364846242-7-27-2022-09-CC-SLOZ-CGPRRG-20220726131506

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364846242
Report Date: 07/26/2022
Date Signed: 07/27/2022 08:34:47 AM

Document Has Been Signed on 07/27/2022 08:34 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:	SBCSS FROST STATE PRESCHOOL		FACILITY NUMBER:	364846242
ADMINISTRATOR:	CYNTHIA RUIZ		FACILITY TYPE:	850
ADDRESS:	12860 BANYAN STREET		TELEPHONE:	(909) 922-5218
CITY:	RANCHO CUCAMONGA	STATE: CA	ZIP CODE:	91739
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	07/26/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	11:27 AM
MET WITH:	Nancy Alvarado Operations Manager		TIME COMPLETED:	01:20 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	Licensing Program Analyst (LPA), Samuel Lopez, toured proposed Preschool center, inside and out. An application for Re-location was received. A Fire Clearance was granted on 6/1/2022. The days and hours of operation will be: Monday through Friday, 8:00am to 11:00am (AM Program) and 11:45am to 2:45pm (PM Program). Measurements were taken and the following was determined: Preschool Indoor Activity Areas LPA has determined that there is sufficient space to accommodate 25 children. Preschool Bathroom Fixtures 2 toilets x 15 = 30 children 3 sinks x 15 = 45 children * Restrooms and sinks are shared with Special Education Program. Waiver to be submitted* Preschool Outdoor Activity Area: LPA has determined that there is sufficient space to accommodate 174 children. * Playground to be shared with Special Education Program. Waiver to be submitted* Limiting factor for preschool capacity is the Fire Clearance granted. Preschool capacity is limited to 24 children. The following was observed: · Classrooms are adequately equipped with age and size appropriate furniture and equipment · Water fountain will supply drinking water in the indoor activity space and paper cups will also be provided · Playgrounds are enclosed by appropriate fences

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Samuel Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2022

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 ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: SBCSS FROST STATE PRESCHOOL	FACILITY NUMBER: 364846242
	VISIT DATE: 07/26/2022

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
· Adequate shade is provided canopies over play structures/equipment
· Drinking water is provided in the outdoor play areas by a water fountain and paper cups will also be provided
· Food preparation area is equipped with refrigerator, sink with hot and cold running water, storage area, utensils, and adequate amount of food supplies - Food will be provided by outside vendor (Renu Hope) and additional snacks, if needed, will be readily available in the School's cafeteria
· The office area is located in Room #104, which is next to the assigned room (Room #101) and will serve as the isolation area for ill children temporarily until parents arrive
· Toxins are locked
· Medication will be stored in Utility Room #103 and will be secured in a locked cabinet
· Medication administration forms were reviewed
· First Aid kit is complete
· Sign in/Sign out record was reviewed and meets regulation requirements
· 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 7/26/2022 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Applicant/Facility representative, Nancy Alvarado, 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: Samuel Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2022

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 ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: SBCSS FROST STATE PRESCHOOL	FACILITY NUMBER: 364846242
	VISIT DATE: 07/26/2022

NARRATIVE

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The applicant can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations862@dss.ca.gov

LPA discussed AB 2370 and provided a copy of PIN 21-21-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. Also, for a license issued on or after July 1, 2022, initial testing results shall be received and posted within 180 days of licensure.

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 discussed the safe sleep regulations with Applicant/Facility representative, Nancy Alvarado, and discussed the Child Care Licensing Safe Sleep web page at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.

LPA also informed Applicant/Facility representative, Nancy Alvarado, 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 Applicant/Facility representative, Nancy Alvarado, 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.

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Samuel Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2022

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 ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: SBCSS FROST STATE PRESCHOOL	FACILITY NUMBER: 364846242
	VISIT DATE: 07/26/2022

NARRATIVE

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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. Waiver to share playground with Special Education program
2. Waiver to share restrooms with Special Education program

Once all corrections have been made, with proof sent to licensing, the application will be submitted for approval with a maximum capacity of 24. 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 Applicant/Facility representative, Nancy Alvarado.

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Samuel Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2022

LIC809 (FAS) - (06/04)

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