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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191570434
Report Date: 07/02/2019
Date Signed: 07/02/2019 04:25:23 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:SHEPHERD OF THE VALLEY PRESCHOOL & DAY CAREFACILITY NUMBER:
191570434
ADMINISTRATOR:SALLY GARCIAFACILITY TYPE:
850
ADDRESS:1723 PARK LAWNTELEPHONE:
(626) 965-7076
CITY:HACIENDA HEIGHTSSTATE: CAZIP CODE:
91745
CAPACITY:74CENSUS: 27DATE:
07/02/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:13 PM
MET WITH:Sally GarciaTIME COMPLETED:
04:35 PM
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Random Site inspection was conducted on this date by Licensing Program Analyst (LPA) Jennifer Hua. LPA met with Director Sally Garcia and head teacher/administrator Socorro Majano. This program currently operates from: Monday - Friday 6:30 AM - 6:30 PM. Children are housed in 3 classrooms.

Rooms identified on facility sketch were inspected. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Storage for children's belongings and an isolation area with a sink, toilet, and mats/cots was inspected. Age appropriate sinks and toilets were inspected for availability and good repair. General sanitation was observed including floor cleanliness. Availability of indoor drinking water was observed.

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. The facility has heating and air conditioning for the children in care.

Snack/lunch menus were reviewed. Menu is posted and available for review. Food and snacks were reviewed for availability, quantity and appropriateness to children in care. A review of cleaning and food supply storage areas was made. There are tight fitting lids on trash cans in the classrooms. Sign In/Sign Out sheets were also reviewed.
SUPERVISOR'S NAME: Katherine HarewoodTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Jennifer HuaTELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2019
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: SHEPHERD OF THE VALLEY PRESCHOOL & DAY CARE
FACILITY NUMBER: 191570434
VISIT DATE: 07/02/2019
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Teacher - child ratios were observed and staff names recorded. Care and supervision was evaluated to determine if the basic needs of children are met. Staff certification in CPR and FIRST AID is current and valid for staff members at this site. Staff/children records were reviewed for completeness including but not limited to: Criminal Record Clearances for adults and Health Screenings. Staff files reviewed contained newly required vaccinations/statements. LPA also observed staff have completed the Mandated Reporter Training. Certificates are in staff files.

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

INTERNET ADDRESS: http://www.ccld.ca.gov – To access licensing forms, updates and Title 22.

After a complete inspection of the facility, (no) deficiencies cited during this visit.

An exit interview was conducted with director. Copy of report given. Notice of Site Visit was issued and posted. This notice is to be posted for 30 consecutive days. Failure to keep this notice posted for the 30 consecutive days will result in an immediate $100 civil penalty.
SUPERVISOR'S NAME: Katherine HarewoodTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Jennifer HuaTELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2019
LIC809 (FAS) - (06/04)
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