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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364844011
Report Date: 03/15/2022
Date Signed: 03/18/2022 09:05:52 AM

Document Has Been Signed on 03/18/2022 09:05 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
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:VOLUNTEERS OF AMERICA EHS CC PPFACILITY NUMBER:
364844011
ADMINISTRATOR:TOLENTO, KRISTINAFACILITY TYPE:
830
ADDRESS:799 E. RIALTO AVENUETELEPHONE:
(909) 332-6690
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92408
CAPACITY: 80TOTAL ENROLLED CHILDREN: 80CENSUS: 24DATE:
03/15/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:TOLENTO, KRISTINATIME COMPLETED:
01:25 PM
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On this date and time, Licensing Program Analysts (LPAs) Laura Mejorado and Destinee Hogue conducted a case management inspection to discuss a temporary waiver to utilize the cafeteria. The purpose of todays inspection is to ensure the facility cafeteria is in compliance and suitable for children to use while the playground is being remodeled.

During this inspection, LPA toured the facility inside and outside, took census, and reviewed the following information with Director Kristina Tolento.

Director, Kristina Tolento, requested a temporary waiver to allow the Early Head Start (EHS) and Preschool children to utilize the cafeteria while the playground is being remodeled, construction is expected to be completed May 13, 2022. Cafeteria will be used as an area to practice gross motor play and has a capacity of 223.

Temporary Waiver Conditions:
1. There will be no commingling of EHS and Preschool children.

2. The daily schedule for the usage of the cafeteria will be posted.

3. Staff will be trained on the daily schedule requirements to ensure no commingling.

4. Site director will conduct daily monitoring to ensure compliance.

5. Children shall have visual care and supervision at all times by qualified staff, including walking to and from the cafeteria.

6. The appropriate teacher-child ratio shall be maintained at all times.

7. The facility shall remain in strict compliance with Title 22 Regulations at all times.

SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Laura Mejorado
LICENSING EVALUATOR SIGNATURE: DATE: 03/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/15/2022
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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: VOLUNTEERS OF AMERICA EHS CC PP
FACILITY NUMBER: 364844011
VISIT DATE: 03/15/2022
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Failure to comply with the conditions of the waiver, may result in termination of the waiver. Director agrees to provide the Department with updates regarding the completion of the playground remodel.


Prior to issuing the temporary waiver the Director agrees to submit photos of the cafeteria ready for use by the EHS and Preschool children.


Director was advised to remove safety hazards which include cafeteria tables and access to staff eating area.


No deficiencies were cited during this inspection.


An exit interview was conducted, and a Notice of Site Visit was provided and must be posted for 30 days.
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Laura Mejorado
LICENSING EVALUATOR SIGNATURE:

DATE: 03/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2022
LIC809 (FAS) - (06/04)
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