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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364846291
Report Date: 08/29/2024
Date Signed: 08/29/2024 03:49:38 PM

Document Has Been Signed on 08/29/2024 03:49 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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:LIL' BLUE HEARTWOOD PRESCHOOLFACILITY NUMBER:
364846291
ADMINISTRATOR/
DIRECTOR:		FANNY TOPETEFACILITY TYPE:
830
ADDRESS:2460 S EUCLID AVETELEPHONE:
(909) 988-5049
CITY:ONTARIOSTATE: CAZIP CODE:
91762
CAPACITY: 16TOTAL ENROLLED CHILDREN: 16CENSUS: 8DATE:
08/29/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Fanny TopeteTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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On the date and time listed above a 3 -year inspection is being conducted as a compliance review. Licensing Program Analyst (LPA), Giselle Carbullido, toured the infant center, inside and out. LPA was granted entry by Director, Fanny Topete. The following was observed and or discussed:
Days and hours of operation are Monday -Friday; 7AM- 6PM.

The inspection consisted of reviews of the CARE tool domains. The inspection found the facility to be in compliance except as noted on the LIC809D. Deficiencies were cited this visit and technical advisories issued.
The licensee is asked to update the following documents and submit to licensing within 30 days: (only if changes have been made)
1. LIC 500 Personnel Report
2. LIC 610 Emergency & Disaster Plan
3. Parent Handbook/ Program Curriculum/Admission policies and procedures/ fee schedule
4. LIC 309 Administrative Organization
5. LIC 308 Designation of Administrative Responsibility- update submitted during this visit
The following items have been posted and are updated where necessary:
License, Emergency Disaster Plan (LIC610) and Earthquake Preparedness Checklist (LIC9148)
Parent’s Rights Poster (PUB393), Personal Rights (LIC613A); Child Car Seat Law, Menu
The facility is operating within the terms of the license: yes
Ratios were met with appropriate supervision during this inspection.
Classrooms are clean, free of hazards and equipped with age-appropriate furniture.
No weapons stored at the facility.
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.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE: DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/29/2024
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 12
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: LIL' BLUE HEARTWOOD PRESCHOOL
FACILITY NUMBER: 364846291
VISIT DATE: 08/29/2024
NARRATIVE
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Medications are stored inaccessible to children: No medications or IMS per Director
Hazards, poisons, and other items that are dangerous are stored inaccessible to infants. All floors are clean and safe.
Bathrooms were observed to be safe, sanitary and in operating condition. Outdoor activity areas are physically separate, have appropriate fences, are free of hazards and have age/size appropriate equipment in good condition Food preparation area is clean, free of litter, rodents and other vermin. Measures are taken to keep the facility free of flies, other insects, and rodents. Food is stored appropriately and protected from contamination. Storage containers for solid waste, including moveable bins-have tight-fitting covers in good repair. Menus are current and posted in a place visible by the child’s authorized representative, dated and made available upon request. Uncontaminated drinking water is readily available both indoors and outdoors: Yes
The areas around or under high climbing equipment have cushioned with material that absorbs a fall: Facility has rubber matting Sign in/Sign out record was reviewed and meets regulation requirements: Yes- electronic Brightwheel A Staff member is present with current Pediatric CPR/First Aid which expires on 3/2026 Opening and closing staff member’s CPR/First Aid expires on 3/2026 FT Director completed Health and Safety Training: See LIC9102TV technical assistance Staff files were reviewed and are complete: No LIC 809D Staff have received on-the-job training for housekeeping, sanitation and universal health precautions. Infant files are complete. Yes/No See LIC 809D/LIC9102TV.
Individual Infant needs and service plans were reviewed and are complete and current for each individual infant: Yes
Infants up to 12 months shall have a sleeping plan LIC9227 on file.
All infants shall have required documentation of 15-minute checks including date, name, time of 15-minute check and staff initials. See LIC9102TV technical advisory
Fire & earthquake drills are conducted and documented every six months. Yes -8/19/24 Facility Representative was informed the Department has inspection authority per Health and Safety Codes. Facility Staff provided the Unusual Incident Reporting email: UnusualIncidentReportsDO09@dss.ca.gov
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024
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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: LIL' BLUE HEARTWOOD PRESCHOOL
FACILITY NUMBER: 364846291
VISIT DATE: 08/29/2024
NARRATIVE
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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.
MyChildCarePlan.org – Centers and Family Child Care Homes Licensee [or facility representative] was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.
CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES: Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For childcare center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP).
LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. PIN 22-05-CCP Page Four. LPA referred licensee [or facility representative] to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

- AB 1207 – Mandated Child Abuse Reporting: Child Day Care Personnel Training, beginning January 1, 2018 – Requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years.

AB2960 – Childcare and development services, online portal – Effective June 20, 2022 - This bill requires the State Superintendent of Public Instruction (SSPI), within the California Department of Education (CDE), to develop and post on CDE's website a comprehensive childcare and development services online portal for families and providers by June 30, 2022.
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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/. See LIC9102TV technical advisory
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024
LIC809 (FAS) - (06/04)
Page: 3 of 12
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: LIL' BLUE HEARTWOOD PRESCHOOL
FACILITY NUMBER: 364846291
VISIT DATE: 08/29/2024
NARRATIVE
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Licensee [or facility representative] was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated. See LIC9102TV

LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] 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.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Facility Representative, Fanny Topete.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/29/2024 03:49 PM - It Cannot Be Edited


Created By: Giselle Carbullido On 08/29/2024 at 03:08 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: LIL' BLUE HEARTWOOD PRESCHOOL
FACILITY NUMBER: 364846291

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/29/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101439(b)
Infant Care Center Fixtures, Furniture, Equipment and Supplies
(b) The infant care center shall be equipped with appropriate furniture and equipment including, but not limited to, cribs, cots or mats; changing tables; and feeding chairs.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) the licensee did not comply with the section cited above in that the sink required for infant toileting needs within arms lengtth was observed not operable which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/02/2024
Plan of Correction
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Facility will submit proof (video) of operable sink for infant toileting needs by POC due date or earlier.
Type B
Section Cited
CCR
101216(g)(1)
Personnel Requirements
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review the licensee did not comply with the section cited above in that S2 did not have LIC503 available for review which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/29/2024
Plan of Correction
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Director found LIC503 for S2 in file cabinet; cleared during visit.
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:Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:
DATE: 08/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/29/2024


LIC809 (FAS) - (06/04)
Page: 5 of 12
Document Has Been Signed on 08/29/2024 03:49 PM - It Cannot Be Edited


Created By: Giselle Carbullido On 08/29/2024 at 03:08 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: LIL' BLUE HEARTWOOD PRESCHOOL
FACILITY NUMBER: 364846291

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/29/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on (record review)], the licensee did not comply with the section cited above in that S1 has expired mandated reporter (7/23) which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/02/2024
Plan of Correction
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Facility will submit proof of mandated renewal for S1 by POC due date or earlier.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:
DATE: 08/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/29/2024


LIC809 (FAS) - (06/04)
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