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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364845826
Report Date: 05/16/2024
Date Signed: 05/16/2024 01:35:28 PM

Document Has Been Signed on 05/16/2024 01:35 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:OCS OUR LADY OF LOURDES PRESCHOOLFACILITY NUMBER:
364845826
ADMINISTRATOR/
DIRECTOR:		MARIA BAHNAFACILITY TYPE:
850
ADDRESS:5303 ORCHARD STREETTELEPHONE:
(909) 621-4418
CITY:MONTCLAIRSTATE: CAZIP CODE:
91763
CAPACITY: 21TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
05/16/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:15 AM
MET WITH:Active Director, Karen Gaitan TIME VISIT/
INSPECTION COMPLETED:
01:45 PM
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Licensing Program Analyst (LPA), Blanca Ruiz conducted a required/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:

    • 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
  • 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.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Blanca Ruiz-Silva
LICENSING EVALUATOR SIGNATURE: DATE: 05/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/16/2024
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: OCS OUR LADY OF LOURDES PRESCHOOL
FACILITY NUMBER: 364845826
VISIT DATE: 05/16/2024
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  • There are no weapons present at the facility as stated by Director, Karen Gaitan.
  • 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. 
  • Present for supply drinking water in the indoor activity - Facility provide bottles of water.
  • Medications are stored where inaccessible to children, NO children are currently under 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
  • 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
  • All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair
  • Food/snacks is stored appropriately and protected from contamination
  • Facility is not providing breakfast/lunch, snacks only. Children bring food from home.
  • Uncontaminated drinking water shall be readily available both indoors and outdoors and provided by bottles of water. Directors was advise if in the future, facility decides to use water from the facility faucets Lead Testing is required.
  • The areas around or under high climbing equipment, swings, slides, and similar equipment shall be cushioned with material that absorbs a fall, wood chips.
  • 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 08/2024
  • Opening and closing staff member’s CPR/First Aid expires on 08/2024
  • Director completed Health and Safety Training- 09/2022
  • 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 05/14/2024
  • 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
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Blanca Ruiz-Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2024
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: OCS OUR LADY OF LOURDES PRESCHOOL
FACILITY NUMBER: 364845826
VISIT DATE: 05/16/2024
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  • A review of staff records on 05/16/2024 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 meet minimum qualifications for the position for which they were hired.
 
LPA discussed the safe sleep regulations with Director, Karen Gaitan 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 Director, Karen Gaitan 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)/ (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

Director, Karen Gaitan 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.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Blanca Ruiz-Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2024
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: OCS OUR LADY OF LOURDES PRESCHOOL
FACILITY NUMBER: 364845826
VISIT DATE: 05/16/2024
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- Go to the licensing webpage www.ccld.ca.gov, and click on the “Receive Important Updates” located on the right side of the page, immediately above the Quick Links. One can add their email address and choose which program(s) they wish to receive Provider Information Notices (PIN) for.
- 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:
 1-844-LET-US-NO (1-844-538-8766) and/or 951-782-4200

No deficiencies cited during inspection. 

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.

Exit interview conducted and report was reviewed with Director, Karen Gaitan. 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.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Blanca Ruiz-Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2024
LIC809 (FAS) - (06/04)
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