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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191570967
Report Date: 05/17/2022
Date Signed: 05/17/2022 10:41:48 AM


Document Has Been Signed on 05/17/2022 10:41 AM - 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:TRACY INFANT CENTERFACILITY NUMBER:
191570967
ADMINISTRATOR:TOM WOODWARDFACILITY TYPE:
830
ADDRESS:12222 CUESTA DRIVE, BLDG FTELEPHONE:
(562) 229-7762
CITY:CERRITOSSTATE: CAZIP CODE:
90703
CAPACITY:62CENSUS: 5DATE:
05/17/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Tom Woodward, DirectorTIME COMPLETED:
10:50 AM
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Licensing Program Analyst (LPA) T. Tran arrived at the above facility to conduct a required inspection. Upon arrival, LPA met with Director Tom Woodward. LPA observed the consolidated Covid-19 CHHS postings and health screening station. About 9:00 AM we toured around the facility.
This is an Infant center with the Toddler option. LPA observed proper care and supervision. The hours of operation are from 7:30AM-3:00PM Monday-Friday.
LPA observed all posting requirements for operation on the posting board LIC 203A-License, LIC 610 A-Emergency Disaster Plan, LIC 9148-Earthquake Preparedness Check List, PUB 394-Notification of parent’s rights poster, LIC 613A- Personal Rights, PUB 269- Child Car Seat Law, Menus, Activity Schedule, Sudden Infant Death Syndrome, Shaken Baby Syndrome Poster, and safe sleep poster.
Children files were reviewed. Staff files located at the main office. LPA will arrange another visit for file reviews. The facility have current pediatric CPR and First Aid for all facility staff members. LPA observed staff and children were wearing mask indoor and outdoor. Per director, the facility has enough cleaning supplies and disinfectants materials to remain open. Staff frequently cleaned and disinfected all high-touch surfaces, including toys and learning materials. LPA observed all products were kept out of children’s reach. LPA recommended when choosing cleaning products, use those approved for use against COVID-19 on the Environmental Protection Agency (EPA)-approved list “N” and follow product instructions.
Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Storage for children's belongings, isolation area was inspected by the staff's office. Classroom observed with a changing area within the arm reach of the sink. Children napping area and cribs were observed to be safe and sanitation. Trash can with tight lids, First Aid supplies, smoke detectors; carbon monoxide/fire extinguishers were observed. Sign in and out sheet procedures were reviewed. All bottles, food items and snacks were observed to be efficient with label and dated. No children required medication or with food allergies at this time. Separated outdoor play areas were observed. The play yards were well fenced. Equipment was inspected for safety. LPA observed shade and drinking water was available for children in care. Play area was inspected for hazards and inaccessibility to bodies of water.
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 05/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/17/2022
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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: TRACY INFANT CENTER
FACILITY NUMBER: 191570967
VISIT DATE: 05/17/2022
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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.htmLPA recommended facility to stay updated with information related to Covid-19 from the California Department of Public Health (CDPH) guidelines, including Centers for Disease Control and Prevention (CDC) guidelines to help prevent and protect staff and children in care.
LPA informed the effects of lead exposure for children between ages 1-6 years old are the most at risk for lead poisoning. A copy of lead exposure was provided.
Licensee was informed of responsibility to report suspected Child Abuse by calling the Child Abuse Hotline at 1-800-540-4000. Also call the Community Care Licensing office and follow up with a written Unusual Incident/Injury Report (LIC 624B). Licensee is reminded that smoking is prohibited on the premises.
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.
Licensee [or facility representative] 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.
LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
No deficiency was cited during today's visit. A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the facility representative, Tom Woodward.
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 05/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2022
LIC809 (FAS) - (06/04)
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