Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334819323
Report Date: 04/21/2016
Date Signed: 04/21/2016 12:39:53 PM

COMPREHENSIVE INSPECTION
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:MCSWEENY ELEMENTARY SCHOOL PRESCHOOL PROGRAMFACILITY NUMBER:
334819323
ADMINISTRATOR:ROBIN FAIRFIELDFACILITY TYPE:
850
ADDRESS:451 W. CHAMBERS STREETTELEPHONE:
(951) 765-1648
CITY:HEMETSTATE: CAZIP CODE:
92543
CAPACITY:26CENSUS: 26DATE:
04/21/2016
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Robin FairfieldTIME COMPLETED:
12:45 PM
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Licensee has applied for a capacity increase from 26 children to 52 children, children are 3 to 5 years of age. A fire clearance for 52 ambulatory children has been obtained on 04/12/2016. Licensing Program Analysts (LPAs), Kimberly Williams and Kim Leung conducted an evaluation visit this date. Upon arrival, LPAs met briefly with the Lead Teacher, Gwendolyn Soto. LPAs observed 1 Lead Teacher, 2 Teacher's Aides, and 1 Parent Volunteer supervising 20 children who were all engaged in age-appropriate activities within the classroom. A tour of the facility was conducted with Site Director, Dr. Robin Fairfield.

The following measurements were taken:
Classroom #R-4 (New classroom): 23.1 x 39.1 = 903.21 sq. ft.

Classroom #R-8 (Formerly Room #1 - Existing): 39.1 x 23.1 = 903.21 sq. ft. per LIC809 dated 07/31/2007

Total indoor activity space: 1806.42 sq. ft. divided by 35 = 51.612 = Per LPM Hise, LPAs are to round this figure up to accommodate 52 children

Bathroom Fixtures: There are 4 toilets and 2 urinals which can accommodate 90 children and 6 sinks which can accommodate 90 children (there is one sink with a water fountain spout in each classroom R-8 & R-4). A waiver is on file for the shared use of Kindergarten students bathrooms.

Facility continues to share the Kindergarten playground with Elementary students on an alternate schedule.
SUPERVISOR'S NAME: Anita HiseTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Kimberly WilliamsTELEPHONE: (951) 680-6841
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2016
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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: MCSWEENY ELEMENTARY SCHOOL PRESCHOOL PROGRAM
FACILITY NUMBER: 334819323
VISIT DATE: 04/21/2016
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A waiver allowing shared use is on record. Per LIC809 dated 07/31/2007 and today's observation, the outdoor play area has sufficient space to accommodate the amount of children the licensee is requesting.

Limiting factor for capacity is indoor activity space. Capacity is limited to 52 children.

A comprehensive review is being conducted as a compliance review this date. Licensing Program Analysts (LPAs), Kimberly Williams and Kim Leung, toured the center, inside and out. The following was observed:

· The facility is operating within the terms of the license
· Ratios were met during this visit
· Appropriate supervision was provided during the visit
· Classrooms are equipped with age appropriate furniture and equipment in good condition
· Classrooms are clean and free of hazards
· No weapons stored at the facility as stated by Director, Robin Fairfield
· Medications are stored where inaccessible to children
· Hazards are stored where inaccessible to children
· Toxins are locked
· Bathrooms were observed to be safe, sanitary and in operating condition
· Playgrounds are enclosed by appropriate fences and free of hazards
· Outdoor activity areas are supplied with age and size appropriate equipment in good condition
· Food preparation area is clean and free of vermin
· Food is stored appropriately and protected from contamination
· Sign in/Sign out records were reviewed and meets regulation
· Staff member’s CPR/First Aid expires on 08/2017
· Required emergency contact forms were reviewed
· A review of staff records on 04/21/16 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
SUPERVISOR'S NAME: Anita HiseTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Kimberly WilliamsTELEPHONE: (951) 680-6841
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2016
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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: MCSWEENY ELEMENTARY SCHOOL PRESCHOOL PROGRAM
FACILITY NUMBER: 334819323
VISIT DATE: 04/21/2016
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· Last fire/disaster drills were conducted on 03/09/16 (Fire) and 03/21/16 (Earthquake)
·The licensee is asked to update the following documents 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)

· 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

No deficiencies cited, facility is in compliance per the California Code of Regulations Title 22, Division 12.

· The facility representative was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed.
· AB 633 - Whenever a Type A deficiency is cited, 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. LIC 9224 form must be signed by parent/guardian and in children files.
· AB 2621 – Requires the California Department of Social Services to post licensing information on its website, to be updated at least monthly
· AB 2084Nutritious Beverages in Child Care Facilities went into effect January 1, 2012- In accordance with California Health and Safety Code Section 1596.808.
SUPERVISOR'S NAME: Anita HiseTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Kimberly WilliamsTELEPHONE: (951) 680-6841
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2016
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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: MCSWEENY ELEMENTARY SCHOOL PRESCHOOL PROGRAM
FACILITY NUMBER: 334819323
VISIT DATE: 04/21/2016
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· SB 277 – Effective January 1, 2016, parents or guardians of children in any school or child care facility, whether public or private, will no longer be allowed to submit a personal beliefs exemption to currently required specified immunization requirements.
· AB 2109 - Amended Health and Safety Code Section 120365, relating to communicable disease to require an additional form prescribed by the State Department of Public Health (CDPH). This form shall be signed by an authorized health care practitioner and parent or guardian when exempting a child from required immunization(s) due to personal beliefs.
· AB 2236 – Increases the amount of civil penalties that may be imposed for a violation that results in the death of, or serious bodily injury or physical injury to, a client
· AB 2386 – Requires facilities to have one or more functioning Carbon Monoxide detectors.

* Please note: There was a request (STD 850) sent to Riverside Fire Dept. on 04/21/16 for a revised fire clearance that indicates a capacity of 52 children with 4 being Non-Ambulatory. If this approved fire clearance is granted the license will be updated to reflect the approved capacity and ambulatory status. The Director also agrees to submit a new LIC200A reflecting this change. However, the capacity increase is being granted today for a capacity of 52 Ambulatory children as reflected on the approved STD 850 received on 04/12/16.


Exit interview was conducted, appeal rights were explained, Notice of Site Visit was posted and must stay posted for 30 days. A copy of this report was left at the facility.

This report must be made available at the facility for 3 years for public review upon request.
SUPERVISOR'S NAME: Anita HiseTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Kimberly WilliamsTELEPHONE: (951) 680-6841
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2016
LIC809 (FAS) - (06/04)
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