Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 360910746
Report Date: 08/07/2015 12:00:00 AM
Date Signed 08/07/2015 02:59:37 PM

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:GRAND TERRACE ELEMENTARY - CHILD CAREFACILITY NUMBER:
360910746
ADMINISTRATOR:PHILLIPS, LINDAFACILITY TYPE:
840
ADDRESS:12066 VIVIENDATELEPHONE:
(909) 825-7359
CITY:GRAND TERRACESTATE: CAZIP CODE:
92313
CAPACITY:70CENSUS: 21DATE:
08/07/2015
TYPE OF VISIT:Required - 5 YearUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Linda PhillipsTIME COMPLETED:
03:15 PM
NARRATIVE
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(3) An Annual visit is being conducted as a compliance review. Licensing Program Analyst (LPA), Yolanda Jackson, toured the center, inside and out. The following was observed:
· The facility is operating within the terms of the license
· The facility will be offering IMS and will submit a Plan of Operation in 30 days
· Ratios were met during this visit
· Appropriate supervision was provided during the visit
· Classrooms are equipped with age appropriate furniture and equipment in good condition
· Classrooms are clean and free of hazards
· No weapons stored at the facility
· No medications are stored where inaccessible to children
· Hazards are stored where inaccessible to children
· Toxins are locked
· Bathrooms were observed to be safe, sanitary and in operating condition
· Playgrounds are enclosed by appropriate fences and free of hazards
· Outdoor activity areas are supplied with age and size appropriate equipment in good condition
· Food preparation area is clean and free of vermin
· Food is stored appropriately and protected from contamination
· Sign in/Sign out record was reviewed and meets regulation requirements
· Staff member’s CPR/First Aid expires on 5/17
· Required emergency contact forms were reviewed
· A review of staff records on 8/7/15 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
SUPERVISOR'S NAME: Lya JohnsonTELEPHONE: (951) 782-4216
LICENSING EVALUATOR NAME: Yolanda JacksonTELEPHONE: (951) 897-5637
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2015
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: GRAND TERRACE ELEMENTARY - CHILD CARE
FACILITY NUMBER: 360910746
VISIT DATE: 08/07/2015
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There are no deficiencies at time of visit.

· The facility representative was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed.
· AB 978 – Zero Tolerance Related Regulations went into effect January 18, 2011 – In accordance with California Health and Safety Code Section 1596.99(c)/1597.58(c) – it was explained that an immediate $150 Civil penalty will be assessed for each serious violation and a civil penalty of $150 per day per violation will be assessed until corrected.
· AB 2084 – Nutritious Beverages in Child Care Facilities went into effect January 1, 2012- In accordance with California Health and Safety Code Section 1596.808- licensee was issued a copy of this new law during this visit.
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Exit interview conducted appeal rights discussed and a copy of this report was left at the facility.

A copy of this report must be made available to the public for 3 years.
SUPERVISOR'S NAME: Lya JohnsonTELEPHONE: (951) 782-4216
LICENSING EVALUATOR NAME: Yolanda JacksonTELEPHONE: (951) 897-5637
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2015
LIC809 (FAS) - (06/04)
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