191592446-5-25-2022-54-CC-AMOY-CERV4C-20220525160607

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191592446
Report Date: 05/25/2022
Date Signed: 05/25/2022 04:06:42 PM

Document Has Been Signed on 05/25/2022 04:06 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	MAOF CHILD CARE CTR-FLORENCE-BELL GARDENS		FACILITY NUMBER:	191592446
ADMINISTRATOR:	ROCIO HERNANDEZ		FACILITY TYPE:	850
ADDRESS:	6431 EAST FLORENCE AVENUE		TELEPHONE:	(562) 806-3731
CITY:	BELL GARDENS	STATE: CA	ZIP CODE:	90201
CAPACITY:	60	CENSUS: 27	DATE:	05/25/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:58 AM
MET WITH:	Teresa Mondragon, Site Supervisor		TIME COMPLETED:	04:15 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 Analyst (LPA) Alicia Mooberry conducted a required Annual Inspection. LPA arrived at 9:58am and met with Site Supervisor, Teresa Mondragon, who provided a tour of the facility. LPA provided LIC 125 Entrance Checklist to Site Supervisor. The facility has three classrooms where care is provided. LPA observed six (6) children with 2 staff in EHS Class #2, ten (10) children and 2 staff in the Teddy Bear Class, Nine (9) children with 3 staff in the Penguin classroom. All staff are qualified and have obtained background clearance.

LPA reviewed Sign In/Out sheets located in the classroom. All children present were signed in with date, time and signature of representative.

The facility operates Monday-Friday 6:30am-5:00pm

The classrooms were inspected for cleanliness and good repair. The floors are clean and lighting in operable condition. There are age appropriate toys and equipment. Sign-in sheets were reviewed. There are first aid kits in each classroom and a first aid located in the office.

10:20am LPA observed an open electrical box in the Teddy Bear Classroom with wiring visible. The box was located in a corner of the classroom above the reach of children in care this poses a potential risk to the health and safety of children in care.

LPA inspected the food preparation area and refrigerator and observed it to be clean and in operable condition. The kitchen was sanitary, free of litter flies, vermin, and rodents. Kitchen had trash bins with tight fitting lids. Food not prepared on site, food is delivered prepackaged and served.

LPA observed that facility is implementing COVID-19 precautions and procedures. Isolation area is located in the office.

There is a washer and dryer also located in the office, the laundry detergent was located in a locked cabinet inaccessible to children.

-----Page 1 - Report continues

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia Mooberry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 4

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: MAOF CHILD CARE CTR-FLORENCE-BELL GARDENS	FACILITY NUMBER: 191592446
	VISIT DATE: 05/25/2022

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
26
27
28
29
30
31
32

LPA observed furniture is good condition and the floors are safe and sanitary. Drinking water is available in each classroom via a water dispenser and disposable cups.

Napping mats and sheets were observed in individual cubbies.

The facility administers medication, storage of medication was observed. Currently, there are no children that require medication to be administered at the faciltiy. (Please contact your analyst for regulations if considering using Nebulizer or administering Blood-Glucose testing.)

The required posted documentation which included, Facility License, Publication (PUB) 393- Notification of Parent Rights, Licensing Form (LIC) 610- Facility Disaster Plan, PUB 269- Child Passenger Restraint System, and LIC 613A- Notification of Parent’s Rights. Due to COVID-19 precautions and parents not entering the facility lunch/snack menus are posted online for parents to view.

Facility records were reviewed for LIC 9040- Facility Roster, 9148- Earthquake Preparedness form, Daily schedule and Disaster drill log, last drill conducted on 04/18/22 .

The required Carbon Monoxide and smoke detector was tested and found operable in EHS Class #2 and in Penguin Class. The required carbon monoxide and smoke detector in Teddy Bear class is tied to facility fire alarm system.

LPA observed the children’s bathroom to be operable toilets and sinks. Bathrooms in all classrooms were observed to be sanitary and free of hazards.
LPA toured the outdoor play area. LPA observed operable water fountains outdoors for children's use. The outdoor area has material and equipment for children to use. LPA observed shaded area over play structures and padding under, that is kept in good condition.

Children’s records were reviewed for Emergency Card with Consent for Medical Treatment, Immunization's Records, Licensing Form (LIC) 995 Notification of Parents’ Rights, LIC 701- Physician’s Report, LIC 613A- Personal Rights, and signed Admissions Agreement.

LPA reminded facility representative that to place facility licence number on all advertisement and to report and changes to the facility sketch or contact information.

-----Page 2 - Report Continues

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia Mooberry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2022

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: MAOF CHILD CARE CTR-FLORENCE-BELL GARDENS	FACILITY NUMBER: 191592446
	VISIT DATE: 05/25/2022

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
26
27
28
29
30
31
32

Staff records were reviewed for approved Pediatric First Aid and CPR certification for at least one staff member, LIC-501: Personnel Record, LIC 9052- Employee Rights, Proof of immunization's against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse, Transcripts or Permit and current Mandated Reporter Training Certificate. LPA observed that 11 out of the 12 staff had First Aid/CPR training that is not EMSA approved. The site supervisor states that the requires EMSA approved Pediatric First Aid/CPR will be completed for all staff on Saturday 5/28/22. Per Site supervisor, staff that has current approved pediatric first aid/CPR is present at all times while children are present.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a plan for providing 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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm

Site supervisor 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.

Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

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.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Site Supervisor, Teresa Mondragon. ------------------PAGE 3 - End of Report

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia Mooberry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2022

LIC809 (FAS) - (06/04)

Page: 3 of 4

Document Has Been Signed on 05/25/2022 04:06 PM - It Cannot Be Edited

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: MAOF CHILD CARE CTR-FLORENCE-BELL GARDENS	FACILITY NUMBER: 191592446
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/25/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101238(a)

Buildings and Grounds

(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on LPA observations, the licensee did not comply with the section cited above in that an an open electrical box in the Teddy Bear Classroom with wiring visible located in a top corner of the classroom which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/01/2022
	Plan of Correction
1 2 3 4	Per Site Supervisor, electrical box will be covered and photo proof of correction will be sent to LPA via email by POC due 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: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia Mooberry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2022

LIC809 (FAS) - (06/04)

Page: 4 of 4