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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376300793
Report Date: 06/15/2023
Date Signed: 06/15/2023 02:59:34 PM

Document Has Been Signed on 06/15/2023 02:59 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 SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:EMMANUEL FAITH PRESCHOOL & INFANT TODDLER CENTERFACILITY NUMBER:
376300793
ADMINISTRATOR:FELICIANO, JESSICAFACILITY TYPE:
830
ADDRESS:639 E 17TH AVENUETELEPHONE:
(760) 745-2541
CITY:ESCONDIDOSTATE: CAZIP CODE:
92025
CAPACITY: 28TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
06/15/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:34 AM
MET WITH:Jessica FelicianoTIME COMPLETED:
03:10 PM
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Licensing Program Analyst (LPA), Ana Noble conducted a pre-licensing inspection this date for a proposed Infant/Toddler Program. The days and hours of operation will be: Monday - Friday 7:30 am - 4:30 pm. LPA met with Jessica Feliciano, Director who led a tour of the facility at 10:05 AM. This is a combination center with Preschool License.
The facility was toured inside and out, and the following was observed:
· Classrooms are adequately equipped with age and size appropriate furniture and equipment
· Water dispenser and zippy cups or disposables, supply drinking water in the indoor activity space
· Playground is enclosed by a wrought iron fence
· Outdoor activity area is supplied with age and size appropriate equipment
· There are no accessible bodies of water present. If wading pools or similar products are used, they must be emptied immediately after use and stored in an upright position.
· An adequate amount of cushioning material rubber padding is in place under play equipment
· Adequate shade is provided by patio cover/canopy.
· Drinking water is provided in the outdoor play area by Water dispenser and zippy or disposable cups.
· Food preparation area is equipped with refrigerator, sink with hot and cold running water, storage area, utensils, and adequate amount of food supplies-no meals are prepared at the facility. Children bring there our meals.
· The office area is located near the entrance of the building by the lobby.
· Director's office will serve as the isolation area for ill children temporarily until parents arrive
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Ana Noble
LICENSING EVALUATOR SIGNATURE: DATE: 06/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/15/2023
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
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: EMMANUEL FAITH PRESCHOOL & INFANT TODDLER CENTER
FACILITY NUMBER: 376300793
VISIT DATE: 06/15/2023
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·There is a working telephone located in the facility.
· Medication will be stored inside the classrooms which is inaccessible to children
· Storage area for toxins and poisons is locked, located in locked storage closet.
· First Aid kit is complete with all required items at this time.
· Sign in/Sign out record was reviewed and meets regulation requirements
· Parent Board located on wall of Room 3/Multipurpose and near the nursery area with all required forms.
· Carbon Monoxide Detector located in ceiling and is hard wired.

Measurements were taken and the following was determined:

Infant Indoor Activity Areas-
LPA has determined that there is sufficient space to accommodate 28 children/16 Infants and 12 Toddler Option. Toddler Option in Room 9-C.

Bathroom Fixtures
1 toilet/3 changing tables x 15 = 60 children
4 sinks x 15 = 75 children

Infant/Toddler Outdoor Activity Area:
LPA has determined that there is sufficient space to accommodate 15 children.
A waiver for sharing playground/outdoor activity space is pending approval.

Limiting factor for Infant/Toddler Option requested Capacity of 28 with 16 Infant (only 8 requiring to use a crib) and 12 Toddler Option (In Room 9-C). The Fire Clearance granted on 5/19/2023.

Infant/Toddler capacity is limited to 28 children.

During the inspection, the following was reviewed with Facility Representative, Jessica Feliciano:
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Ana Noble
LICENSING EVALUATOR SIGNATURE:

DATE: 06/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2023
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
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: EMMANUEL FAITH PRESCHOOL & INFANT TODDLER CENTER
FACILITY NUMBER: 376300793
VISIT DATE: 06/15/2023
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·Component II Orientation was completed
· The applicant was informed of their reporting requirements and provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO10@dss.ca.gov
· The importance of checking for recalled infant (children) devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant (children) devices with the CPSC to be notified of any recalls on their purchased equipment.

· Provider Information Notice (PIN) 22-20-CCP: Resources and Requirements on Lead Testing in Child Care

· LPA reviewed Incidental Medical Services (IMS). For IMS information, see PIN 22-02-CCP. A Plan of Operation that includes IMS must be submitted to the Department if the facility will provide the services. 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


· 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.

Facility representative 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: Deborah Mullen
LICENSING EVALUATOR NAME: Ana Noble
LICENSING EVALUATOR SIGNATURE:

DATE: 06/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2023
LIC809 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: EMMANUEL FAITH PRESCHOOL & INFANT TODDLER CENTER
FACILITY NUMBER: 376300793
VISIT DATE: 06/15/2023
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A review of staff records on 5/14/2023 indicates that the applicant and/or designated individual who is required to have caregiver background checks have received criminal record and child abuse index clearances or exemptions. The applicant can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations858@dss.ca.gov

LPA discussed the safe sleep regulations with facility representative, Jessica Feliciano, Director 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 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.

LPA reviewed with Facility representative, 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.

SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Ana Noble
LICENSING EVALUATOR SIGNATURE:

DATE: 06/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2023
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
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: EMMANUEL FAITH PRESCHOOL & INFANT TODDLER CENTER
FACILITY NUMBER: 376300793
VISIT DATE: 06/15/2023
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The following items need to be completed/corrected prior to a license being issued:

1. Submit a copy of Orientation for Jeremy Johnson for Component 3.
2. Waiver request approval for shared restroom with Preschool children.
3. Waiver request approval for shared playground for infants and toddlers.
3. Obtain copy of Financial Statement, LIC403.

Once all corrections have been made, with proof sent to licensing, the application will be submitted for approval with a maximum capacity of 28 children total /16 infants-12 toddlers. As agreed upon by facility representative, Jessica Feliciano, all corrections are due within 30 days. If not received within 30 days from the date of this report, the application will be denied.

If all corrections are approved and facility licensed, you must have the drinking water outlets used for drinking and cooking tested for lead and post the results within 180 days of licensure.

Exit interview conducted and report was reviewed with Facility representative, Jessica Feliciano.
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Ana Noble
LICENSING EVALUATOR SIGNATURE:

DATE: 06/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2023
LIC809 (FAS) - (06/04)
Page: 5 of 5