191597494-8-15-2019-33-CC-BBEL-BF3UEH-20190815153110

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191597494
Report Date: 08/09/2019
Date Signed: 08/15/2019 03:31:25 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:	ARROYO/CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	191597494
ADMINISTRATOR:	CELIA ASEBEDO		FACILITY TYPE:	850
ADDRESS:	1605 W. ARROYO AVE.		TELEPHONE:	(909) 397-4573
CITY:	POMONA	STATE: CA	ZIP CODE:	91768
CAPACITY:	92	CENSUS: 0	DATE:	08/09/2019
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Licensing & Facilities Planner Kym Allen		TIME COMPLETED:	05:00 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	An announced Case management-Licensee-initiated inspection was conducted on this date by Licensing Program Analyst (LPA) B. Emiko Bell. The inspection was announced because school is currently not in session and as there are no staff or children present, LPA had to be let into the facility. The purpose of the inspection was to take measurements of the indoors of rooms HS3, HS4, K2 and K3, as well as the outdoor play yard, as Pomona Unified School District is requesting a capacity increase. The application was received by the Department on 07/19/19. The Center will open on August 12. Upon arrival, LPA was greeted by Licensing & Facilities Planner Kym Allen in the parking lot. Mr. Allen then let LPA into the area where the portables are located. Arroyo Child Development Center consists of four portables located on the east side of the Arroyo School campus. The portables are segregated from the elementary school by a chain-link fence and by the parking lot by a wrought iron fence. One portable contains rooms HS1 and HS2; the second contains rooms HS3 and HS4; the third contains rooms K1, K2, and K3; and the fourth contains rooms K5 and K6. Room K1 will be used as a social room for Head Start; the parents and children are present every other Friday and share the playground, though it's understood that they are never to be on the playground at the same time as the pre-schoolers. The children who were in rooms HS1 and HS2 will be moved to K2 and K3, thus leaving HS1 and HS2 vacant and rooms K5 and K6 were

SUPERVISOR'S NAME: Adriana Hernandez	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Betty Bell	TELEPHONE: (323) 981-3364
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2019

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: ARROYO/CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 191597494
	VISIT DATE: 08/09/2019

NARRATIVE

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All posting requirements were observed on the Parent Board in each classroom. The Parent Board is located on the wall directly to the left or to the right of the entryway in each classroom.

The monthly menu is posted on the refrigerator in the kitchenette area in each classroom. All food will be provided by the School District. For the K2 A.M. session, A.M. snack will be served at 10:00 A.M.; for the P.M. session, lunch will be served at 11:45 A.M. For the full-day programs, breakfast will be served at 7:30 A.M., lunch will be served at 11:00 A.M. and P.M. snack will be served at 1:05 in room K3 and HS3 and at 1:40 in room HS4.

Each kitchenette area contains a full-size refrigerator and a microwave, along with an adult-size spigot and a drinking faucet. Medications which require refrigeration will be
stored in a lock box in the refrigerator. Medications which do not require refrigeration will be stored in a cabinet which is designated for the First Aid Kit (there is a label indicating the cabinet) and which is rendered inaccessible by a childproof latch. In each classroom, the cleaning supplies will be kept in the cabinet indicated by a "Danger" sign and which is locked by key. Each teacher will keep the key either on their person or in a drawer in their desk. Each classroom will have a portable pitcher with water and individual cups from which the children can drink while inside the classroom.

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.

SUPERVISOR'S NAME: Adriana Hernandez	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Betty Bell	TELEPHONE: (323) 981-3364
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2019

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: ARROYO/CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 191597494
	VISIT DATE: 08/09/2019

NARRATIVE

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When children become ill during school hours, the Center will call their parent and either the elementary school nurse on site or the PUSD nurse. If the parent arrives before the nurse, the child will be released to the parent. Though there is no designated isolation room or area, ill children may be kept in the classroom or in K-1 until the parent arrives. Each classroom also has an emergency backpack which is hung on a hook by the entryway and which is rendered inaccessible by zipties. Each backpack contains first aid supplies.

There is age-appropriate furniture and equipment in each room. Each classroom has a phone. Each classroom has central heating and air-conditioning. Overhead lighting provides the majority of the light, but natural lighting comes through the windows as well.

Full-day children will nap on mats, which are stored in the office area or on a cart.

The outdoor activity area is completely surrounded by the portables. There are two areas which contain play structures. There is blacktop, grass with four benches on which to sit, foam rubber cushioning underneath each of the play structures, and sand. Shade is provided by trees and there is a canopy shade structure over one of the play structures. The playground equipment both have signs which state that they are appropriate for children ages 2-5. There is age-appropriate play equipment, which is stored in the storage shed which is on the playground. There is a drinking faucet with two faucet heads which is located next to rooms Hs3 and HS4.

Each classroom will be on the playground at separate times, except for room K3 and roo HS3, who will be on the playground at the same time. The A.M. session of K2 will be

SUPERVISOR'S NAME: Adriana Hernandez	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Betty Bell	TELEPHONE: (323) 981-3364
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2019

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: ARROYO/CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 191597494
	VISIT DATE: 08/09/2019

NARRATIVE

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previously used by the elementary school but are now vacant. Thus, Arroyo will now only occupy HS3, HS4 and K2 and K3. As LPA had not taken measurements previously, all four classrooms and the playground were measured and inspected during today's inspection.
The wrought iron fence is kept locked during operating hours and a teacher will stand by the gate and leave it propped open only when children are being dropped off and picked up. In order to gain unannounced entry, an LPA would need to either enter through the elementary school office and walk back to the portables or phone the office. The office would then phone the portables so that staff could let LPA in the gate, as each classroom has a phone. The phone number for the school is (909) 397-4573.

The Center proposes to serve children ages 2 until entry into Kindergarten. The Center will operate on the same schedule as Pomona Unified School District. The hours are approximately concurrent as the elementary school, Monday-Friday 7:30 A.M. to 3:15 P.M. Arroyo B-2 (room HS3), Arroyo 1 (room HS4) Arroyo D-4 (room K3) will all be full day Head Starts, while Arroyo C (A.M. session State Preschool) and Arroyo 3 (P.M. session Head Start) room K2 are half day sessions. (Room K2 P.M. session only runs Monday-Thursday.) Room

All parents will sign their child in/out in the classroom to which their child is assigned. Each classroom will only allow parents to enter/exit through the same door (rooms HS3 and HS4 each have two doors).

The bathrooms in HS3 and HS4 each have two toilets and two sinks, while rooms K2 and K3 each have two toilets and one sink.

SUPERVISOR'S NAME: Adriana Hernandez	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Betty Bell	TELEPHONE: (323) 981-3364
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2019

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: ARROYO/CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 191597494
	VISIT DATE: 08/09/2019

NARRATIVE

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outside from 8:50-9:20 and the P.M. session will be outside from 12:30-1:00. Rooms K3
and HS3 will be outside at 8:15 in the morning and at 1:40 in the afternoon. Room HS4 will be outside at 10:20 in the morning and at 1:00 in the afternoon. There is a water fountain with two faucet heads attached to P1.

There is a fire extinguisher mounted on the wall next to the entryway of each classroom. Each fire extinguisher is classification 3-A:40-B:C and was last serviced 07/02/19. There is a fire alarm system. Each classroom has a carbon monoxide detector mounted on a wall; all were tested and are operable.

Mr. Allen assisted LPA with measuring. The encumbered space in each classroom varies,
but are the teacher's filing cabinets, teacher's desk, storage cabinets, the children's cubbies, and the kitchenette. The bathrooms and the offices were not included in the measurements.

Based on measurements taken on this date, the maximum indoor capacity shall be for a total of 101 children. The maximum outdoor capacity shall be for 184 children. Applicant is currently applying for 120 children (an increase from 92 children).

Fire clearance was granted on 08/06/19 for a capacity of 120 children.

Based upon today's inspection, the four classrooms appear to meet Title 22 requirements.

SUPERVISOR'S NAME: Adriana Hernandez	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Betty Bell	TELEPHONE: (323) 981-3364
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2019

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: ARROYO/CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 191597494
	VISIT DATE: 08/09/2019

NARRATIVE

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Licensure is pending LPA's reciept of a revised LIC 200A and a revised STD 850 (fire clearance) of 101 children. By signing below, Licensing and Facilities Planner is agreeing to the revised capacity of 101 children.

The Notice of Site Visit has been posted on the Parent Board. LPA informed Licensing & Facilities Planner Kym Allen that if the Notice of Site Visit is removed prior to thirty (30) days, a $100 civil penalty may be assessed.

An exit interview has been conducted with and a copy of this report has been signed by and provided to Licensing & Facilities Planner Kym Allen. Appeal Rights have been provided and explained to same.

SUPERVISOR'S NAME: Adriana Hernandez	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Betty Bell	TELEPHONE: (323) 981-3364
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2019

LIC809 (FAS) - (06/04)

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