191500276-9-12-2022-54-CC-KCHE-CJ7SDL-20220912134718

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191500276
Report Date: 09/12/2022
Date Signed: 09/12/2022 01:47:36 PM

Document Has Been Signed on 09/12/2022 01:47 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	GOLDEN WEST PRESCHOOL		FACILITY NUMBER:	191500276
ADMINISTRATOR:	EMILY NALASA		FACILITY TYPE:	850
ADDRESS:	10248 ALONDRA BLVD.		TELEPHONE:	(562) 866-5616
CITY:	BELLFLOWER	STATE: CA	ZIP CODE:	90706
CAPACITY:	77	CENSUS: 25	DATE:	09/12/2022
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Emily Nalasa, Director		TIME COMPLETED:	02:10 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	An unannounced Required – 1 Year Inspection was conducted on 09/12/2022 at 11:45 AM by Licensing Program Analyst (LPA) Katrina Chicote. Facility is currently licensed for a capacity of 77. Licensing staff met with Emily Nalasa, Director. The program currently operates Monday thru Friday from 6:30 AM to 6:00 PM. LPA was taken on a guided tour of the facility of both indoors and outdoors. At the initial start of the site visit, there is a total census of 25 children and a total census of four teachers present. The facility is made up of three classrooms: Room 1 for 2 year olds, Room 2 for 3-4 year olds, and Room 3 for 4-5 year olds. Per Director, Room 3 is currently not being used due low enrollment at this time. LPA observed Room 1 to have Staff #1 and #2 with seven preschoolers and Room 2 to have Staff #3 and #4 with 18 preschoolers. Beginning at 11:50 AM, furniture and equipment were inspected for age appropriateness and good repair in each classroom. Telephone service, heating, lighting and ventilation were evaluated. There were cubbies observed as storage for children's belongings. LPA observed cubbies with baskets filled with child appropriate toys and reading area available for quiet play. Cots were inspected and stored in closet in classroom. Per Director, sheets are provided by facility and blankets are provided by families and taken home weekly. Availability of drinking water was reviewed. LPA observed water pitchers in each classroom with reusable children's water bottles brought from home. Age appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, area safety and sanitation. Room 1 and Room 2 share a bathroom that is a jack-n-jill bathroom between the two classrooms. LPA observed three toilets and one sink, with another sink in each classroom totaling three sinks. A first aid kit is kept in a closet in each classroom. Carbon monoxide detectors and smoke detectors are present in the facility. Fire extinguishers have been serviced in 06/09/2022. Hazardous items including poisonous cleaning compounds were stored inaccessible to children. LPA observed these items stored in closet in classroom on high shelf. Per Director, no drill has been conducted the past six months. Report Continues - Page 1 of 3

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2022

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 7

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: 09/12/2022

NARRATIVE

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Snack/lunch menus were reviewed. Food and snacks were reviewed for availability, quantity and appropriateness to children in care. At 12:00 PM, food preparation areas were toured for safety, cleanliness and proper equipment. LPA observed lunch being served to children during inspection. Facility serves, Breakfast, Lunch, and PM snack.

At 12:05 PM, outdoor equipment was inspected for safety, cushioning material, good repair and age-appropriateness. Required shade and fencing were inspected. LPA observed three play areas separated by fences. LPA observed large play structure well maintained with cushioning material below to absorb fall, plastic play house, and plant boxes for gardening, in separate play area LPA observed bicycles with concrete bike path, and another separate play area with large play house available for children all well maintained. LPA Chicote advised Director that the children need to be within the direct care and supervision, including visual supervision of the teacher(s) at all times. Per Director, the children have access to their personal water bottles that are brought out during outside play. Play area was inspected for hazards and inaccessibility to bodies of water; no bodies of water or hazards observed.

Teacher-child ratios were observed and staff names recorded. Care and supervision was evaluated to determine if the basic needs of children are met and appropriate. Sign-in and out sheets and procedures were reviewed. LPA observed 25 of 25 children signed in at time of inspection. Personal Rights of children were observed by LPA.

Staff and Children’s Records were reviewed. Criminal Record Clearances were reviewed for adults. CPR card expires in 05/21/2024 for Staff #3. Inspection of required forms made. LPA did not observe AB1207 Mandated Reporter training for Staff #4 and #2 and expired for Director at time of inspection. Per Director, Staff #4 and #2 just started last week and are working on it.

Incidental Medical Services:
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
Report Continues - Page 2 of 3

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2022

LIC809 (FAS) - (06/04)

Page: 2 of 7

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: 09/12/2022

NARRATIVE

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The following were discussed with the Director:
No Licensee (or facility representative) was reminded that all adults 18 and over in the facility, 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 licensed facility. 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.

The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and Carbon Monoxide detectors should be checked and batteries replaced as needed.

Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your location.

LPA advised of the requirement to report Unusual Incidents and/or injuries to the parent/guardian and to CCL within the time frame specified by the regulation.

Based on this information, the following deficiencies on the attached LIC 809D are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted and report was reviewed with the Site Supervisor, Emily Nalasa.

Report Ends - Page 3 of 3

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2022

LIC809 (FAS) - (06/04)

Page: 3 of 7

Document Has Been Signed on 09/12/2022 01:47 PM - It Cannot Be Edited

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
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/12/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101174(d)

Disaster and Mass Casualty Plan

(d) Disaster drills shall be conducted at least every six months. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on LPA observation and interview, no disaster drill log was available and Director states they have not yet conducted one and facility has been open since 03/2022. This is a potential health, safety, and personal rights risk to children in care.
	POC Due Date: 09/30/2022
	Plan of Correction
1 2 3 4	Director states she will provide prood of disaster drill completion by POC date via text.

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on LPA record review and interview, Staff #4 and #2 do not have mandated reporter training completed. Per Director, they are still completing it. Director's mandated reporter expired on 07/2022. This is a potential health, safety, and personal rights risk to children in care.
	POC Due Date: 09/16/2022
	Plan of Correction
1 2 3 4	Director states she will provide proof of completion of training and provide by POC date via text message.

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: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2022

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2022

LIC809 (FAS) - (06/04)

Page: 4 of 7