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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364840980
Report Date: 05/28/2025
Date Signed: 05/28/2025 10:09:34 AM

Document Has Been Signed on 05/28/2025 10:09 AM - 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 CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:OMSD/HOWARD ELEMENTARYFACILITY NUMBER:
364840980
ADMINISTRATOR/
DIRECTOR:		KELLY GUILLENFACILITY TYPE:
850
ADDRESS:4650 HOWARD STREETTELEPHONE:
(909) 591-2339
CITY:MONTCLAIRSTATE: CAZIP CODE:
91763
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 0DATE:
05/28/2025
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:33 AM
MET WITH:Gianna RocaTIME VISIT/
INSPECTION COMPLETED:
10:20 AM
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On 5/28/2025 Licensing Program Analyst (LPA) Chase Atherton conducted a licensee initiated Case Management inspection for the purpose of inspecting and taking measurements of a proposed room change. This will change the licensed room from from room 12 to room K4. Center capacity remains the same at 24 children. Hours of operation will be 6:30 am to 6:30 pm, as previously licensed. Fire inspection was conducted and approved on 5/19/2025. Upon arrival, LPA met with facility representative Gianna Roca and Teresa Atilano. A facility tour was given inside and outside. Census was taken.

The carbon monoxide detector in room K4 were tested by facility staff during this inspection and found to be functioning.

There is sufficient indoor activity space to accommodate the current capacity of 24 preschool children. Total indoor activity space measured 992.87 square feet, which is sufficient to accommodate the already licensed capacity of 24 children. Currently the facility restrooms can accommodate 30 total preschool children based on the presence of 2 sinks and 2 toilets. LPA observed all indoor activity space to be complete with safe, age-appropriate furniture and equipment, including tables, chairs, cubbies, bookshelves, and other activity supplies for the children. LPA observed no napping cots/mats as the program works on a "am class and different pm class" basis. Drinking water is available in the classrooms via water fountain attached to a sink. The current outdoor activity space has been determined to be sufficient as per inspection conducted on 8/4/2011 and waiver for sharing of the outdoor activity space dated 8/10/11. Facility was found to be in substantial compliance on this date. The preschool will no longer be operating in room 12. Upon Licensing Program Manager's (LPM) approval the preschool will be operating in room K4.
NAME OF LICENSING PROGRAM MANAGER: Ana Noble
NAME OF LICENSING PROGRAM ANALYST: Chase Atherton
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/28/2025
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 CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: OMSD/HOWARD ELEMENTARY
FACILITY NUMBER: 364840980
VISIT DATE: 05/28/2025
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The following items need to be completed/corrected prior to a new license being issued:

1. The facility will submit proof (photos) of all children's equipment set up in such a way that it allows access to all the tables, chairs, cubbies, bookshelves, and other activity supplies for the children.
2. The facility will submit proof (copies) of all lead testing results of all water outlets in room K4. If no lead testing results can be obtained, facility will submit a detailed plan on how they will provide a sufficient amount uncontaminated drinking water to children in room K4.

Once all corrections have been made, with proof sent to licensing, and approved by the LPM, the application to change the room from room 12 to room K4 will be approved. As agreed upon by facility representative, GIanna Roca, all corrections are due by July 21st 2025. If not received by July 21st 20225, the application will be denied.

If all corrections are approved and facility licensed, you must have the drinking water outlets used for drinking and cooking tested for lead and post the results within 180 days of licensure.

A notice of site visit was given to facility representative and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.
Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
Exit interview conducted and report was reviewed with the facility representative, Gianna Roca.
NAME OF LICENSING PROGRAM MANAGER: Ana Noble
NAME OF LICENSING PROGRAM ANALYST: Chase Atherton
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2025
LIC809 (FAS) - (06/04)
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