<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 366425634
Report Date: 06/09/2022
Date Signed: 06/09/2022 09:49:10 AM

Document Has Been Signed on 06/09/2022 09:49 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, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
FACILITY NAME:PLUM LANE LEARNING CENTERFACILITY NUMBER:
366425634
ADMINISTRATOR:ANNALISA SIALANAFACILITY TYPE:
775
ADDRESS:1711 PLUM LANE, UNIT CTELEPHONE:
(909) 798-4003
CITY:REDLANDSSTATE: CAZIP CODE:
92374
CAPACITY: 30CENSUS: 27DATE:
06/09/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:01 AM
MET WITH:Annalisa Sialana- AdministratorTIME COMPLETED:
09:57 AM
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) Ryan Gardner made an unannounced visit to the facility. The purpose of the visit was to conduct a required annual inspection, with an emphasis on infection control due to the COVID-19 pandemic.

LPA Gardner met with Administrator Annalisa Sialana who confirmed that there are no cases/exposures of COVID-19 within the facility. At the time of visit there were seven (7) staff and eleven (11) clients present. The day program has a total of twenty-seven (27) clients enrolled. There are twelve (12) clients enrolled for in-person services and fifteen (15) enrolled in remote services.

LPA Gardner toured the facility inside and out and went over COVID-19 best practices for infection control and prevention with Annalisa Sialana. LPA Gardner observed that all staff members were properly fitted with a proper face mask. The clients have hand sanitizer available to them throughout the facility and the bathrooms were stocked with hand soap and paper towels. LPA Gardner observed the facility to have multiple postings throughout the facility for cough etiquette, proper hand washing procedure, and social distancing. The facility has a plan in place which follows Community Care Licensing Division guidelines for COVID-19 testing, isolating/quarantining clients, and properly caring for clients with COVID-19 positive results and/or exposures. The facility has a designated infection control person who is responsible for ensuring that the facility is compliance with infection control practices. LPA Gardner requested to inspect the facility's Personal Protective Equipment (PPE) supply, which was located in the laundry room. The facility has a full thirty (30) day supply of PPE items such as gloves, face shields, gowns, surgical masks, N95 masks, disinfectant, and hand sanitizer.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Ryan Gardner
LICENSING EVALUATOR SIGNATURE: DATE: 06/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/09/2022
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
FACILITY NAME: PLUM LANE LEARNING CENTER
FACILITY NUMBER: 366425634
VISIT DATE: 06/09/2022
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
All clients and staff are practicing all other COVID-19 precautions, which minimize the risk of them contracting COVID-19.

Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations.



An exit interview was conducted, and this report was discussed and provided to Administrator Annalisa Sialana.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Ryan Gardner
LICENSING EVALUATOR SIGNATURE:

DATE: 06/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2