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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364846188
Report Date: 05/10/2022
Date Signed: 05/10/2022 01:46:23 PM

Document Has Been Signed on 05/10/2022 01:46 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
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:KIDDIE ACADEMY OF RANCHO CUCAMONGAFACILITY NUMBER:
364846188
ADMINISTRATOR:HEATHER JENKINSFACILITY TYPE:
850
ADDRESS:7220 VICTORIA PARK LANETELEPHONE:
(909) 891-8700
CITY:RANCHO CUCAMONGASTATE: CAZIP CODE:
91739
CAPACITY: 127TOTAL ENROLLED CHILDREN: 127CENSUS: 71DATE:
05/10/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:01 PM
MET WITH:Ashley Stuehrmann/Interim Director TIME COMPLETED:
02:02 PM
NARRATIVE
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On 5/10/2022 at 1:01 pm, LPA discovered during a complaint investigation; touring the facility, the food in the freezer and refrigerator not covered properly.LPA observed frozen burritos not covered and in the refrigerator a pasta dish not covered and other foods that were questionable. According to regulation 101227 (a) In child care centers providing meals to children, the following shall apply:(19) All food shall be protected against contamination. Contaminated food shall be discarded immediately. Director immediately discarded the uncovered foods and addressed the foods that were questionable.

See 809D for Deficiency


Exit interview conducted with director, report, appeal rights and Notice of Site Visit provided to director.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Patricia Berry
LICENSING EVALUATOR SIGNATURE: DATE: 05/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/10/2022
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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Document Has Been Signed on 05/10/2022 01:46 PM - It Cannot Be Edited


Created By: Patricia Berry On 05/10/2022 at 01:20 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: KIDDIE ACADEMY OF RANCHO CUCAMONGA
FACILITY NUMBER: 364846188

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/10/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/16/2022
Section Cited
CCR
101227(a)(19)

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Food Services (a) In child care centers providing meals to children ...(19) All food shall be protected against contamination. Contaminated food shall be discarded immediately.
This requirement was not.met as evidenced by
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Director immediately discarded the uncovered foods. Director stated she will have staff meeting on regulation 101227 and will send the topic and a list of participants to CCL by 5/16/22.
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Based on LPA's observation the food in the freezer and refrigerator were not covered properly.LPA observed frozen burritos not covered and in the refrigerator a pasta dish not covered.
This is a potential risk to the health and safety of children in care.
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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:Gilbert Sena
LICENSING EVALUATOR NAME:Patricia Berry
LICENSING EVALUATOR SIGNATURE:
DATE: 05/10/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/10/2022


LIC809 (FAS) - (06/04)
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