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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364846291
Report Date: 01/24/2025
Date Signed: 01/24/2025 02:07:42 PM

Document Has Been Signed on 01/24/2025 02:07 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: 7DATE:
01/24/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Fernando Chavez, Owner TIME VISIT/
INSPECTION COMPLETED:
02:30 PM
NARRATIVE
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On the date and time listed above, Licensing Program Analyst (LPA) arrived at the facility on another matter. Upon arrival, LPA was met with the assistant director, who walked her over to the director, Adriana Topete. LPA was later met with the co-owner, Fernando Chavez.

During the tour of the facility, LPA observed a closet to the left of the small sink where baby bottles are washed and stored. In this closet, LPA observed a sink which had several plastic bags in it, weighted down with old water. Items in the sink appeared greenish-yellow/orange, and grey. The areas around the inside of the sink had visibly hardened from sitting too long. Additionally, there are two baskets on the left wall of the closet, which hold what looked to be rags. One of the labels on one of the baskets had "Clean" written on it. The other basket, closer to the floor, had black/green specks growing behind the wall it is hanging from.

Furthermore, staff files were reviewed during this inspection. There were 2 out of 4 staff files missing paperwork. Lastly, facility did not inform licensing of new site director. See LIC809D for cited deficiencies.

Also, LPA Aman Lama informed the owner, Fernando Chavez to provide a copy of this licensing report dated January 24, 2025 that documents any Type A citation(s) to parents/guardians of all children currently enrolled, or newly enrolled by the next business day or the next day the child(ren) is(are) in care. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification and kept on file for 12 months from the date of this report.


LPA Aman Lama also informed the owner, Fernando Chavez that this report dated January 24, 2025document(s) (1) Type A citation(s) which shall be posted for 30 consecutive days as there is(are) immediate risk(s) to the health, safety, or personal rights of children in care.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Aman Lama
LICENSING EVALUATOR SIGNATURE: DATE: 01/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/24/2025
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
Document Has Been Signed on 01/24/2025 02:07 PM - It Cannot Be Edited


Created By: Aman Lama On 01/24/2025 at 01:21 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: 01/24/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/27/2025
Section Cited
CCR
101238(a)

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101238 Buildings and Grounds(a)The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This was not met as evidenced by: During the tour of the infant classroom,
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The facility owner agrees to immediately remediate the issue in the storage closet of the infant classroom. Proof of this via pictures are due to the department no later than the POC due date.
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LPA observed mildew-like and mold-like substances in the storage closet. This poses an immediate health and safety risk to 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:Aman Lama
LICENSING EVALUATOR SIGNATURE:
DATE: 01/24/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/24/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/24/2025 02:07 PM - It Cannot Be Edited


Created By: Aman Lama On 01/24/2025 at 01:31 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: 01/24/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/14/2025
Section Cited
HSC
1596.8662(b)(1)

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(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
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Facilty agrees to subit proof of MRT for S2 no later than the POC due date. The mandated reporter training certificate should be for "Child Care Providers" and can be found online at mandatedreporterca.com
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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: 1 out of 4 staff did not have an updated MRT on file.
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Type B
02/14/2025
Section Cited
HSC1596.7995(a)(1)

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(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.This requirement is not met as evidenced by:
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Facility agrees to submit proof of immunizations (measles, pertussis and/or flu shot/written declination of flu shot) for S4 no later than POC due date.
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& Dec 1 of each year. This requirement is not met as evidenced by: 1 out of 4 staff did not have their immunizations (measles, pertussis, and/or flu shot/written declination of flu shot) on file.
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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:Aman Lama
LICENSING EVALUATOR SIGNATURE:
DATE: 01/24/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/24/2025


LIC809 (FAS) - (06/04)
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