364846261-9-13-2022-09-CC-SLOZ-CJ8N6K-20220913101117

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364846261
Report Date: 09/13/2022
Date Signed: 09/13/2022 03:17:24 PM

Document Has Been Signed on 09/13/2022 03:17 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
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	OLIVE TREE DAY SCHOOL		FACILITY NUMBER:	364846261
ADMINISTRATOR:	WEGLEY, KELLY		FACILITY TYPE:	850
ADDRESS:	7690 ARCHIBALD AVE		TELEPHONE:	(909) 652-0140
CITY:	RANCHO CUCAMONGA	STATE: CA	ZIP CODE:	91730
CAPACITY: 55	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	09/13/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	07:45 AM
MET WITH:	Applicant Kelly Wegley		TIME COMPLETED:	10:10 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. A Fire Clearance was granted on 8/30/2022. The days and hours of operation will be: Monday through Thursday, 8:30am to 3:00pm and Friday, 9:00am to 12:00pm. Measurements were taken and the following was determined: Preschool Indoor Activity Areas LPA has determined that there is sufficient space to accommodate 57 children. Preschool Bathroom Fixtures 8 toilets x 15 = 120 children 6 sinks x 15 = 90 children Preschool Outdoor Activity Area: LPA has determined that there is sufficient space to accommodate 125 children. Limiting factor for preschool capacity is the Fire Clearance granted. Preschool capacity is limited to 55 children. The following was observed: · Classrooms are adequately equipped with age and size appropriate furniture and equipment · Bottled water will be provided in the indoor activity space. Children will utilize their own personal cups · Playgrounds are enclosed by appropriate fences · 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.

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Samuel Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2022

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 4

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: OLIVE TREE DAY SCHOOL	FACILITY NUMBER: 364846261
	VISIT DATE: 09/13/2022

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
26
27
28
29
30
31
32

· An adequate amount of cushioning material (wood chips) is in place under play equipment
· Adequate shade is provided by trees
· Drinking water is provided in the outdoor play areas by bottled water. Child's cup will be filed prior to going outside
· Food/Snack preparation area is equipped with refrigerator, storage area, and utensils
· The office area is located between room 2 and room 3 and will serve as the isolation area for ill children temporarily until parents arrive
· Toxins are locked
· Medication will be stored in a locked box that is located in a room, next to room 4, where children have no access to.
· 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 9/13/2022 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, Kelly Wegley 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.

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

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Samuel Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2022

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: OLIVE TREE DAY SCHOOL	FACILITY NUMBER: 364846261
	VISIT DATE: 09/13/2022

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
26
27
28
29
30
31
32

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 by January 1, 2023.

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 reviewed with applicant, Kelly Wegley 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.

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. Purchase food/snacks
2. Proof of sign in/out sheet or alternative
3. Add lock or keyed door knob to the door that leads to room 5 from room 4
4. Remove restroom stall doors or submit a plan for supervision while children are using restrooms

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Samuel Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2022

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: OLIVE TREE DAY SCHOOL	FACILITY NUMBER: 364846261
	VISIT DATE: 09/13/2022

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 26 27 28 29 30 31 32	Once all corrections have been made, with proof sent to licensing, the application will be submitted for approval with a maximum capacity of 55. 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, Kelly Wegley.

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Samuel Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2022

LIC809 (FAS) - (06/04)

Page: 4 of 4