191501766-2-1-2023-33-CC-NTCG-CNMVEV-20230201152257

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191501766
Report Date: 02/01/2023
Date Signed: 02/01/2023 03:23:11 PM

Document Has Been Signed on 02/01/2023 03:23 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	GOOD SHEPHERD CHILDREN'S CENTER, THE		FACILITY NUMBER:	191501766
ADMINISTRATOR:	BROWN, LINDA		FACILITY TYPE:	850
ADDRESS:	400 W. DUARTE ROAD		TELEPHONE:	(626) 447-1249
CITY:	ARCADIA	STATE: CA	ZIP CODE:	91007
CAPACITY: 56	TOTAL ENROLLED CHILDREN: 56	CENSUS: 42	DATE:	02/01/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Cindy Ostry - Office Manager		TIME COMPLETED:	11:10 AM

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	Licensing Program Analyst (LPA) Nolan Tcheng conducted an unannounced random annual inspection. Upon arrival at 8:40am, LPA was met with Office Manager Cindy Ostry. At 9am, LPA was led on a tour of the facility. Director Linda Brown arrived during the inspection at 9:50am. This is a preschool program which consists of 4 classrooms. This facility also has an infant license (#191598906). Per licensee, there are currently 64 enrolled in the program. Hours of operation for this facility are 7am-6pm, Monday to Friday. Licensing staff observed all required forms/publications to be posted in the office. PHYSICAL PLANT: At 9am LPA entered and inspected Room 2 (2s): 5 children with 2 staff members, Room 3 (3s): 13 children with 2 staff members, Room 4 (4-5s): 12 children with 2 staff members, and Room 5 (2.5-3s): 12 children with 2 staff members. Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children in a high cabinet above the sinks. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. All floors are clean and safe. All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids. The facility was observed to be free of flies, other insects and rodents. Sufficient individual storage space for children was observed and each child has a cubby. Drinking water was readily available indoors. At 9:15am, LPA observed napping equipment in the form of cots. At this time, the office is used as an isolation area. A cot is available for an ill child to rest on. First Aid supplies are available and complete. Facility has a functioning carbon monoxide detector that meets statutory requirements. Director states there are no weapons, firearms, or bodies of water on the premises. The facility has a restroom in Room 2 and Room 5 for children to use. There is a restroom for shared use by Room 3 and Room 4, or by whoever is outside playing. REPORT CONTINUES PAGE 1 of 3

Claudia Guangorena
Nolan Tcheng
	DATE: 02/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2023

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: GOOD SHEPHERD CHILDREN'S CENTER, THE	FACILITY NUMBER: 191501766
	VISIT DATE: 02/01/2023

NARRATIVE

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All toilets, hand washing, and bathing facilities are safe, sanitary and are operating properly. At 9:25am, a fire extinguisher was observed. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 08/26/2022, as indicated on service tag. Per State Fire Marshall standards, fire extinguishers shall be serviced annually. This facility does not provide food. Families provide snacks and lunch for their children.

OUTDOORS: At 9:40am, LPA reviewed the outdoor play area. Outdoor playground equipment is in safe condition, free of sharp, 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, swings, slides, and similar equipment are cushioned with material that absorbs a fall. There is one outside play space with swings, a large play structure, and large bike path. Another outside play space observed for the younger children. There is an age appropriate play structure. Drinking water is readily available outdoors.

Teacher-child ratios were observed to be in accordance with Title 22 regulations. Staff names were recorded. All children were observed to be under visual supervision of a teacher during tour. The Licensee is within the conditions, limitations, and capacity specified on the license. All areas were identified on the Facility Sketch were inspected.

FACILITY RECORDS: Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. Disaster drills have been conducted at least every six months. Staff files were reviewed for a health screening report and immunizations that meet regulatory requirements. Criminal Record Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed. The name of the child care center director or fully qualified teacher(s) designated to act in the director's absence is on file. Educational background, training, and/or experience for each staff present are on file and were reviewed. At 11:15am, LPA observed that 3 of 9 staff files did not have a current proof of completion for Mandated Reporter Child Care Provider training. LPA discussed the importance of completing this training every two years. A random sample of Children’s Records were reviewed to ensure that they are complete.

REPORT CONTINUES PAGE 2 of 3

SUPERVISOR'S NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2023

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: GOOD SHEPHERD CHILDREN'S CENTER, THE	FACILITY NUMBER: 191501766
	VISIT DATE: 02/01/2023

NARRATIVE

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INCIDENTAL MEDICAL SERVICES:
This facility provides Incidental Medical Services –( IMS). Facility has submitted IMS plan for all locations. 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

Licensee was reminded 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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process

LPA advised the licensee how to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov. AB1207 Mandated Child Abuse Reporting – Implementation was discussed with Licensee. Website provided: http://mandatedreporterca.com/

The deficiencies listed on the following pages were observed by the LPA and are being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809D for deficiencies that are being cited and 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 visit by a licensing representative.

Exit interview was conducted with Director Linda Brown, at 10:55am, and Plan of Corrections were reviewed and developed. Copy of report provided. END OF REPORT PAGE 3 of 3

SUPERVISOR'S NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/01/2023 03:23 PM - It Cannot Be Edited

Created By: Nolan Tcheng On 02/01/2023 at 01:27 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GOOD SHEPHERD CHILDREN'S CENTER, THE	FACILITY NUMBER: 191501766
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/01/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

b) (1) 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 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 interview and record review, the licensee did not comply with the section cited above in 3 out of 9 Staff files, Staff #1, 3, & 9's files did not have current Mandated Reporter Child Care Provider (AB1207) training completed, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/08/2023
	Plan of Correction
1 2 3 4	Per Director, they will have Staff #1, 3, 9 complete the Mandated Reporter Child Care Provider (AB1207) training and send proof to LPA by POC date.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Claudia Guangorena

LICENSING EVALUATOR NAME:

Nolan Tcheng

LICENSING EVALUATOR SIGNATURE:

DATE: 02/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2023

LIC809 (FAS) - (06/04)

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