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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364846291
Report Date: 10/20/2025
Date Signed: 10/20/2025 03:14:40 PM

Document Has Been Signed on 10/20/2025 03:14 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:LIL' BLUE HEARTWOOD PRESCHOOLFACILITY NUMBER:
364846291
ADMINISTRATOR/
DIRECTOR:		FANNY TOPETEFACILITY TYPE:
830
ADDRESS:2460 S EUCLID AVETELEPHONE:
(909) 988-5049
CITY:ONTARIOSTATE: CAZIP CODE:
91762
CAPACITY: 16TOTAL ENROLLED CHILDREN: 9CENSUS: 8DATE:
10/20/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:20 AM
MET WITH:Fernando Chavez, licensee TIME VISIT/
INSPECTION COMPLETED:
03:40 PM
NARRATIVE
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Licensing Program Analyst (LPA), Aman Lama arrived at the center to conduct an annual inspection. LPA was met with assistant director, Gissel Olivares and later with licensee, Fernando Chavez. The center also has a preschool program, which was not inspected on this date. LPA toured inside and outside, and the following was observed and/or noted:

The following documents are requested to be updated if any changes made, and submit to the Riverside Regional Office (RRO) within 30 days of this report:
1. LIC 500 Personnel Report
2. LIC 610 Emergency & Disaster Plan- collected during a previous date
3. Parent Handbook/ Program Curriculum/Admission policies and procedures/ fee schedule (only if changes have been made)
4. LIC 309 Administrative Organization
5. LIC 308 Designation of Administrative Responsibility

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
- Food menu.
NAME OF LICENSING PROGRAM MANAGER: Gilbert Sena
NAME OF LICENSING PROGRAM ANALYST: Aman Lama
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/20/2025
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 18
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)
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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: LIL' BLUE HEARTWOOD PRESCHOOL
FACILITY NUMBER: 364846291
VISIT DATE: 10/20/2025
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·The facility is operating within the limits as stated on the license.
· Ratios were met during this inspection.
· Classrooms are adequately equipped with age and size appropriate furniture and free of hazards.
· There are no weapons present at the facility.
· No accessible bodies of water were observed by LPA at the time of this inspection. All wading pools or similar product must be emptied immediately after use and stored in an upright position.
· Children bring their own water bottles/cups from home. There are water fountains on the property, but they are non-operable & children do not utilize them for drinking water. There is a water dispenser in the kitchen with uncontaminated drinking water, and staff will refill bottles, as needed.
· Hazards are stored where they were inaccessible to children. These include: Disinfectants, cleaning solutions and other items that are dangerous to the health and safety of children in care.
· Poisons and toxins are to be kept locked and were observed accessible, per Title 22 Regulations.
· All floors were observed clean, safe, and shall remain so at all times.
· Restrooms were not observed to be sanitary and operating condition.
· Playgrounds are enclosed by appropriate fences.
· Outdoor activity areas are in good condition and supplied with age/size appropriate equipment.
· The areas around or under high climbing equipment, swings, slides, and similar equipment were cushioned with material that absorbs a fall.
· All storage containers for solid waste, including moveable bins have tight-fitting covers that were observed on and in good repair.
· Sign in/Sign out record was reviewed and meets regulation requirements.
· There is at least one closing and one opening staff present with a current CPR/First Aid on file.
· A review of children’s records were found to be complete during this inspection.
· The center was unable to provide proof of disaster drills, which are to be conducted every six months.
· The facility is 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 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 facility can submit transfer forms to associate or disassociate someone from their facility at: Associations_Disassociations862@dss.ca.gov
NAME OF LICENSING PROGRAM MANAGER: Gilbert Sena
NAME OF LICENSING PROGRAM ANALYST: Aman Lama
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2025
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: LIL' BLUE HEARTWOOD PRESCHOOL
FACILITY NUMBER: 364846291
VISIT DATE: 10/20/2025
NARRATIVE
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·A review of staff records indicates that staff that were present meet minimum qualifications for the position for which they were hired.

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

- Facility representative 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 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



Licensee 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.
NAME OF LICENSING PROGRAM MANAGER: Gilbert Sena
NAME OF LICENSING PROGRAM ANALYST: Aman Lama
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2025
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: LIL' BLUE HEARTWOOD PRESCHOOL
FACILITY NUMBER: 364846291
VISIT DATE: 10/20/2025
NARRATIVE
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During the exit interview, it was confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

See LIC809-D for cited deficiencies.

LPA Aman Lama informed licensee, Fernando Chavez that this report dated 10/20/2025 document(s) 2 Type A citations. 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 Aman Lama informed the licensee to provide a copy of this licensing report dated 10/20/2025 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. Upon receipt of a Type A violation, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. A copy of the Fact Sheet - Child Care Parent Notification. Requirements and a copy of LIC 9224 Acknowledgement of Receipt of Licensing Reports was given to the licensee.

A Civil Penalty has been assessed during this inspection. Payment is due when billed and the check(s) or money orders shall be made payable to the “California Department of Social Services”. YOU WILL RECEIVE AN INVOICE IN THE MAIL. DO NOT SEND MONEY UNTIL YOU RECEIVE YOUR INVOICE. DO NOT SEND CASH.



A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee, Fernando Chavez.
NAME OF LICENSING PROGRAM MANAGER: Gilbert Sena
NAME OF LICENSING PROGRAM ANALYST: Aman Lama
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2025
LIC809 (FAS) - (06/04)
Page: 5 of 18
Document Has Been Signed on 10/20/2025 03:14 PM - It Cannot Be Edited


Created By: Aman Lama On 10/20/2025 at 02:01 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: LIL' BLUE HEARTWOOD PRESCHOOL
FACILITY NUMBER: 364846291

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/20/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101439.1(f)
Infant Care Center Sleeping Equipment
(f) Cribs shall be free from all loose articles and objects, including blankets and pillows.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, 2 out of 3 sleeping infants had bottles in the crib while they slept. 1 infant had the bottle near their feet, while the other had it cradled under their left armpit while they slept on their stomach. This poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 10/21/2025
Plan of Correction
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Facility representative will schedule a meeting regarding safe sleep with staff. The agenda for this meeting is due to the department no later than the POC due date.
Type A
Section Cited
CCR
101238(g)(1)
Buildings and Grounds
(g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. (1) Storage areas for poisons shall be locked.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, 2 areas in the infant classroom contained items that are poisonous to infants. (1)The storage closet containing Clorox, 2 mop buckets & other cleaning chemicals. (2)A doorless closet to the left of the storage closet, with storage of hand sanitizers (3 large bottles). Although these items were inaccessible and not in reach of infants, these items were not kept locked. This poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 10/21/2025
Plan of Correction
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Facility representative agrees to submit photos and/or videos of storage closet containing hazardous chemicals with lock, locked. Additionally, the 3 large containers of hand sanitizer also behind a key lock. This is due to the department no later than the POC due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Gilbert Sena
NAME OF LICENSING PROGRAM MANAGER:
Aman Lama
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/20/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/20/2025 03:14 PM - It Cannot Be Edited


Created By: Aman Lama On 10/20/2025 at 02:01 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: LIL' BLUE HEARTWOOD PRESCHOOL
FACILITY NUMBER: 364846291

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/20/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101174(d)
Disaster and Mass Casualty Plan
(d) Disaster drills shall be conducted at least every six months.

This requirement is not met as evidenced by:
Deficient Practice Statement
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During a past visit to the facility for the other program, the facility did not have any documentation of disaster drills available for review. During this previous visit, director recalls the disaster drills being done sometime in January, but have not done any since then. This poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/24/2025
Plan of Correction
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The facility agrees to begin implementing a disaster drill log, and conduct disaster drills with all the children immediately. These drills are to be conducted at least every 6 months. Documentation shall be submitted to the department no later than the POC due date.
Type B
Section Cited
CCR
101439.1(f)(3)
Infant Care Center Sleeping Equipment
(f) Cribs shall be free from all loose articles and objects, including blankets and pillows. (3) There shall be no objects hanging above or attached to the side of the crib.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, 2 out of 3 cribs had items hanging off them while infants were asleep in them. 1 item was a baby bib, and the other a speaker for music. This is being downgraded to a Type B due to the staff correcting it immediately. This poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/21/2025
Plan of Correction
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Facility representative will schedule a meeting regarding safe sleep with staff. The agenda for this meeting is due to the department no later than the POC due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Gilbert Sena
NAME OF LICENSING PROGRAM MANAGER:
Aman Lama
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/20/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/20/2025 03:14 PM - It Cannot Be Edited


Created By: Aman Lama On 10/20/2025 at 02:01 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: LIL' BLUE HEARTWOOD PRESCHOOL
FACILITY NUMBER: 364846291

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/20/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238.2(f)
Outdoor Activity Space
(f) Sandboxes shall be inspected daily and kept free of hazardous foreign materials.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, there is a circular pit, at least 1 inch deep. There is sand in this area, but the sand has not been replaced or refilled, leaving it semi-empty. The area is deep enough for an infant to fall into, posing a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/31/2025
Plan of Correction
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Facility representative agrees to remediate this area and submit proof of remediation to the department no later than the POC due date.
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, 2 out of 5 staff files did not provide proof of Tdap(pertussis) or MMR(measles). S3 did not have Tdap and S4 did not have Tdap nor MMR. This poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/07/2025
Plan of Correction
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Facility representative agrees to submit proof of Tdap for S3 and Tdap as well as MMR for S4, no later than the POC due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Gilbert Sena
NAME OF LICENSING PROGRAM MANAGER:
Aman Lama
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/20/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/20/2025 03:14 PM - It Cannot Be Edited


Created By: Aman Lama On 10/20/2025 at 02:01 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: LIL' BLUE HEARTWOOD PRESCHOOL
FACILITY NUMBER: 364846291

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/20/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(g)(1)
Personnel Requirements
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, 1 out of 5 staff files did not provide proof of LIC503, health screening. S2 did not have the LIC503 on file. This poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/07/2025
Plan of Correction
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Facility representative agrees to submit proof of LIC503, health screening for S2 to the department no later than the POC due date.
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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4
Based on record review, 2 out of 5 staff did not have an updated Mandated Reporter Training (MRT) on file. S2 and S4 did not have updated MRTs. This poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/07/2025
Plan of Correction
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The facility representative agrees to submit proof of MRT "Child Care Provider" certificate for S2 and S4, no later than the POC due date. This training can be accessed online at mandatedreporterca.com
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Gilbert Sena
NAME OF LICENSING PROGRAM MANAGER:
Aman Lama
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/20/2025


LIC809 (FAS) - (06/04)
Page: 9 of 18
Document Has Been Signed on 10/20/2025 03:14 PM - It Cannot Be Edited


Created By: Aman Lama On 10/20/2025 at 02:01 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: LIL' BLUE HEARTWOOD PRESCHOOL
FACILITY NUMBER: 364846291

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/20/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
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 record review during the tour of the facility, LPA asked for 15 minute sleep log for the 1 sleeping infant out of 7. The log was last updated more than 15 minutes to the time written on the log, approximately 25 minutes. Additionally, the form only has a "start" and "end" time of sleep, no 15 minute checks. 15 minute sleep logs were later available, but only for this date. This poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/24/2025
Plan of Correction
1
2
3
4
Facility representative agrees to submit proof of 15 minute sleep log to the department no later than the POC due date.
Type B
Section Cited
CCR
101212(b)
Reporting Requirements
(b) The name of the child care center director, and any fully qualified teacher(s) designated to act in the child care center director's absence, shall be reported to the Department within 10 days of a change of child care center director or designee(s).

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
During a previous visit, LPA discovered there was a change in director for the center. This change had taken place well over the 10 days allotted, and was never communicated to LPA. LPA had requested the new appointed director submit a directors packet, which has still not been received. LPA reviewed what was available, and left the center with a list of missing items. This poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/24/2025
Plan of Correction
1
2
3
4
Facility representative agrees to submit a directors packet for the new appointed director. This is due to licensing, no later than the POC due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Gilbert Sena
NAME OF LICENSING PROGRAM MANAGER:
Aman Lama
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/20/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/20/2025 03:14 PM - It Cannot Be Edited


Created By: Aman Lama On 10/20/2025 at 02:50 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: LIL' BLUE HEARTWOOD PRESCHOOL
FACILITY NUMBER: 364846291

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/20/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8595


This requirement is not met as evidenced by:
A licensed child day care facility shall provide to the parents or guardians of each child receiving services in the facility copies of any licensing report that documents any Type A citation that represents an immediate risk to the health, safety, or personal rights of children in care...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 in 4 out of 4 persons. Multiple children's files did not have the LIC9224 on file. This poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/24/2025
Plan of Correction
1
2
3
4
All infant files should have 2 LIC9224's on file, one from February 2025, and the other from todays inspection. Licensee ensures placing both of these in all currently and any newly enrolled children. LPA will return at a later date to ensure center is in compliance with this regulation.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
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.
Gilbert Sena
NAME OF LICENSING PROGRAM MANAGER:
Aman Lama
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/20/2025


LIC809 (FAS) - (06/04)
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