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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336300853
Report Date: 08/29/2025
Date Signed: 08/29/2025 12:16:46 PM

Document Has Been Signed on 08/29/2025 12:16 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:MORENO VALLEY USD - CHAPARRAL HILLS ELEMENTARYFACILITY NUMBER:
336300853
ADMINISTRATOR/
DIRECTOR:
JENNIFER ADCOCKFACILITY TYPE:
850
ADDRESS:24850 DELPHINIUM AVENUETELEPHONE:
(951) 571-4716
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92553
CAPACITY: 20TOTAL ENROLLED CHILDREN: 20CENSUS: 15DATE:
08/29/2025
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:40 AM
MET WITH:Director Misty KelleyTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On 08/29/2025, at 11:41 AM, Licensing Program Analyst (LPA), Brian Morris and Licensing Program Manager (LPM) Carlos Martinez conducted an unannounced Case Management inspection for an increase in capacity. Upon arrival, LPA met with Director Misty Kelley. The Licensee is requesting an increase in capacity from 20 to 44 Preschool children in Classrooms K-3 (A-203), K-2 (A-202). Currently, Classroom K-2 is licensed for a total capacity of 20. A fire clearance was granted for an increase of capacity on 08/07/2025.

All indoor and outdoor activity space utilized for the children was inspected today and all new additional indoor activity spaces were measured. The total indoor activity space in Classroom K-3 measured at 1019.67 sq ft, which is sufficient to accommodate the requested capacity of (44) children in all classrooms. The total square footage for the Preschool outdoor activity play yard was measured and is sufficient for the capacity requested. A total of (3) sinks and (2) toilets are available for children’s use in Classroom K-3, which is sufficient to accommodate the requested total capacity of (44) children. Currently, Classroom #K-2 has a total of (2) toilets and (3) sinks.

· Indoor activity space was complete with safe, age-appropriate furniture and equipment, including tables, chairs, cubbies, napping cots, bookshelves, and other activity supplies for the children.

· The Outdoor/playground area was fully fenced, and shade is provided via a shade structure.

· Ratios are being met during this inspection.

NAME OF LICENSING PROGRAM MANAGER: Carlos Martinez
NAME OF LICENSING PROGRAM ANALYST: Brian Morris
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 08/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/29/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: MORENO VALLEY USD - CHAPARRAL HILLS ELEMENTARY
FACILITY NUMBER: 336300853
VISIT DATE: 08/29/2025
NARRATIVE
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· Classrooms are adequately equipped with age and size appropriate furniture and equipment and free of hazards.

· There are no weapons present at the facility as stated by Director Kelley.

· There are no accessible bodies of water present. All wading pools or similar products must be emptied immediately after use and stored in an upright position.

· Public drinking water is available via faucets.

· Medications are stored where inaccessible to children, (there were no children on medication at time of inspection)

· Hazardous items are stored where inaccessible to children.

· There are sufficient outdoor age-appropriate toys and play equipment available on the playground.

· Drinking water is available in the classrooms via filtered water, children bring their own water bottles, the facility has paper cups if needed.

· There is a climbing structure on the playground for children ages 2-5, which is properly anchored.

· There is adequate cushioning in fall zones of climber provided by sand.

· A Staff member is present with current Pediatric CPR/First Aid.

· Director completed Health and Safety Training.

· All staff present meet minimum qualifications for the position for which they were hired.

· A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

NAME OF LICENSING PROGRAM MANAGER: Carlos Martinez
NAME OF LICENSING PROGRAM ANALYST: Brian Morris
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2025
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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: MORENO VALLEY USD - CHAPARRAL HILLS ELEMENTARY
FACILITY NUMBER: 336300853
VISIT DATE: 08/29/2025
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The application for an increase in capacity will be submitted for approval with a maximum capacity of 44.

(If Corrections are required)

Correction(s) needed: No corrections required.

A notice of site visit was given to licensee and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Exit interview conducted and report was reviewed with the Director Misty Kelley.

NAME OF LICENSING PROGRAM MANAGER: Carlos Martinez
NAME OF LICENSING PROGRAM ANALYST: Brian Morris
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2025
LIC809 (FAS) - (06/04)
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