Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600287
Report Date: 10/04/2017
Date Signed: 10/12/2017 09:18:53 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:CAJON VALLEY STATE PRESCHOOL-RIOS ELEMENTARYFACILITY NUMBER:
376600287
ADMINISTRATOR:MARIA KEHOEFACILITY TYPE:
850
ADDRESS:14314 RIOS CANYON ROADTELEPHONE:
(619) 588-3090
CITY:EL CAJONSTATE: CAZIP CODE:
92021
CAPACITY:25CENSUS: 15DATE:
10/04/2017
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:05 AM
MET WITH:Tere HannaTIME COMPLETED:
11:20 AM
NARRATIVE
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Licensing Program Analysts (LPA), Farah Tanous conducted an unannounced annual random inspection at the facility. Upon arrival, LPA met with substitute Lead Teacher, Marsha Nelson, and two teachers. All three teachers were waiting inside Classroom #4 for children to be dropped off by their parents. At 8:30 am, LPA observed 15 children enter the classroom after being signed in by their parents. This facility operates a morning preschool program from 8:30am to 11:30 am. LPA proceeded to inspect/tour the facility. Shortly into the inspection, Lead Teacher, Tere Hanna arrived arrived at Classroom #4, and LPA was able to conduct the rest of the inspection with Ms. Hanna. LPA observed that the facility was operating within the approved licensed ratio. All required notices, forms and licenses were posted.

While touring the facility, LPA observed two trash moveable bins filled with solid waste without tight-fitting covers accessible to daycare children; one trash bin was located inside the preschool bathroom, and the second one was located on the preschool play ground. (See LIC 809 D for cited deficiency)

All disinfectants, cleaning solutions, and other hazardous items are inaccessible to children through latches and locks. Storage area for poisons is locked. The facility provides a morning snack. Furniture and age appropriate equipment is in good condition indoors. Children's toilets and hand washing facilities are operational and sanitary. Paper towels and toilet paper are available.

Outdoor play area is fenced with adequate sand for cushioning. Water is available for outdoor activities via water fountain. Climbing structures and slides are securely fixed to the ground. Outdoor playground has canopies used for shade. There are no bodies of water or weapons at this facility.
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Farah TanousTELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2017
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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: CAJON VALLEY STATE PRESCHOOL-RIOS ELEMENTARY
FACILITY NUMBER: 376600287
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/04/2017
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/05/2017
Section Cited
CCR
101239(f)(1)
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Fixtures, Furniture, Equipment and Supplies. All storage containers for solid waste, including moveable bins, shall have tight-fitting covers that are kept on, be in good repair, and shall be leak-proof and rodent-proof.
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Corrected During Visit. Both trash bins were removed and made inaccessible to day-care children.
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LPA observed two trash moveable bins filled with solid waste without tight-fitting covers accessible to daycare children; one trash bin was located inside the preschool bathroom, and the second one was located on the preschool playground. This poses a potential risk to the health and safety of children in care.
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****This is an amended version of the original report dated 10/04/2017.
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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: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Farah TanousTELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2017
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2017
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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: CAJON VALLEY STATE PRESCHOOL-RIOS ELEMENTARY
FACILITY NUMBER: 376600287
VISIT DATE: 10/04/2017
NARRATIVE
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See LIC809D for cited deficiency. LPA provided Notice of Site Visit (LIC 9213). LPA observed Licensee post the LIC9213 and it shall remain posted for the next 30 days. The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. Exit Interview conducted. Access our updated Regulation & Forms by using our WEBSITE: http://ccld.ca.gov Office: (619) 767-2200, Open Monday thru Friday 8am-5pm.
Access our updated Regulation & Forms by using our WEBSITE: http://ccld.ca.gov Office: (619) 767-2200, Open Monday thru Friday 8am-5pm.

****This is an amended version of the original report dated 10/04/2017

SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Farah TanousTELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2017
LIC809 (FAS) - (06/04)
Page: 4 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: CAJON VALLEY STATE PRESCHOOL-RIOS ELEMENTARY
FACILITY NUMBER: 376600287
VISIT DATE: 10/04/2017
NARRATIVE
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No excluded individuals are present. The last fire drill was conducted on 09/29/2017. First Aid/CPR reviewed and in compliance. Sign in/sign out sheets are well maintained. The classroom has adequate heating, lighting, ventilation and drinking water from a water fountain. Storage cubbies are readily available and rooms accommodate class size.
Some staff and children’s records were reviewed and found to be complete.

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

*** New immunization law (SB792) was discussed with Ms. Hanna. Licensee understands that anyone who provides care and supervision to the children must have immunization records maintained at the facility for: pertussis, measles, and influenza. Ms. Hanna was able to provide immunization record for staff as per SB792.



During today's inspection LPA requested from Ms. Hanna to have the following documents submitted to Child Care Licensing Division:
  • A request for an outdoor waiver allowing the preschool children to share the same playground as the kindergarteners.
  • A request for a waiver allowing the preschool children to use the Elementary school restrooms.
  • An updated LIC 309, LIC 308, LIC 500, Plan of Operation, Parent's Handbook, a board resolution, Parent's handbook, and updated facility sketch.

****This is an amended version of the original report dated 10/04/2017
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Farah TanousTELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2017
LIC809 (FAS) - (06/04)
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