CITY OF MORENO VALLEY CREEKSIDE

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On December 19, 2024, at 02:00 PM, Licensing Program Analyst (LPA), Jesse Gardner, conducted an annual inspection as part of a compliance review. A tour of the inside and outside of the facility was granted and the following was observed and/or noted: During the annual inspection, and concluding a review of staff records on 12/19/2024, LPA found that staff or other individuals who require caregiver background checks have not received a cleared criminal record check. Staff One (S1) was found to not have a cleared background; thus, a $500 immediate civil penalty was issued. Record review further revealed that S1 had been working at the facility since 2023. LPA witnessed S1 leave the facility and S2 replace S1 to maintain ratio. An exit interview was conducted where a copy of this report was reviewed with and provided to Site Supervisor Iris Hughes along with a copies of the LIC 421BG, LIC 811 (Confidential names list), LIC 809D (deficiency page), and Appeal Rights. SUPERVISORS NAME: Deborah Mullen LICENSING EVALUATOR NAME: Jesse Gardner LICENSING EVALUATOR SIGNATURE: DATE: 12/19/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/19/2024 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 2 FACILITY NAME: CITY OF MORENO VALLEY CREEKSIDE FACILITY NUMBER: 334816836 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 12/19/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type A 12/20/2024 Section Cited CCR 101216(i)(1) 1 2 3 4 5 6 7Personnel Requirements: (i) Prior to employment or initial presence in the child care center, all employees and volunteers subject to a criminal record review shall:(1) Obtain a California clearance or a criminal record exemption as required by law or Department regulations. These requirements were not being met as evidenced by:1 2 3 4 5 6 7Licensee states they will immediately send S1 to get re-fingerprinted and provide proof of the clearance to LPA when received. Additionally, Licensee states they will provide an statement of understanding of the regulation to LPA by POC date 8 9 10 11 12 13 14Based on record review, S1 does not have a cleared background. This is an immediate health and safety risk to children in care. 8 9 10 11 12 13 14 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 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:Deborah Mullen LICENSING EVALUATOR NAME:Jesse Gardner LICENSING EVALUATOR SIGNATURE: DATE: 12/19/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/19/2024

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On December 19, 2024, at 02:00 PM, Licensing Program Analyst (LPA), Jesse Gardner, conducted an annual inspection as part of a compliance review. A tour of the inside and outside of the facility was granted and the following was observed and/or noted: During the annual inspection, and concluding a review of staff records on 12/19/2024, LPA found that staff or other individuals who require caregiver background checks have not received a cleared criminal record check. Staff One (S1) was found to not have a cleared background; thus, a $500 immediate civil penalty was issued. Record review further revealed that S1 had been working at the facility since 2023. LPA witnessed S1 leave the facility and S2 replace S1 to maintain ratio. An exit interview was conducted where a copy of this report was reviewed with and provided to Site Supervisor Iris Hughes along with a copies of the LIC 421BG, LIC 811 (Confidential names list), LIC 809D (deficiency page), and Appeal Rights. SUPERVISORS NAME: Deborah Mullen LICENSING EVALUATOR NAME: Jesse Gardner LICENSING EVALUATOR SIGNATURE: DATE: 12/19/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/19/2024 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 2 FACILITY NAME: CITY OF MORENO VALLEY CREEKSIDE FACILITY NUMBER: 334816836 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 12/19/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type A 12/20/2024 Section Cited CCR 101216(i)(1) 1 2 3 4 5 6 7Personnel Requirements: (i) Prior to employment or initial presence in the child care center, all employees and volunteers subject to a criminal record review shall:(1) Obtain a California clearance or a criminal record exemption as required by law or Department regulations. These requirements were not being met as evidenced by:1 2 3 4 5 6 7Licensee states they will immediately send S1 to get re-fingerprinted and provide proof of the clearance to LPA when received. Additionally, Licensee states they will provide an statement of understanding of the regulation to LPA by POC date 8 9 10 11 12 13 14Based on record review, S1 does not have a cleared background. This is an immediate health and safety risk to children in care. 8 9 10 11 12 13 14 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 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:Deborah Mullen LICENSING EVALUATOR NAME:Jesse Gardner LICENSING EVALUATOR SIGNATURE: DATE: 12/19/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/19/2024

Type A citation - immediate risk to health, safety, or personal rights