191591710-10-16-2019-33-CC-AALN-BGZUTJ-20191016155201

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191591710
Report Date: 10/16/2019
Date Signed: 10/16/2019 03:52:09 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:	PACIFIC FRIENDS SCHOOL		FACILITY NUMBER:	191591710
ADMINISTRATOR:	MCKINLEY, KELLIE		FACILITY TYPE:	850
ADDRESS:	6210 TEMPLE CITY BLVD		TELEPHONE:	(626) 287-6880
CITY:	TEMPLE CITY	STATE: CA	ZIP CODE:	91780
CAPACITY:	58	CENSUS: 32	DATE:	10/16/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Kellie McKinley		TIME COMPLETED:	02:38 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	Licensing Program Analysts (LPAs) Ariel Cazares and Bardo Baluyot conducted an unannounced annual/random inspection on this date. LPA met with Director Kellie McKinley and was guided on a tour of the facility. There were 32 children present and 4 teachers in total. The facility’s hours of operation are Monday-Friday, 6:30-6:30pm. There is a school-age component on site, license # 198000608. LPA toured the areas according to the facility sketch on file. Per Director, no alterations have been made since the last inspection. The facility consists of 3 classrooms and an outdoor playground. There is a dome located in the duck farm that is used for activity space. Each classroom was inspected. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Children have their own cubby to store their belongings. Napping equipment is available in form of mats. Facility washes linens every week. There is available drinking water in form of water fountains in each classroom. There are first aid and emergency supplies located in the classrooms. LPAs observed carbon monoxide detectors in each classroom and tested them all, finding them to be operational. LPAs observed electrical outlets accessible to children that were exposed in Teddy Bears and Pre-K classrooms. LPAs informed director to have them covered. There are children’s restrooms in each classroom. The restrooms were observed to be clean and in good condition, with sufficient supplies for children to use. LPAs found that the hot water in the Pre-K classroom's restroom was at a temperature that would pose a hazard to children. The water heater was immediately adjusted to turn off the hot water until maintenance can correct it. There have been no incidents related to the hot water.

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Ariel Almazan	TELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2019

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: PACIFIC FRIENDS SCHOOL	FACILITY NUMBER: 191591710
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/16/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/18/2019 Section Cited	1 2 3 4 5 6 7	The person who brings the child to, and removes the child from, the center shall sign the child in/out. This requirement has not been met as evidenced by review of sign in/out sheets finding 30 out of 32 children present today were signed in. This poses a potential risk to the health and safety of children in care.
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

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) 981-3417
LICENSING EVALUATOR NAME: Ariel Almazan	TELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2019

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: PACIFIC FRIENDS SCHOOL	FACILITY NUMBER: 191591710
	VISIT DATE: 10/16/2019

NARRATIVE

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Per director, the isolation area is located in the office and a staff restroom is available for ill children to use. LPAs observed a cot in the office. The office is used to store medication for children. LPA also reviewed criminal record clearances, children and staff records. Records were found to be complete. Sign in and out sheets were reviewed. LPAs observed only 30 of 32 children present were signed in.

The facility has a kitchen where meals and snacks are prepared and cooked for the children. The kitchen was inspected and observed to be clean, orderly, and sufficient storage for supplies. The facility provides lunch and two snacks. The menus were observed to be posted.

LPA inspected the children’s outdoor space. The playground was inspected for safety, cushioning material, good repair and age appropriateness. LPA observed there to be shade and adequate fencing. Drinking water is available in form of a water fountain that were functional.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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

See attached deficiencies page for citations in accordance with Title 22 California Code of Regulations. Exit interview conducted with Director Kellie McKinley. A copy of this report and appeal rights were provided and explained. 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. Failure to maintain posting as required will result in a civil penalty of $100.00.

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Ariel Almazan	TELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2019

LIC809 (FAS) - (06/04)

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