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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364846073
Report Date: 02/27/2024
Date Signed: 02/27/2024 12:26:56 PM

Document Has Been Signed on 02/27/2024 12:26 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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:EVERBROOK ACADEMYFACILITY NUMBER:
364846073
ADMINISTRATOR:VAN DUZER, MARGARET GALEFACILITY TYPE:
830
ADDRESS:3040 CHINO AVETELEPHONE:
(909) 591-7574
CITY:CHINO HILLSSTATE: CAZIP CODE:
91709
CAPACITY: 28TOTAL ENROLLED CHILDREN: 24CENSUS: 15DATE:
02/27/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Margaret Van Duzer - Director TIME COMPLETED:
12:15 PM
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Licensing Program Analyst (LPA), Rachel Zeron conducted a Case Management inspection based on lead testing results received on the facility. LPAs toured the facility, took census and met with Margaret Van Duzer to further discuss lead results received and measures taken for remediation of lead exceedances.

During the inspection, LPA toured and observed the following water outlet identified with lead exceedances: Outlet O, at 13.9 ppb which is a hand washing sink located in the older infants restroom. This sink is not used for drinking water. LPA observed and obtained a copy of the retest assessment in which the faucet removed and replaced,retested on 10/27/2022. Results came back for Outlet O on this date at 2.07 ppb.

Facility provides filtered water for the daycare children, and it is kept in each classroom. LPAs observed lead testing results posted at the entrance of the facility in the parent informational board.

No deficiencies were cited.

An exit interview was conducted, and a copy of this report and a Notice of Site Visit (required to be posted for the next 30 days) was provided to the Director Margaret Van Duzer. This report must be made available to the public upon request for three years.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Rachel Zeron
LICENSING EVALUATOR SIGNATURE: DATE: 02/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/27/2024
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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