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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191201970
Report Date: 08/01/2019
Date Signed: 08/12/2019 12:27:44 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:MOUNT OLIVE WILLA LEE NURSERY SCHOOLFACILITY NUMBER:
191201970
ADMINISTRATOR:NULTY, JANETTEFACILITY TYPE:
850
ADDRESS:4519 WILLA LEE AVENUETELEPHONE:
(818) 249-9200
CITY:LA CRESCENTASTATE: CAZIP CODE:
91214
CAPACITY:21CENSUS: DATE:
08/01/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:25 AM
MET WITH:Janette Nulty TIME COMPLETED:
03:15 PM
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Licensing Program Analyst (LPA) Justin Dorsey conducted an unannounced Annual Random Inspection. LPA met with Janette Nulty, Director, who guided LPA on a tour of the facility.

LPA inspected all areas identified on the Facility Sketch. The following staff were observed in each classroom during this visit: Class #1 (3-4 year olds): Staff #1 with 8 children and Class #2 (4-5 year olds): Staff #2 with 10 children.

Students have access to the classrooms, restrooms (located in each classroom), and the outdoor play area. Students of the program are signed in at the main entrance by their parents. The facility does not provide transportation. Furniture and equipment are safe and in good repair. There is telephone service, heating, lighting and ventilation available at the facility. The area near the directors desk has been designated as an isolation area. Ill Children use the restroom in the classrooms.

Drinking water is available indoors and outdoors. Restrooms used were inspected for availability, good repair, water temperature, toilet paper, area safety and sanitation.

On 08/01/19 at 11:40 am during the inspection the director told LPA Dorsey that after changing children's diapers staff use the kitchen sink to wash their hands. At 1:10 pm LPA observed staff #2 change a child's diaper and wash their hands in the kitchen sink.

The kitchen, which the students don't have access to is located behind close doors to the left upon entry of the facility. The facility provides lunch, am and pm snacks. Containers used to discard food have tight fitting lids at this time. Snack menus were posted in the kitchen and the main room upon entry. Snacks were reviewed for availability, quantity and appropriateness to children in care. Poisons, cleaning compounds and sharp items are inaccessible.
SUPERVISOR'S NAME: Adriana HernandezTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2019
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 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MOUNT OLIVE WILLA LEE NURSERY SCHOOL
FACILITY NUMBER: 191201970
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/01/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/15/2019
Section Cited
CCR
101638.1
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101638.1 General Sanitation (e)(6) Washing, cleaning and sanitizing requirements for areas used by staff and children...shall include: Sinks used for food preparation shall not be used to wash infants or to wash fecally contaminated hands. This requirement is not met as evidenced by:
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Per Director, she will move the changing station to the childrens bathroom so that staff can wash their hands appropriatly.
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Based on observation and interview the director stated that staff washed their hands in the kitchen sink after changing childrens diapers. LPA also observed staff #2 changing a child's diaper and washing her hands in the kitchen sink, which poses a potential Health, Safety or Personal Rights risk to children in care.
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Type B
08/15/2019
Section Cited
HSC
1596.8662
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On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training, and shall complete renewal mandated reporter training every two years following the date on which he
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Per Director, she will provide LPA Dorsey a copy of the mandated reporter taraning fror both herself and staff #2.
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 or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
Based on observation and interview staff #2 and the Director have no proof of completing the mandated reporter training, which poses a potential Health, Safety or Personal Rights 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: Adriana HernandezTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2019
LIC809 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MOUNT OLIVE WILLA LEE NURSERY SCHOOL
FACILITY NUMBER: 191201970
VISIT DATE: 08/01/2019
NARRATIVE
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The outdoor area includes a grass and dirt area with shade sails for shade. The play area is fully fenced. Per Director the children use a portable pool (walls are low enough for children to step over) that is located above the facilities play area in the yard of the church. The children are walked up by teachers to the pool. Per Director two teachers monitor groups of 10 children when doing pool activities. A review of records was conducted for staff and participants. Ratios were observed to be in compliance. CPR/First Aid current. First Aid supplies are available. Disaster drills are documented and all posting requirements have been met.

On 08/01/19 at 12:30 pm LPA Dorsey found that staff #2 did not have an immunization record in her their file. Per director she will get an immunization record from staff #2

On 08/01/19 at 12:30 pm during file review LPA Dorsey found that staff #2 has not completed the mandated reporter training.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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
REMINDER: Failure to obtain a criminal record background check clearance prior to initial presence will result in an immediate $100.00 dollar or more.

LPA advised how to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov. Also, discussed new requirements for providers, including mandate reporting training for staff which can be found at: http:/www.mandatedreporterca.com/training /training.htm. This is a new regulatory requirement beginning January 2018. According to staff, training has been completed through Community Care Licensing. Please review all elements outlined in AB 1207- Mandated Reporting Training.
SUPERVISOR'S NAME: Adriana HernandezTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MOUNT OLIVE WILLA LEE NURSERY SCHOOL
FACILITY NUMBER: 191201970
VISIT DATE: 08/01/2019
NARRATIVE
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The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing reprehensive. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Director Janette Nulty Appeal Rights were given.
SUPERVISOR'S NAME: Adriana HernandezTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4