191597454-8-29-2023-33-CC-CTUA-CV6RA3-20230829125027

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191597454
Report Date: 08/29/2023
Date Signed: 08/29/2023 12:50:43 PM

Document Has Been Signed on 08/29/2023 12:50 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	HACIENDA LA PUENTE PRESCHOOL (VALINDA)		FACILITY NUMBER:	191597454
ADMINISTRATOR:	ELIZABETH LAZO		FACILITY TYPE:	850
ADDRESS:	1030 INDIAN SUMMER		TELEPHONE:	(626) 933-4756
CITY:	VALINDA	STATE: CA	ZIP CODE:	91744
CAPACITY:	24	CENSUS: 17	DATE:	08/29/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:35 AM
MET WITH:	Ryan Martinez		TIME COMPLETED:	01:00 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	On August 29, 2023, Licensing Program Analyst (LPA) Carolyn Tuba conducted an unannounced required 1-year inspection. A COVID-19 risk assessment was conducted prior to entering the facility. LPA entered facility through the Valinda elementary school’s front office and walked towards the back of the school to enter through a gate into the preschool program. LPA met with On Site Supervisor/Teacher, Elizabeth Catan and LPA took a census of 17 children and 2 staff in care. The program that operates is a Head Start preschool program. LPA spoke to Ryan Martinez Site Supervisor at 9:55 am at their main office that is located off-site. At approximately 10:25 am Site Supervisor, Ryan Martinez who oversees the preschool program arrived and met with LPA to facilitate the visit. Hours of operation: The days and hours of operation for the Preschool Head Start: Monday-Friday, 8:00 A.M.-2:00 P.M. Location: In order to gain entry, the LPA went through the main office of the elementary school office. The portable is located on the south side of Valinda Elementary’s main office. The portable and the playground are surrounded by a chain link fence, separating it from the rest of the elementary school. The portable is one large classroom with two restrooms for the children, one staff restroom, a kitchenette, and one office for the staff. The chain link fence which surrounds the portable are kept locked during operating hours and are only unlocked when children are being dropped off and picked up. The children will enter through one door and exit through the emergency exit door in the back of the portable. To gain access to the school there is a side gate for parents to drop-off and pick-up children. There is playground that is shared with 2 Kindergarten classes but according to On Site Supervisor the preschool children go out to play at 8:45 am-9:20 am and then at 11:30 am to 12:05 pm. So the preschool children do not interact or play at the same time as the Kindergarten classes play outside. They have a different schedule and On Site staff are aware to not take the children out at the same time. page 1 of 4

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn Tuba	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 08/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2023

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 5

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: HACIENDA LA PUENTE PRESCHOOL (VALINDA)	FACILITY NUMBER: 191597454
	VISIT DATE: 08/29/2023

NARRATIVE

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All posting requirements were observed on the Parent Board. In the portable, the Parent Board is located on the wall adjacent to the door through which the children will enter. LPA viewed a copy of the monthly menus which is posted on the teacher cabinet. Parents also get a breakfast, lunch and PM snack menu emailed to them. All food is provided by the School District. Breakfast is served at 8:00 am, lunch at 11:00 am and PM snack at 1:30 pm.

Portable has a kitchenette area which contains a full-size refrigerator. There are currently three (3) children who require medication and are kept in the cupboard up high in the staff office labeled "Medication" and locked by a chain and padlock which requires a key to open. LPA observed medication which is not expired and required paperwork was stored with the medication. Portable has a First Aid Kit in the kitchen cabinet which is labeled with a sign. The cleaning supplies are kept in the cabinet under the kitchen sink in the kitchenette; it is locked with a chain and a padlock.

Staff and children's files were reviewed and found to be complete.

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 PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

There is a carbon monoxide and smoke detectors that are connected to the elementary school and are tested by the school district through-out the year. The last annual maintenance on the Fire Extinguisher was on August 8, 2023.

Inside the portable, there are two (2) children's restrooms, and each have two (2) toilets totaling four (4) toilets in all. There are two (2) child-size sinks located inside each bathroom located near the kitchenette area. According to the On Site Supervisor children currently use a drinking water filter with individual disposable cups. The filtered water pitcher is filled from the kitchenette sink. The adult restroom located
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SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn Tuba	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2023

LIC809 (FAS) - (06/04)

Page: 2 of 5

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: HACIENDA LA PUENTE PRESCHOOL (VALINDA)	FACILITY NUMBER: 191597454
	VISIT DATE: 08/29/2023

NARRATIVE

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inside the portable is used by staff only.

There is napping equipment in the Head Start program, children nap and bring napping items from home on Monday and is sent home on Friday to be laundered. Napping cots labeled with each child’s name is sanitized each day and located in the classroom.

LPA referred Site Supervisor to the Department website for lead: Lead Toxicity Prevention and Water Testing Information. LPA provided Site Supervisor and Manager with PIN 21-21.1-CCP for written directives of Lead Testing.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Site Supervisor was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Site Supervisor was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

The deficiency listed on the following page were observed by the LPA and is being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809-D. The deficiency that is being cited needs to be cleared to protect the children’s health & safety.

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SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn Tuba	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2023

LIC809 (FAS) - (06/04)

Page: 3 of 5

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: HACIENDA LA PUENTE PRESCHOOL (VALINDA)	FACILITY NUMBER: 191597454
	VISIT DATE: 08/29/2023

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	A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Site Supervisor, Ryan Martinez. page 4 of 4

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn Tuba	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2023

LIC809 (FAS) - (06/04)

Page: 4 of 5

Document Has Been Signed on 08/29/2023 12:50 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: HACIENDA LA PUENTE PRESCHOOL (VALINDA)	FACILITY NUMBER: 191597454
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/29/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview, the licensee did not comply with the section cited above in facility has not been lead tested since 2019 which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/29/2023
	Plan of Correction
1 2 3 4	Per Site Supervisor, facility will test water outlet (Kitchen)

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: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn Tuba	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2023

LIC809 (FAS) - (06/04)

Page: 5 of 5