<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364846209
Report Date: 06/20/2022
Date Signed: 06/20/2022 02:50:43 PM

Document Has Been Signed on 06/20/2022 02:50 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:FERN ACADEMY EDUCATIONAL CHILDCAREFACILITY NUMBER:
364846209
ADMINISTRATOR:HE, LINGLINFACILITY TYPE:
850
ADDRESS:6921 SCHAEFER AVETELEPHONE:
(909) 696-9638
CITY:CHINOSTATE: CAZIP CODE:
91710
CAPACITY: 128TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
06/20/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:LingLin HeTIME COMPLETED:
03:15 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analysts (LPAs), Rachel Zeron and Samuel Lopez, toured proposed Preschool center, inside and out. A Fire Clearance was granted on 04/08/2022. The days and hours of operation will be: Monday-Friday 7:30 am – 6:30 pm. Measurements were taken and the following was determined:

Preschool Indoor Activity Areas
LPA has determined that there is sufficient space to accommodate 128 children.
Toddler component waiver pending for napping area/activity area to be shared.
Preschool Bathroom Fixtures
11 toilets x 15 = 165 children
20 sinks x 15 = 300 children

Preschool Outdoor Activity Area:
LPA has determined that there is sufficient space to accommodate 128 children. A separate playground for the toddler component.

Limiting factor for preschool capacity the fire clearance granted on 04/08/2022 . Preschool capacity is limited to 128 children.

The following was observed:
· Classrooms are adequately equipped with age and size appropriate furniture and equipment
· *supply drinking water in the indoor activity space
· Playgrounds are enclosed by appropriate fences
· Outdoor activity areas are supplied with age and size appropriate equipment
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Rachel Zeron
LICENSING EVALUATOR SIGNATURE: DATE: 06/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/20/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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: FERN ACADEMY EDUCATIONAL CHILDCARE
FACILITY NUMBER: 364846209
VISIT DATE: 06/20/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
· There are no accessible bodies of water present. All wading pools or similar product must be emptied immediately after use and stored in an upright position.
· An adequate amount of cushioning material under the synthetic grass, in place under play equipment
· Adequate shade is provided
· Drinking water is provided in the outdoor play areas by water pitchers with cup available .
· Food preparation area is equipped with refrigerator, sink with hot and cold running water, storage area, utensils, and adequate amount of food supplies. Lunch is provided by an outsourced vendor.
· The office area is located and will serve as the isolation area for ill children temporarily until parents arrive
· Staff bathroom will also be used as the isolation bathroom and is conveniently located at the rear of the facility.
· Toxins are locked
· First Aid kit is complete
· Sign in/Sign out record was reviewed and meets regulation requirements
· Component II Orientation was completed during this inspection
· The applicant was informed of their reporting requirements and is provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO09@dss.ca.gov
· A review of staff records on 06/20/2022 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Licensee was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

The applicant can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations862@dss.ca.gov

SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Rachel Zeron
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: FERN ACADEMY EDUCATIONAL CHILDCARE
FACILITY NUMBER: 364846209
VISIT DATE: 06/20/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.

LPA also informed Licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPA reviewed with licensee the LIC 311A, Records to Be Maintained at The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

The Duty Officer is available to answer questions Monday – Friday; 8:00am to 5:00pm at:


1-844-LET-US-NO (1-844-538-8766) and/or 951-782-4200

Exit interview conducted and report was reviewed with the licensee, LingLin He. Waiver has been submitted for the toddler component and requires approval before final approval is granted.
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Rachel Zeron
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2022
LIC809 (FAS) - (06/04)
Page: 3 of 3