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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191500276
Report Date: 01/25/2022
Date Signed: 01/25/2022 05:04:47 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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:GOLDEN WEST PRESCHOOLFACILITY NUMBER:
191500276
ADMINISTRATOR:SANDRINE BELLAIRSFACILITY TYPE:
850
ADDRESS:10248 ALONDRA BLVD.TELEPHONE:
(562) 866-5616
CITY:BELLFLOWERSTATE: CAZIP CODE:
90706
CAPACITY:80CENSUS: DATE:
01/25/2022
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
01:03 PM
MET WITH:Emily Nalasa, DirectorTIME COMPLETED:
05:15 PM
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On Tuesday, January 25, 2022 at 1:05 PM, Licensing Program Analyst (LPA) Mayra Rivera conducted a case management initiated inspection and met with Director Emily Nalasa who guided LPA Rivera on a tour of the facility. The facility is currently inactive as of March, 2021 and facility plans on reopen by February 2022.

This is a preschool program which consists of preschool classrooms; room one, room two, room three and a multipurpose room. This program serves children ages 2 years to 6 years. This program will operate Monday - Friday 6:30 AM - 6:00 PM.

All areas identified on the facility sketch were toured both indoors and outdoors; measurements were taken due to changes and upgrades to the facility. The facility is currently licensed for 80 preschoolers.

Sign-In and Sign-out procedure is located in the lobby entrance. Parents/guardians will sign in and out utilizing sign in/out sheets. Health checks will be conducted as children enter their classrooms. Director states that there are no firearms or weapons stored at the facility.

At approximately 1:10 PM LPA Rivera entered classroom number one to conduct an inspection and measurements. LPA observed the classroom furniture and equipment to be in good condition, free of sharp, no loose, or pointed parts. LPA observed the cleaning supplies, first aid kit and cots stored inside the classroom closet. LPA observed a safety latch on top of the closet door making it inaccessible to children to open the closet door. LPA observed cubbies against the wall for children to place their personal items. LPA also observed trash bins with tight fitting lids.

SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3368
LICENSING EVALUATOR NAME: Mayra RiveraTELEPHONE: (323) 629-7782
LICENSING EVALUATOR SIGNATURE:

DATE: 01/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2022
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 5
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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: GOLDEN WEST PRESCHOOL
FACILITY NUMBER: 191500276
VISIT DATE: 01/25/2022
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At approximately 1:16 PM LPA Rivera entered classroom number two to conduct an inspection and measurements. LPA observed the classroom furniture and equipment to be in good condition, free of sharp, no loose, or pointed parts. LPA observed the cleaning supplies, first aid kit and cots stored inside the classroom closet. LPA observed a safety latch on top of the closet door making it inaccessible to children to open the closet door.LPA observed cubbies against the wall for children to place their personal items. LPA also observed trash bins with tight fitting lids.

At approximately 1:23 PM LPA Rivera entered classroom number three to conduct an inspection and measurements. LPA observed the classroom furniture and equipment to be in good condition, free of sharp, no loose, or pointed parts. LPA observed a stage with music equipment but the music equipment will not be utilized by the children. LPA observed a gate barrier in place around the stage to prevent children access to the music equipment. The music equipment will be removed and children will be able to utilize the stage area for activities. LPA observed the cleaning supplies, first aid kit and cots stored inside the classroom closet. LPA observed a safety latch on top of the closet door making it inaccessible to children to open the closet door. LPA observed cubbies against the wall for children to place their personal items. LPA also observed trash bins with tight fitting lids.

At approximately 1:30 PM LPA entered the multipurpose room to conducted an inspection and measurements. LPA observed the furniture and equipment to be in good condition, free of sharp, no loose, or pointed parts. The multipurpose room will be utilize for the parents and children activities.

Heating lighting and ventilation were evaluated by LPA. LPA observed central AC/heater and vents located on the ceiling walls of the facility. The thermostat is located in room one and LPA observe the current room temperature to be at 63 degrees. LPA observed the fire extinguisher located inside the classrooms and kitchen and the valve on the required 2A10BC fire extinguisher indicating fully charged and serviced on 7/19/2021. Smoke detector, carbon monoxide detector and fire alarm are located in the classrooms on the top ceiling and connected to the fire alarm.

At 1:35 PM LPA Rivera observed the bathrooms to be in good condition with working toilets, sinks, hand soap dispenser and paper towels. LPA observed a total of six toilets and 2 sinks. Restrooms are located in classroom one and between classroom two and three. Ill/isolation area children utilize the teacher's lounge and staff restroom located by the director's office and a mat will be available for children to rest if needed.

SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3368
LICENSING EVALUATOR NAME: Mayra RiveraTELEPHONE: (323) 629-7782
LICENSING EVALUATOR SIGNATURE:

DATE: 01/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2022
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: GOLDEN WEST PRESCHOOL
FACILITY NUMBER: 191500276
VISIT DATE: 01/25/2022
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Breakfast, lunch and pm snack are provided by the facility and prepared on site. Classrooms will utilize water jugs with children's personal cups for water drinking. LPA observed the kitchen area/food preparation area to be clean and are free of litter, rubbish, rodents, and/or any other vermin and storage containers for solid waste, including moveable bins with tight-fitting covers that are kept on, and in good repair. The facility was observed to be free of flies, other insects and rodents.

At approximately 1:45 PM LPA Rivera entered the outdoor playground to conduct an inspection and measurements. LPA observed the equipment to be in safe condition, free of sharp, no loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under high climbing equipment, are cushioned with material that absorbs a fall. LPA observed the tag on the playground structure for ages 2-12. The shade sail provides adequate shade in the play yard. LPA observed the gates closed and with self latches. Water pitchers and children individual water bottles will be provided . LPA's advised director that the children need to be within the direct care and supervision, including visual supervision of the teacher(s) at all times. LPA did not observe bodies of water on the premises.

Director Emily Nalasa has proof of pediatric First Aid/CPR certification (expires 08/2023), preventative health and safety training with the Lead Component dated 10/28/21, child abused mandated certification (AB 1207) dated 9/17/20 and immunization against pertussis, and measles, and influenza declination. Director has been informed mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com



LPA Rivera and director Emily Nalasa discussed Covid procedures. Temperature checks are conducted prior to entering the facility, children wash their hands during drop off, during transitions, after using restroom and before and after lunch, Health checks are conducted daily during drop off, if any symptoms related to Covid child is not allowed to stay and if a fever over 100.4 child is not allowed to come in to the center and a Covid test is required. If child is exposed, child will need to quarantine .
Items discussed during this visit:

1. The following items are prohibited by Licensing: Refused Entry to a Facility or Any Part of a Facility is a violation of Section 1596.852, 1596.853 or 1597.09. Regulations 101238 (g) (2), The Presence of an Excluded Individual, Fire Clearance Violations, Accessible Bodies of Water, Accessible Firearms, Ammunition or Both.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3368
LICENSING EVALUATOR NAME: Mayra RiveraTELEPHONE: (323) 629-7782
LICENSING EVALUATOR SIGNATURE:

DATE: 01/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2022
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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: GOLDEN WEST PRESCHOOL
FACILITY NUMBER: 191500276
VISIT DATE: 01/25/2022
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2. Breakfast/Lunch/Snack Menus: Menus are required to be posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days must also be available upon request.
3. Current Children’s Roster: Each child day care facility shall maintain a current roster of children who are provided care in the facility. The roster shall include the name, address, and daytime telephone number of the child's parent or guardian, and the name and telephone number of the child's physician. This roster shall be available to the licensing agency upon request.
4. LIC 311A - Records to be Maintained at the Facility: Child Care Centers was provided to the applicant during this visit. LPAs advised that forms, regulations and quarterly updates can be accessed on the Child Care Licensing website at: www.ccld.ca.gov.
5.Pediatric First Aid and CPR: At least one person trained in Pediatric First Aid and CPR must be present.
6. Designated Staff: The name of the childcare center director or fully qualified teacher(s) designated to act in the director's absence must be on file. Document Link Icon
7. Qualifications: Educational background, training, and/or experience for each staff present must be available for review.
8.Immunization Requirements: 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
9. Children’s Records: must be available for review; including but not limited to, the following: Name, address and telephone number of the child's authorized representative and of relatives or others who can assume responsibility for the child if the authorized representative cannot be reached when necessary.
10.Incidental Medical Services (IMS): This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A Plan of Operation that includes IMS must be submitted to the Department. (An IMS Plan was provided with the application and will be reviewed).
11.Liability insurance was also discussed.
12.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
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3368
LICENSING EVALUATOR NAME: Mayra RiveraTELEPHONE: (323) 629-7782
LICENSING EVALUATOR SIGNATURE:

DATE: 01/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2022
LIC809 (FAS) - (06/04)
Page: 4 of 5
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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: GOLDEN WEST PRESCHOOL
FACILITY NUMBER: 191500276
VISIT DATE: 01/25/2022
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Criminal Record Statement
Director Emily Nalasa was informed that all adults 18 and over, 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.

Based on measurements taken during today's inspection and sinks availability the facility is equipped for 30 preschoolers.



To accommodate 77 preschool children corrections are needed. The facility needs to install 4 additional sinks to accommodate 77 preschool children. Director Emily has been informed once the sinks have been installed to notify LPA Rivera. LPA also informed the Center Application needs to be updated to reflect the capacity of 77 preschool children.

Exit interview was conducted and plans of correction were reviewed with director Emily Nalasa. Appeal rights explained & provided. A copy of this report and appeal rights were discussed and left with director Emily Nalasa whose signature on this form confirms receipt of these documents.

SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3368
LICENSING EVALUATOR NAME: Mayra RiveraTELEPHONE: (323) 629-7782
LICENSING EVALUATOR SIGNATURE:

DATE: 01/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2022
LIC809 (FAS) - (06/04)
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