Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334818074
Report Date: 11/07/2019
Date Signed: 11/07/2019 01:30:24 PM

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 STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:FSA-HEMET CDCFACILITY NUMBER:
334818074
ADMINISTRATOR:ALONDRA RIOS DOMINGUEZFACILITY TYPE:
830
ADDRESS:41931 E. FLORIDA AVE.TELEPHONE:
(951) 925-2160
CITY:HEMETSTATE: CAZIP CODE:
92544
CAPACITY:24CENSUS: 23DATE:
11/07/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Alondra DominguezTIME COMPLETED:
12:30 PM
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(1) A Random Annual inspection is being conducted as a compliance review. Licensing Program Analyst (LPA), Alaina Wilburn toured the infant center, inside and out. The following was observed:

· A review of the staff records and a sampling of the children's records was conducted as part of this evaluation. See Confidential Names List (LIC811).
· The licensee 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)

· 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
- Menu
SUPERVISOR'S NAME: Telma SandovalTELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Alaina WilburnTELEPHONE: (951) 255-9024
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2019
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 STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: FSA-HEMET CDC
FACILITY NUMBER: 334818074
VISIT DATE: 11/07/2019
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· The facility is operating within the terms of the license
· Ratios were met during this inspection
· Appropriate supervision was provided during this inspection
· Rooms are physically separated from other components
· Rooms are equipped with age appropriate furniture and equipment in good condition
· Activity areas are physically separated from all other components at this center
· Drinking water is provided in both the indoor and outdoor activity areas by water cooler/ water pitchers
· Napping equipment is sufficient for capacity and meets licensing requirements.
· Rooms are clean and free of hazards
· No weapons stored at the facility
· There are no bodies of water present. All wading pools or similar product must be emptied immediately after use and stored in an upright position.
· Medications are stored where inaccessible to infants
· Hazards are stored where inaccessible to infants
· Toxins are locked
· Toileting area was observed to be safe, sanitary and in operating condition
· Outdoor play area is physically separated by appropriate fencing and free of hazards
· Outdoor activity areas are supplied with age and size appropriate equipment in good condition
· There is sufficient cushioning material under high climbing equipment, swings, slides and similar equipment
· Food preparation area is clean and free of vermin
· Food is stored appropriately and protected from contamination
· All storage containers for solid waste have tight-fitting covers that are kept on, and in good repair
· Individual feeding plans were reviewed
· There is an individual feeding plan for each infant as required
· Infant needs and services plans were reviewed
· Sign in/Sign out record was reviewed and meets regulation requirements
SUPERVISOR'S NAME: Telma SandovalTELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Alaina WilburnTELEPHONE: (951) 255-9024
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2019
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 STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: FSA-HEMET CDC
FACILITY NUMBER: 334818074
VISIT DATE: 11/07/2019
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· A Staff member is present with current Pediatric CPR/First Aid which expires on 05/2021
· Opening and closing staff member’s CPR/First Aid expires on 05/2021
· Director completed Health and Safety Training on file
· Staff qualifications were reviewed – health screening is on file and all staff meet educational requirements
· Children’s files were reviewed – Identification and Emergency contact information is on file along with a medical assessment
· A review of staff records on 11/07/19 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
· This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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.
· For more information on SIDS and Safe Sleep Environments, please visit:
California Department of Public Health – California SIDS Program: http://www.cdph.ca.gov/programs/SIDS/pages/default.aspx
AAP – Safe Sleep Campaign: http://www.healthychildcare.org/sids/html
AAP-Free Training: Reducing the Risk of SIDS in Early Education and Child Care: http://shop.aap.org/Reducing-the-Risk-of-SIDS-in-Early-Education-and-Child-Care
And Caring for our Children, Safe Sleep Practices and SIDS/Suffocation Risk Reduction: http://cfoc/nrckids/org/standardview/spccol/safe_sleep
SUPERVISOR'S NAME: Telma SandovalTELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Alaina WilburnTELEPHONE: (951) 255-9024
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2019
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 STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: FSA-HEMET CDC
FACILITY NUMBER: 334818074
VISIT DATE: 11/07/2019
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The following was also reviewed and discussed:
v - SB 277 – Immunizations, Personal Beliefs Exemption, effective January 1, 2016 - it eliminates the exemption from existing specified immunization requirements based upon personal beliefs, and only allows an exemption from future immunization requirements deemed appropriate by the State Department of Public Health or a medical professional for medical reasons.
v - AB290 – Child Nutrition, effective January 1, 2016 - In accordance with California Health and Safety Code Section 1596.866 - each child care center shall have at least one person employed who was completed one hour of childhood nutrition training as part of the preventive health practices course or courses.
v - SB 792 – Immunization requirements for staff, volunteers, effective September 1, 2016 – In accordance with California Health and Safety Code Section 1596.7995(a)(1) - a person shall not be employed or volunteer at a child care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination or they may provide a statement declining the vaccination. If employees/volunteers are receiving the influenza vaccination, they must do so between August 1 and December 1 of each year.
v - AB2231 (2016) – Increased Civil Penalties, effective July 1, 2017 – For failing to correct a violation the civil penalty is increased to $100 per day for EACH violation until corrected; For failing to correct a repeated violation the civil penalty is increased to $250 immediately assessed , and $100 per day afterwards for EACH repeated violation until corrected; For a Zero Tolerance violation the civil penalty is increased to $500 immediately assess, and $100 per day for EACH violation after that until corrected; For any repeated Zero Tolerance violation the civil penalty is increased to $1,000 immediately assess, and $100 per day afterwards for EACH repeated violation until corrected.
v NOTE: Repeat violations are defined as a violation of a previously cited statutory or regulatory Section and/or subsection within 12 months prior.
v Effective January 1, 2017 – Children under 2 years of age shall ride in a rear-facing car seat unless the child weighs 40 or more pounds OR is 40 or more inches tall. For additional information regarding car seat laws see www.chp.ca.gov
SUPERVISOR'S NAME: Telma SandovalTELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Alaina WilburnTELEPHONE: (951) 255-9024
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2019
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 STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: FSA-HEMET CDC
FACILITY NUMBER: 334818074
VISIT DATE: 11/07/2019
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v AB2370 – Lead Exposure, day care facilities, effective January 1, 2019 - An act amending Sections 1596.866 and 1596.8661 and adding Sections 1596.7996 and 1597.16 to the Health and Safety Code for the education of risks and effects of lead exposure in child care facilities and for the testing of drinking water in licensed child care centers. Licensed providers have access to a document regarding lead toxicity prevention created in partnership with the California Department of Public Health (CDPH) to provide to parents/guardians of newly enrolled or reenrolled children with information on the following:
· Risks and effects of lead exposure
· Blood lead testing recommendations and requirements
· Options for obtaining blood lead testing, including any programs that offer free or discounted tests
This printable document (Lead Poisoning Facts) is located here as well as on the Child Care Licensing website. The bill also requires that that the Department add instruction on the prevention of lead exposure to the Preventative Health and Safety Training curriculum for providers licensed on or after July 1, 2020. Finally, it requires that all Child Care Centers, operating in a building constructed before January 1, 2010, shall have their drinking water tested for excessive lead levels, on or after January 1, 2020, but no later than January 1, 2023. Child Care Centers must thereafter test their drinking water every five years after the date of the initial test. The Department must adopt regulations in consultation with the State Water Resources Control Board for the implementation of the requirements for the testing of drinking water for lead in Child Care Centers by January 1, 2021. The regulations shall include requirements to ensure the collection and submission of valid water samples.
v AB605 – Child day care facilities, birth to school-age license; Effective January 1, 2021 - An act amending Sections 1596.76, 1596.955 and 1596.956 and adding Section 1596.951 to the Health and Safety Code to address requirements for a single license and extend the period for possible participation in the toddler programs. It requires the California Department of Social Services, in consultation with stakeholders, to adopt regulations on or before January 1, 2021, to create a Child Care Center license to serve infant, toddler, preschool, and school-age children. It also requires, before January 1, 2024, that all Child Care Centers transition to one-center licenses.
SUPERVISOR'S NAME: Telma SandovalTELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Alaina WilburnTELEPHONE: (951) 255-9024
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2019
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 STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: FSA-HEMET CDC
FACILITY NUMBER: 334818074
VISIT DATE: 11/07/2019
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Access to forms & Regulations for Child Care Centers online at www.ccld.ca.gov.

v AB2960 – Child care and development services, online portal – Effective June 20, 2022 - This bill requires the State Superintendent of Public Instruction (SSPI), within the California Department of Education (CDE), to develop and post on CDE's website a comprehensive child care and development services online portal for families and providers by June 30, 2022. Further, the bill would require the SSPI to submit a report to the Legislature by January 1, 2021, proposing plans for enhancements to the online portal and inclusive of a comprehensive implementation plan, based on recommendations from the workgroup.

v Please subscribe at childcareadvocatesprogram@dss.ca.gov to receive Department updates. They will be sent directly to your e-mail account once you have set up an account. This website can also be accessed through www.ccld.ca.gov



v The Duty Officer is available to answer questions Monday – Friday at 1-844-LET-US-NO (1-844-538-8766).

An exit interview was conducted and during the interview, the Director, Alondra Dominguez confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.

A NOTICE OF SITE VISIT WAS ISSUED AND LPA VERIFIED THAT IT WAS POSTED IN A PROMINENT LOCATION AT THE FACILITY BEFORE LEAVING. THE LICENSEE UNDERSTANDS THAT IT MUST REMAIN POSTED FOR THE NEXT 30 DAYS.

Appeal rights were provided and discussed. This report must be available for review, upon request, for the next 3 years.
SUPERVISOR'S NAME: Telma SandovalTELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Alaina WilburnTELEPHONE: (951) 255-9024
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2019
LIC809 (FAS) - (06/04)
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