191500952-8-13-2019-33-CC-JHUA-BEZTWZ-20190813150623

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191500952
Report Date: 08/13/2019
Date Signed: 08/13/2019 03:06:28 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:	HACIENDA LA PUENTE USD - BIXBY		FACILITY NUMBER:	191500952
ADMINISTRATOR:	ELIZABETH LAZO		FACILITY TYPE:	850
ADDRESS:	16446 WEDGEWORTH DR. ROOM K-3		TELEPHONE:	(626) 933-6544
CITY:	HACIENDA HEIGHTS	STATE: CA	ZIP CODE:	91745
CAPACITY:	24	CENSUS: 17	DATE:	08/13/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:22 PM
MET WITH:	Beverly Reyes & Claudia Lopez		TIME COMPLETED:	03:20 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	Random site inspection was conducted by Licensing Program Analyst, Jennifer Hua. State preschool program is located on Bixby Elementary school site in room K-3. LPA met with teacher, Beverly Reyes. LPA toured the facility for children's health and safety inspection. All areas identified on the Facility Sketch were inspected. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Availability of drinking water was reviewed. Age appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, paper towels, area safety and sanitation. Snack/lunch menus were reviewed. Food and snacks were reviewed for availability, quantity and appropriateness to children in care. Food is stored in the cafeteria of the school. Snacks are picked up/delivered from school cafeteria daily and placed in classroom refrigerator. Outdoor equipment was inspected for safety, cushioning material, good repair, and age appropriateness. Required shade, drinking water and fencing were inspected. Play area was inspected for hazards and inaccessibility to bodies of water. Teacher child ratios were observed and staff names recorded. Care and supervision were evaluated to determine if the basic needs of children are met and appropriate. Reporting requirements discussed. Sign in and out sheets were reviewed. Policy of checking children for illnesses. Personal Rights of children were discussed.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 513-3793
LICENSING EVALUATOR NAME: Jennifer Hua	TELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:	DATE: 08/13/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2019

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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: HACIENDA LA PUENTE USD - BIXBY	FACILITY NUMBER: 191500952
	VISIT DATE: 08/13/2019

NARRATIVE

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A review of Staff records were reviewed to identify that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Clearances are done through the school district as a condition of employment. Current Pediatric CPR/First Aid certificates observed. LPA observed working carbon monoxide detector in place. Site Supervisor CPR/First Aid certificate is current and will expire on 9/20/19. Staff completed the mandated reporter training through the Hacienda La Puente School District. A sampling of children's record reviewed.

The 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 and 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

No deficiency cited during this visit.

An exit interview conducted, copy of report provided. Notice of Site Visit Form posted. The notice shall be posted for 30 days accessible for review.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 513-3793
LICENSING EVALUATOR NAME: Jennifer Hua	TELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:	DATE: 08/13/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2019

LIC809 (FAS) - (06/04)

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