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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364846434
Report Date: 01/08/2025
Date Signed: 01/08/2025 12:51:30 PM

Document Has Been Signed on 01/08/2025 12:51 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:CJUSD/SYCAMORE HILLSFACILITY NUMBER:
364846434
ADMINISTRATOR/
DIRECTOR:		WILLIAMSON,MELISSAFACILITY TYPE:
850
ADDRESS:11036 MAHOGANY DR.TELEPHONE:
(909) 580-5000
CITY:FONTANASTATE: CAZIP CODE:
92337
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 13DATE:
01/08/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:47 AM
MET WITH:Cecilia Sanchez-De La RivaTIME VISIT/
INSPECTION COMPLETED:
01:10 PM
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Licensing Program Analysts (LPAs), Eric Ramos and Perla Ordones 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:

· The following were 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 are free of hazards
· There are no weapons present at the facility as stated by Child Development Supervisor Cecilia Sanchez-De La Riva
· There are no accessible bodies of water present. All wading pools or similar products must be emptied immediately after use and stored in an upright position.
· Drinking water is provided in the indoor/outdoor activity space by children bringing their own refillable water bottles from home and plastic water bottles are also provided by the facility.
· No medications are present at the facility per Facility Representative Melina Delgado.
· Hazardous items are stored where inaccessible to children which include: Disinfectants, cleaning solutions and other items that are dangerous
SUPERVISORS NAME: Ana Noble
LICENSING EVALUATOR NAME: Eric Ramos
LICENSING EVALUATOR SIGNATURE: DATE: 01/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/08/2025
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: CJUSD/SYCAMORE HILLS
FACILITY NUMBER: 364846434
VISIT DATE: 01/08/2025
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·Poisons and toxins are not locked. During facility tour, LPA Ordones observed several poisons/toxins in an unlocked area in the on-limit bathroom area. LPA brought this to the attention of Child Development Supervisor Cecilia Sanchez-De La Riva and the poisons/toxins were locked during the visit.
· All floors are clean and safe
· Bathrooms were observed to be safe, sanitary and in operating condition
· Playgrounds are enclosed by appropriate fencing and free of hazards
· Outdoor activity areas are supplied with age and size appropriate equipment in good condition
· The areas around or under high climbing equipment, swings, slides, and similar equipment have wood chips that absorbs falls
· Food preparation area is clean, free of litter and rubbish and free of rodents and other vermin
· 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.
· Food is stored appropriately and protected from contamination
· Sign in/Sign out record was reviewed and meets regulation requirements
· Disaster drills are conducted at least every six months – last drill conducted on 12/04/24

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 & current designation is on file)
· Children’s records were found to be complete during this inspection.
· A Staff member is present with current Pediatric CPR/First Aid which expires on 08/2025
· Opening and closing staff member’s CPR/First Aid expires on 08/2025
· Director completed Health and Safety Training
SUPERVISORS NAME: Ana Noble
LICENSING EVALUATOR NAME: Eric Ramos
LICENSING EVALUATOR SIGNATURE:

DATE: 01/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2025
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: CJUSD/SYCAMORE HILLS
FACILITY NUMBER: 364846434
VISIT DATE: 01/08/2025
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·A review of staff records indicates that all staff present meet minimum qualifications for the position for which they were hired.
· A review of staff records on 01/08/2025 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

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.

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

The following items were discussed with Child Development Supervisor Cecilia Sanchez-De La Riva during inspection:

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/.
The Licensee was informed of their reporting requirements and provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO09@dss.ca.gov
The Licensee can submit transfer forms to associate new individuals or to disassociate someone from their facility at: Associations_Disassociations862@dss.ca.gov

LPA discussed the safe sleep regulations with facility representative 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.
SUPERVISORS NAME: Ana Noble
LICENSING EVALUATOR NAME: Eric Ramos
LICENSING EVALUATOR SIGNATURE:

DATE: 01/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2025
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: CJUSD/SYCAMORE HILLS
FACILITY NUMBER: 364846434
VISIT DATE: 01/08/2025
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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.
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.

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.

Facility representative 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.

***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

See LIC809-D for cited deficiencies.
SUPERVISORS NAME: Ana Noble
LICENSING EVALUATOR NAME: Eric Ramos
LICENSING EVALUATOR SIGNATURE:

DATE: 01/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2025
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: CJUSD/SYCAMORE HILLS
FACILITY NUMBER: 364846434
VISIT DATE: 01/08/2025
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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.

An exit interview was conducted, and this report was reviewed with Child Development Supervisor Cecilia Sanchez-De La Riva

***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.
SUPERVISORS NAME: Ana Noble
LICENSING EVALUATOR NAME: Eric Ramos
LICENSING EVALUATOR SIGNATURE:

DATE: 01/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/08/2025 12:51 PM - It Cannot Be Edited


Created By: Eric Ramos On 01/08/2025 at 11:39 AM
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: CJUSD/SYCAMORE HILLS
FACILITY NUMBER: 364846434

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/08/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
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, the facility did not comply with the section cited above in that several poisons/toxins were in an unlocked area in the on-limit bathroom which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/22/2025
Plan of Correction
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LPA brought this to the attention of Child Development Supervisor Cecilia Sanchez-De La Riva and the poisons/toxins were locked during the visit. Licensee agrees to submit a written statement of understanding of the above listed regulation as well as written plan of action as to how the facility will remain in compliance with the above listed regulation. Licensee agrees to submit proof of the Plan of Correction (POC) to Community Care Licensing by 01/22/2025.
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
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Based on interview and record review, the facility did not comply with the section cited above in that LPAs observed the director listed on the LIC200A, Melissa Williamson, is no longer the current director and the department was not notified of who is currently the new director which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/22/2025
Plan of Correction
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Licensee agrees to designate a director who meets regulation requirements in order to become compliant with the above listed regulation. Licensee agrees to submit the LIC200A with the new designee along with the LIC500, LIC308, and LIC610 forms to Community Care Licensing by 01/22/2025.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Ana Noble
LICENSING EVALUATOR NAME:Eric Ramos
LICENSING EVALUATOR SIGNATURE:
DATE: 01/08/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/08/2025


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