191501798-12-19-2019-33-CC-BBEL-BK25V7-20191219191706

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191501798
Report Date: 12/19/2019
Date Signed: 12/19/2019 07:17:20 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:	ABILITY FIRST		FACILITY NUMBER:	191501798
ADMINISTRATOR:	JULIE MARTIN		FACILITY TYPE:	840
ADDRESS:	480 SOUTH INDIAN HILL BLVD.		TELEPHONE:	(909) 621-4727
CITY:	CLAREMONT	STATE: CA	ZIP CODE:	91711
CAPACITY:	58	CENSUS: 43	DATE:	12/19/2019
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME BEGAN:	09:40 AM
MET WITH:	Director Julie Martin		TIME COMPLETED:	07:00 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 Annual/Required inspection was conducted on this date by Licensing Program Analyst (LPA) Emiko Bell. Licensee is on required annual inspections in order to ensure the Center's compliance with the Home Community Based Services (HCBS) Waiver. LPA arrived at the Center at 9:30 A.M. and was greeted by Lisa Fisher, who phoned Director Julie Martin. Director Martin arrived at 9:55 A.M. The purpose of the inspection was announced to Director Martin, who then guided LPA on a tour of the entire facility, including all four classrooms and the playground. Census was taken at 3:30 because the "consumers" are school-age and everyone has to arrive by 3:15 P.M. In rm. 2, there were four staff with 9 consumers; in rm. 3, there were two staff with six consumers; in rm. "Nicky," there were three staff with 13 consumers and in rm. 1, there were four staff with 15 consumers. Staff-child ratio was met. LPA noted that Claudine Ignacio was not listed on the "Facility Personnel Report Summary,." A citation has been issued and a civil penalty has been assessed. The hours of operation are: Monday-Friday,8:00 A.M. to 6:00 P.M. The persons who attend the Center are referred to as "consumers,"as they are not all minors. All areas identified on the Facility Sketch were inspected, including the food preparation area,

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR NAME: Betty Bell	TELEPHONE: (323) 981-3364
LICENSING EVALUATOR SIGNATURE:	DATE: 12/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2019

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: ABILITY FIRST	FACILITY NUMBER: 191501798
	VISIT DATE: 12/19/2019

NARRATIVE

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storage and refrigeration; rest rooms, equipment, outside play area and overall conditions of facility. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating (the Center has central heating and air-conditioning), lighting and ventilation were evaluated. Storage for children's belongings (there are
cubbbies in each classroom) and an isolation area (the office by the front door is the designated isolation area has a mat) was inspected. Availability of drinking water was reviewed . There is a pitcher of water in each classroom with individual paper cups and there is a water dispenser in the hallway between classrooms 2 and 3 and the older "consumers" go to the kitchen to get water. Age-appropriate sinks and toilets were inspected for availability, good repair, water temperatures, toilet paper, paper owels, area safety and sanitation. First Aid supplies were inventoried. review of medication policy, including administering, labeling, storage, and records was made. There is currently one "consumer" on medication.

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 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: Claudia Guangorena	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR NAME: Betty Bell	TELEPHONE: (323) 981-3364
LICENSING EVALUATOR SIGNATURE:	DATE: 12/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2019

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: ABILITY FIRST	FACILITY NUMBER: 191501798
	VISIT DATE: 12/19/2019

NARRATIVE

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The last fire drill was run 12/05/1 at 1:00 P,M. Children and staff records were reviewed. Snack, menus, food and snacks were reviewed for availability, quantity and appropriateness to children in care. A.M. snack is served at 10:00 A.M., lunch is served at 12:00 P.M. and P.M. snack is served at 4:00 P.M. All of the "consumers" bring their own lunch;. The food preparation area (i.e. kitchen) was toured for safety, cleanliness and
proper equipment. A review of cleaning and food supply storage areas was made. Outdoor equipment was inspected for safety, cushioning material, good repair and age appropriateness. Required shade, drinking water (there is a drinking fountain) and fencing were inspected. Play area was inspected for hazards and inaccessibility to bodies of water. Teacher-"consumer" ratios were observed and staff names recorded. Care and supervision was evaluated to determine if the basic needs of children are met appropriately. Sign in and out sheets and procedures were reviewed with staff, as was the policy of checking children for illnesses. All of the "consumers" in attendance today were signed in. Personal Rights of "consumers" were observed by LPA. There are several carbon monoxide and smoke detectors throughout the facility; one of each was randomly tested today since they are all battery operated; both were operable. Staff and children records were reviewed for completeness including but not limited to Criminal Record Clearances for adults, Director Qualifications and verification of CPR/First Aid and health preventive practices documentation. Inspection of required forms for the "consumers" and staff files was made. All "consumers" files were checked for the Admissions Agreement, LIC 700, LIC 702, LIC 701, LIC 613A. LIC 627, and the LIC 995A, Per Director Martin, there are currently no firearms or weapons on the premises. Required postings were observed on the board which is located outside of the Director's office. As there are eighty-three

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR NAME: Betty Bell	TELEPHONE: (323) 981-3364
LICENSING EVALUATOR SIGNATURE:	DATE: 12/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2019

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: ABILITY FIRST	FACILITY NUMBER: 191501798
	VISIT DATE: 12/19/2019

NARRATIVE

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(83) "consumers" currently enrolled, the files of five were reviewed. As there are ninetten (19) pre-school staff, the files of five staff were reviewed, During the file review, LPA observed that the files of Staff #4 and #5 were missing the Mandated Reporter Training certificate.

During today's inspections, the Confidential list of names of the children and staff whose files were reviewed was provided to Director Julie Martin.

Please see 9099D for the citations issued for today's inspection.

Director Julie Martin posted the Notice of Site Visit in LPA's presence on the Board. LPA informed Director Julie Martin that if the Notice of Site Visit is removed prior to thirty (30) days, a citation will be issued and a civil penalty assessed.

An exit interview has been conducted with, and a copy of this report has been signed by and provided to Director Julie Martin. Appeal Rights have been provided and explained to
Director Julie Martin

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR NAME: Betty Bell	TELEPHONE: (323) 981-3364
LICENSING EVALUATOR SIGNATURE:	DATE: 12/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2019

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: ABILITY FIRST	FACILITY NUMBER: 191501798
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/19/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 12/20/2019 Section Cited	1 2 3 4 5 6 7	CRIMINAL RECORD CLEARANCE All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: Request a transfer of a criminal record clearance as specified in Section 101170(f)
	8 9 10 11 12 13 14	-This requirement is not met as evidenced by: iLPA observed that Claudine Ignaciom though she has Criiminal Background Clearance, is not associated to the facility. An immediate civli penalty of $500 has been asssesed. This poses a potential risk to the health and safety of clients in care.	8 9 10 11 12 13 14	Her date of hire was 11/16/19.
Type B 12/30/2019 Section Cited	1 2 3 4 5 6 7	Availability of information regarding detecting and reporting child abuse and neglect; training for mandated reporter who is licensed day care provider, administrator, or employee of a licensed child day care facility; proof of completion 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.
	8 9 10 11 12 13 14	-This requirement is not met as evidenced by: during review of staff files, LPA observed that the files of Staff #4 and #5 were missing Mandated Reporter Training certificates, though	8 9 10 11 12 13 14

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	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR NAME: Betty Bell	TELEPHONE: (323) 981-3364
LICENSING EVALUATOR SIGNATURE:	DATE: 12/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2019

LIC809 (FAS) - (06/04)

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