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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364846291
Report Date: 01/24/2023
Date Signed: 01/24/2023 11:02:00 AM

Document Has Been Signed on 01/24/2023 11:02 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:LIL' BLUE HEARTWOOD PRESCHOOLFACILITY NUMBER:
364846291
ADMINISTRATOR:TOPETE, FANNYFACILITY TYPE:
830
ADDRESS:2460 S EUCLID AVETELEPHONE:
(909) 988-5049
CITY:ONTARIOSTATE: CAZIP CODE:
91762
CAPACITY: 16TOTAL ENROLLED CHILDREN: 0CENSUS: 4DATE:
01/24/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Applicants Fanny Topete and Fernando ChavezTIME COMPLETED:
10:40 AM
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Licensing Program Analyst (LPA), Samuel Lopez, toured proposed Infant center, inside and out. A Fire Clearance was granted on 10/5/2022.
The days and hours of operation will be: Monday through Friday, 7:00am to 6:00pm

Measurements were taken and the following was determined:
Infant Indoor Activity Areas
LPA has determined that there is sufficient indoor activity space to accommodate 16 children.

Infant Bathroom Fixtures
1 toilets x 15 = 15 children
2 sinks x 15 = 30 children
*potty chairs available

Infant Outdoor Activity Area:
LPA has determined that there is sufficient outdoor activity space to accommodate 24 children.

Limiting factor for infant capacity is the Fire Clearance given. Infant capacity is limited to 16 children.

The following was observed:
· Classrooms are adequately equipped with age and size appropriate furniture and equipment
· There is a changing table within arm’s reach of a sink
· Bottled water 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: Aaron Ross
LICENSING EVALUATOR NAME: Samuel Lopez
LICENSING EVALUATOR SIGNATURE: DATE: 01/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/24/2023
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: LIL' BLUE HEARTWOOD PRESCHOOL
FACILITY NUMBER: 364846291
VISIT DATE: 01/24/2023
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· 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.
· Toxins are locked
· An adequate amount of cushioning material (padding/rubber mat) is in place under play equipment
· Adequate shade is provided
· Drinking water will be provided in the outdoor play areas by bottled water
· Food preparation area is equipped with refrigerator, sink with hot and cold running water, storage area, utensils, and adequate amount of food supplies
· The office area is located at the entrance and will serve as the isolation area for ill children temporarily until parents arrive
· Medication will be stored in the front office in a locked box/cabinet (once IMS plan is submitted)
· First Aid kit is complete
· Sign in/Sign out record was reviewed and meets regulation requirements (Brightwheel)
· Component II Orientation was completed during the 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
· Needs and Services plans were reviewed and discussed and must be updated at least quarterly or whenever needed.
· There are sufficient cribs and/or mats for each child
· There is a separate napping area
· A review of staff records on 1/24/2023 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Applicants Fanny Topete and Fernando Chavez 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.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Samuel Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2023
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: LIL' BLUE HEARTWOOD PRESCHOOL
FACILITY NUMBER: 364846291
VISIT DATE: 01/24/2023
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The applicant can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations862@dss.ca.gov

LPA discussed AB 2370 and provided a copy of PIN 21-21.1-CCP which explains the requirement for lead testing of water. All licensed Child Care Centers operating in buildings constructed before January 1, 2010, shall test their water for lead.
For more information visit:
https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information

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 Applicants Fanny Topete and Fernando Chavez 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 Applicants Fanny Topete and Fernando Chavez 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 Applicants Fanny Topete and Fernando Chavez the LIC 311A, Records to Be Maintained at The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Samuel Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2023
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: LIL' BLUE HEARTWOOD PRESCHOOL
FACILITY NUMBER: 364846291
VISIT DATE: 01/24/2023
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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

The following items need to be completed/corrected prior to a license being issued:

1. Clean toys and debris on the playground
2. Clean out the restroom
3. Install Carbon Monoxide detector
4. HVAC fully operable

Once all corrections have been made, with proof sent to licensing, the application will be submitted for approval with a maximum capacity of 16. As agreed, upon by the applicant, all corrections are due within 30 days. If not received within 30 days from the date of this report, the application will be denied.

Exit interview conducted and report was reviewed with the Applicants Fanny Topete and Fernando Chavez
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Samuel Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2023
LIC809 (FAS) - (06/04)
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