Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600287
Report Date: 02/11/2019
Date Signed: 02/20/2019 01:22:31 PM

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: 0DATE:
02/11/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Tere Hanna Teacher TIME COMPLETED:
01:45 PM
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Licensing Program Analyst (LPA) Michelle Hood, conducted an annual/random visit. Met with Teacher. The facility operates Monday-Friday from 8:30 am to 11:30 am.

The indoor and outdoor of the facility was inspected. Room #4 currently has 22 children enrolled. There were no children in care at time of visit. The facility operates within licensed capacity and ratio limitations. The classroom and restrooms have adequate lighting, heating, and ventilation. All floors appeared to be safe and clean. Furniture, children's cubbies, and toys. Trash cans have tight-fitting cover. Disinfectants, cleaning solutions and other hazardous items are stored up high in unreachable location. Menu is posted monthly. All food was inspected and protected from contamination. Sign in/out sheets were reviewed showing parent/guardian’s signature and time of day recorded. The food storage areas appeared to be clean. The surface of the outdoor activity space is maintained in a safe condition with sufficient shade. Drinking water are available inside the classrooms and outdoor play area. There are no bodies of water and weapons present on the premises. The last fire drill was conducted on documented on 01/31/2019. The privacy area of the classroom is designated for use by children who are ill. A sample of the children's records, including medical assessment and identification & emergency information were reviewed. Staff's records and transcripts were reviewed to verify teacher qualifications and experiences. Opening and closing staff members have current CPR and First Aid certifications. A review of staff records on 02/20/2019, indicated that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Facility does not provide Incidental Medical Services (IMS) at this time. IMS was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (559) 243-4588
LICENSING EVALUATOR NAME: Michelle HoodTELEPHONE: (619) 767-2241
LICENSING EVALUATOR SIGNATURE:

DATE: 02/14/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2019
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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: CAJON VALLEY STATE PRESCHOOL-RIOS ELEMENTARY
FACILITY NUMBER: 376600287
VISIT DATE: 02/11/2019
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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

Director was provided information on Effects of Lead Exposure.

Teacher provided LPA with an updated facility roster, LIC 500, LIC 610, kindergarten & preschool playground schedule and campus map identifying playground bathroom and classroom bathroom. LPA requested an updated playground waiver, LIC 308 and LIC 309, to the Licensing Agency by March 1, 2019.

The Notice of Site Visit (LIC 9213) was provided to be posted at the facility for 30 days. LPA observed form LIC 9213 posted. An exit interview was conducted.
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (559) 243-4588
LICENSING EVALUATOR NAME: Michelle HoodTELEPHONE: (619) 767-2241
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2019
LIC809 (FAS) - (06/04)
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