4 complete the Mandated Reporter Child Care Providers Training (AB1207). Licensee agrees to provide proof of S3 and S4 Mandated Reporter Child Care Providers Training (AB1207) certificate of completion to Community Care Licensing by the end of the business day on the POC due date of 09/29/2025.
www.mandatedreporterca.com
Type B
Section Cited
CCR
101221(a)
Child's Records
(a) The licensee shall ensure that a separate, complete and current record for each child is maintained in the child care center.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, interview, and record review, the licensee did not comply with the section cited above. By the directors on admission the facility maintains electronic children’s records. C1’s physical record was the only record observed at the facility during the visit, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/29/2025
Plan of Correction
1
2
3
4
Licensee agrees to obtain and maintain a current record for each child at the facility. Licensee agrees to provide proof to Community Care Licensing that C1, C2 and C3 record is maintained at the facility by the end of the business day on the POC due date of 09/29/2025.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Aaron Ross
NAME OF LICENSING PROGRAM MANAGER:
Taityana Benson
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/15/2025


LIC809 (FAS) - (06/04)
Page: 6 of 15
Document Has Been Signed on 09/15/2025 04:13 PM - It Cannot Be Edited


Created By: Taityana Benson On 09/15/2025 at 01:31 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: SBCUSD-ARROYO VALLEY INFANT TODDLER CENTER
FACILITY NUMBER: 364810159

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/15/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101221(b)(6)
Child's Records
(b) Each record shall contain information including, but not limited to, the following: (6) A signed copy of the admission agreement specified in Section 101219.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above. Child 2 and 3 (C2 and C3) Admission Agreement is not available for review during this visit, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/29/2025
Plan of Correction
1
2
3
4
Licensee agrees to have C2 and C3 authorized representative complete an Admission Agreement and maintain proof at the facility. Licensee agrees to provide proof of C2 and C3 completed Admission Agreement to Community Care Licensing by the end of the business day on the POC due date of 09/29/2025.
Type B
Section Cited
CCR
101419.2(a)
Infant Needs and Services Plan
(a) Prior to the infant's first day at the center, the infant care center director or assistant director shall complete a needs and services plan for the infant.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above. Child 2 and 3 (C2 and C3) Needs and Service Plan is not available for review during this visit, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/29/2025
Plan of Correction
1
2
3
4
Licensee agrees to have C2 and C3 authorized representative complete a Needs and Service Plan and maintain proof at the facility. Licensee agrees to provide proof of C2 and C3 completed Needs and Service Plan to Community Care Licensing by the end of the business day on the POC due date of 09/29/2025.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Aaron Ross
NAME OF LICENSING PROGRAM MANAGER:
Taityana Benson
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/15/2025


LIC809 (FAS) - (06/04)
Page: 7 of 15
Document Has Been Signed on 09/15/2025 04:13 PM - It Cannot Be Edited


Created By: Taityana Benson On 09/15/2025 at 01:31 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: SBCUSD-ARROYO VALLEY INFANT TODDLER CENTER
FACILITY NUMBER: 364810159

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/15/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101220(a)
Child's Medical Assessments
(a) Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child. This medical assessment enables the licensee to assess whether the center can provide necessary health-related services to the child.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above. Child 1 (C1) LIC701: Physician's Report is not available for review during this visit, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/29/2025
Plan of Correction
1
2
3
4
Licensee agrees to have C1’s authorized representative obtain form LIC701: Physician's Report and maintain proof at the facility. Licensee agrees to provide proof of C1’s LIC701: Physician's Report to Community Care Licensing by the end of the business day on the POC due date of 09/29/2025.
Type B
Section Cited
CCR
101429(a)(2)(C)(3)
Responsibility for Providing Care and Supervision for Infants
(C) Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: (3) Time of each 15-minute check

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation and record review C2 was observed to be sleep and placed in the crib at 10:44 a.m. - 11:14 and record review, the licensee did not comply with the section cited above. Child 2 (C2) each 15-minute check was not documented on the log. This poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/29/2025
Plan of Correction
1
2
3
4
Licensee agrees to document and maintain an Infant Sleep Log for C2 that documents the date, infant’s name, and time of each 15-minute check. Licensee agrees to provide proof of the 15-minute checks for C2, to Community Care Licensing by the end of the business day on the POC due date of 09/29/2025.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Aaron Ross
NAME OF LICENSING PROGRAM MANAGER:
Taityana Benson
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/15/2025


LIC809 (FAS) - (06/04)
Page: 8 of 15
Document Has Been Signed on 09/15/2025 04:13 PM - It Cannot Be Edited


Created By: Taityana Benson On 09/15/2025 at 01:31 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: SBCUSD-ARROYO VALLEY INFANT TODDLER CENTER
FACILITY NUMBER: 364810159

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/15/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101416.5(b)
Staff-Infant Ratio
(b) There shall be a ratio of one teacher for every four infants in attendance.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, interview, record review, the licensee did not comply with the section cited above. S3 was observed in the infant classroom alone with 5 infants, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/29/2025
Plan of Correction
1
2
3
4
Licensee agrees to immediately maintain required staff - infant ratio at all times and establish a plan of action of how staff - infant ratio will be maintained at all times, and provide a copy of the plan of action to CCLD by POC due of 09/29/2025.
Type B
Section Cited
CCR
101427(h)
Infant Care Food Services
(h) Infants who are unable to hold a bottle shall be held by a staff person or other adult for bottle feeding. At no time shall a bottle be propped for an infant. An infant shall not be allowed to carry a bottle while ambulatory. A bottle given to an infant able to hold his/her own bottle shall be unbreakable.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, interview, record review, the licensee did not comply with the section cited above. S3 was observed bottle feeding C2 while C2 was lying on a pillow, on the floor, in the infant room, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/29/2025
Plan of Correction
1
2
3
4
Licensee agrees to immediately have staff hold infants who are unable to hold their bottle while bottle feeding. Licensee also agrees to establish a plan of action to ensure staff maintain compliance of regulation 101427(h) and submit a copy to CCLD by POC due date 09/29/2025.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Aaron Ross
NAME OF LICENSING PROGRAM MANAGER:
Taityana Benson
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/15/2025


LIC809 (FAS) - (06/04)
Page: 9 of 15
Document Has Been Signed on 09/15/2025 04:13 PM - It Cannot Be Edited


Created By: Taityana Benson On 09/15/2025 at 02:44 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: SBCUSD-ARROYO VALLEY INFANT TODDLER CENTER
FACILITY NUMBER: 364810159

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/15/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101239(i)
101239(i) There shall be one toilet and one handwashing fixture, separate from and in addition to the number of toilets and handwashing fixtures required in (h) above, designated for use by children who are ill, for use by staff, and for emergency use. This toilet and handwashing fixture shall be conveniently located in relation to the isolation area.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above. Two staff members were observed utilizing the infant restroom (right restroom), which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/29/2025
Plan of Correction
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Licensee agrees to immediately cease staff from utilizing the infant restroom. Licensee also agrees to establish a plan of action that requires staff to cease using the infant restroom and submit a copy to CCLD by POC due date of 09/29/2025.
Type B
Section Cited
CCR
101238.2(e)
101238.2(e) As a condition of licensure, the areas around and under high climbing equipment, swings, slides and other similar equipment shall be cushioned with material that absorbs falls.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above, the areas around and under high climbing equipment does not have a cushioned material that absorbs falls. The areas and under the high climbing equipment has grass, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/29/2025
Plan of Correction
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Licensee agrees to remove the high climbing equipment from the playground or install cushioned material that absorbs falls in the areas around and under high climbing equipment and submit proof to CCLD by POC due date of 09/29/2025.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Aaron Ross
NAME OF LICENSING PROGRAM MANAGER:
Taityana Benson
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/15/2025


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: SBCUSD-ARROYO VALLEY INFANT TODDLER CENTER
FACILITY NUMBER: 364810159
VISIT DATE: 09/15/2025
NARRATIVE
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-Parent’s Rights Poster (PUB393)

- Personal Rights (LIC613A)

- Child Car Seat Law

- Menu

· The facility is operating with the limits as stated on the license.


· Ratios are not being met during this inspection (see LIC809-D).
· 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 Adriana Mendez.
· 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.
· Per Adriana Mendez, there are no children currently enrolled who require medication.
· Hazards are stored where inaccessible to children which include: Disinfectants, cleaning solutions and other items that are dangerous.
· Poisons and toxins are locked.
· All floors shall be clean and safe.
· Sanitation solution is out of the reach of infants.
· Highchairs and tables have broad based legs and trays lock into place.
· Changing tables are within arm’s reach of a sink; padding is at least 1” think with raised sides of at least 3” covered in washable vinyl or plastic.
· Hand washing is completed before and after each diaper change and before feeding an infant.
· Bathrooms were observed to be safe, sanitary and in operating condition; there is at least 1 potty chair for every 5 potty-training infants.
· Playgrounds are enclosed by appropriate fences and not free of hazards (see LIC809-D).
· Outdoor activity areas are supplied with age-and-size equipment in good condition.
· Food preparation area is clean, free of litter, rubbish and free of rodents and other vermin.

Report Continued On LIC809-C

NAME OF LICENSING PROGRAM MANAGER: Aaron Ross
NAME OF LICENSING PROGRAM ANALYST: Taityana Benson
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2025
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: SBCUSD-ARROYO VALLEY INFANT TODDLER CENTER
FACILITY NUMBER: 364810159
VISIT DATE: 09/15/2025
NARRATIVE
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·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 shall be readily available both indoors and outdoors and provided sippy cups and bottles.
· The areas around or under high climbing equipment, swings, slides, and similar equipment shall be cushioned with material that absorbs a fall. The facility utilizes: grass (see LIC809-D).
· Sign in/Sign out record was reviewed and meets regulation requirements.
· A Staff member is present with current Pediatric CPR/First Aid which expires on 04/16/2027.
· Opening and closing staff member’s CPR/First Aid expires on 04/16/2027.
· Director completed Health and Safety Training – On File.
· A review of children’s records was conducted, and records were found to be incomplete during this inspection (see LIC809-D).
· Disaster drills to be conducted every six months – last drill conducted on 01/21/2025 (see LIC809-D).
· A review of staff records indicates that all staff present meet minimum qualifications for the position for which they were hired.
· 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 09/15/2025 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

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

Report Continued On LIC809-C

NAME OF LICENSING PROGRAM MANAGER: Aaron Ross
NAME OF LICENSING PROGRAM ANALYST: Taityana Benson
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2025
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: SBCUSD-ARROYO VALLEY INFANT TODDLER CENTER
FACILITY NUMBER: 364810159
VISIT DATE: 09/15/2025
NARRATIVE
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For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP).

LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

LPA discussed the safe sleep regulations with Teacher Adriana Mendez and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed Teacher Adriana Mendez 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Teacher Adriana Mendez was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Report Continued On LIC809-C

NAME OF LICENSING PROGRAM MANAGER: Aaron Ross
NAME OF LICENSING PROGRAM ANALYST: Taityana Benson
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2025
LIC809 (FAS) - (06/04)
Page: 14 of 15
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: SBCUSD-ARROYO VALLEY INFANT TODDLER CENTER
FACILITY NUMBER: 364810159
VISIT DATE: 09/15/2025
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Teacher Adriana Mendez was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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

See LIC809-D for cited deficiencies.

LPA Taityana Benson informed Teacher Adriana Mendezthis report dated 09/15/2025 document(s) 1 Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Taityana Benson informed the Teacher Adriana Mendezto provide a copy of this licensing report dated 09/15/2025 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

A notice of site visit was given and must remain posted 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 the Teacher Adriana Mendez.

NAME OF LICENSING PROGRAM MANAGER: Aaron Ross
NAME OF LICENSING PROGRAM ANALYST: Taityana Benson
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2025
LIC809 (FAS) - (06/04)
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