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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364841507
Report Date: 05/30/2024
Date Signed: 07/10/2024 09:18:00 AM

Document Has Been Signed on 07/10/2024 09:18 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:CHINO CHILD DEVELOPMENT CENTERFACILITY NUMBER:
364841507
ADMINISTRATOR/
DIRECTOR:		MALIGASPE, CHARMAINEFACILITY TYPE:
830
ADDRESS:4266 WALNUT AVENUETELEPHONE:
(909) 627-7428
CITY:CHINOSTATE: CAZIP CODE:
91710
CAPACITY: 14TOTAL ENROLLED CHILDREN: 5CENSUS: 5DATE:
05/30/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:22 PM
MET WITH:Licensee Charmaine MaligaspeTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
NARRATIVE
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*************************************AMENDED REPORT*********************************************
Licensing Program Analyst (LPA) Samuel Lopez arrived at the facility to address an unrelated issue. LPA proceeded to take a census of infants present and tour the classroom/portable. LPA observed an infant inside of play yard/pack and play, with a pacifier, that had clip which was attached to their shirt. LPA informed staff present of the observation made and explained that it was a violation of Title 22 regulation(s), for a pacifier to have anything attached.

See LIC809-D for cited deficiency

A notice of site visit was given 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 Licensee Charmaine Maligaspe.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Samuel Lopez
LICENSING EVALUATOR SIGNATURE: DATE: 05/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/30/2024
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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Document Has Been Signed on 05/30/2024 03:23 PM - It Cannot Be Edited


Created By: Samuel Lopez On 05/30/2024 at 02:28 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: CHINO CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 364841507

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/30/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/06/2024
Section Cited
CCR
101439.1(f)(1)(A)

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Infant Care Sleeping Equipment: There shall not be anything attached to the pacifier. This requirement is not met as evidenced by: an infant was observed with a pacifier that has a clip/ribbon that was attached to their shirt. This poses/posed a potential health, safety or personal rights risk to persons in care.
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The clip/ribbon was removed from the pacifier at time of visit. Licensee/Director agrees to provide in-service training regarding infant safe sleep and submit a copy of agenda and sign in to the Riverside Child Care Regional Office by 6/6/2024.

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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:Aaron Ross
LICENSING EVALUATOR NAME:Samuel Lopez
LICENSING EVALUATOR SIGNATURE:
DATE: 05/30/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/30/2024


LIC809 (FAS) - (06/04)
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