191597512-9-14-2022-54-CC-KCHE-CJ9PG2-20220914111736

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191597512
Report Date: 09/14/2022
Date Signed: 09/14/2022 11:17:59 AM

Document Has Been Signed on 09/14/2022 11:17 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:	ERNIE PYLE SCHOOL-BELLFLOWER U.S.D.		FACILITY NUMBER:	191597512
ADMINISTRATOR:	CRISTINA BLEVINS		FACILITY TYPE:	850
ADDRESS:	14500 S. WOODRUFF AVE.		TELEPHONE:	(562) 461-2227
CITY:	BELLFLOWER	STATE: CA	ZIP CODE:	90706
CAPACITY:	20	CENSUS: 12	DATE:	09/14/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Stephanie Garcia, Teacher		TIME COMPLETED:	11:35 AM

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 unannounced Required – 1 Year Inspection was conducted on 09/14/2022 at 9:20 AM by Licensing Program Analyst (LPA) Katrina Chicote. Facility is currently licensed for a capacity of 20. Licensing staff met with Stephanie Garcia, Teacher and Sara Bray, Teacher's Assistant. Facility is located on elementary school campus. The program currently operates two part-time programs Monday thru Friday: AM Program from 8:30 AM to 11:30 AM and PM program 12:30 PM to 3:30 PM. LPA singularly toured the facility both indoors and outdoors. Director, Bettie Guerrero, arrived at facility at 9:45 AM and left at approximately 10:00 AM. Required postings were observed on bulletin board by classroom entrance including waivers for use of shared out door play yard, use of play equipment, use of elementary bathrooms, and use of Assistant for supervision. At the initial start of the site visit, LPA observed there is a total census of 12 children and a total census of two teachers present playing outside. The facility is made up of single bungalow. Beginning at 9:40 AM, LPA observed furniture and equipment were inspected for age appropriateness and good repair. LPA observed child size tables and chairs, learning stations with dramatic play toys, art materials, and math manipulative toys available for children in care that is well maintained and free of loose and sharp parts. Telephone service, heating, lighting and ventilation were evaluated. There were cubbies observed as storage for children's belongings. There is no nap time at this facility due to part time programs. Availability of drinking water was reviewed. LPA observed individual water bottles available for drinking water. Age appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, area safety and sanitation. LPA observed one toilet and one sink available for children in the classroom. A first aid kit is kept in a backpack hanging by the entrance and was inventoried for supplies. LPA observed medications stored for two children in first aid backpack that meet Tittle 22 Regulation requirements. Carbon monoxide and smoke detectors are present in the facility. Fire extinguishers have been serviced on 08/08/22. Disaster drill log was posted and last drill was conducted on 08/30/2022. Report Continues Page 1 of 3

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2022

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 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ERNIE PYLE SCHOOL-BELLFLOWER U.S.D.	FACILITY NUMBER: 191597512
	VISIT DATE: 09/14/2022

NARRATIVE

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Snack/lunch menus were reviewed. Facility is provided AM and PM snack by elementary school cafeteria.

At 9:35 AM, outdoor equipment was inspected for safety, cushioning material, good repair and age-appropriateness. LPA observed large play structure being used by the children during inspection with wood chips below to absorb fall and well maintained, LPA observed a concrete basketball court also available for use. Play yard is shared with Kindergarten class and waiver is posted for staggered play time. Required shade and fencing were inspected. LPA Chicote advised Teacher that the children need to be within the direct care and supervision, including visual supervision of the teacher(s) at all times. The children have access to their water bottles for outside play. Play area was inspected for hazards and inaccessibility to bodies of water; no bodies of water or hazards observed.

All staff and employees have obtained a criminal record clearance or criminal record exemption as a condition of employment with the Bellflower Unified School District.

Teacher-child ratios were observed and staff names recorded. Care and supervision was evaluated to determine if the basic needs of children are met and appropriate. Sign-in and out sheets and procedures were reviewed. 12 of 12 children were signed at time of inspection. Personal Rights of children were observed by LPA.

Children’s Records were reviewed. Bellflower USD keeps confidential files for children in Admin office which includes Physician Report, Immunization Records, and TB risk assessment. Per Director, staff files are also kept in office. LPA will review files at a later time. LPA notified Director that LPA will have to review Mandated Reporter training and Pediatric First Aid/CPR training for staff present, which Director stated they should have readily available during today's inspection. Upon review, staff present did not have current Pediatric First Aid/CPR and Mandated Reporter Training certificate available during today's inspection. CPR card expired on 02/2022 for Teacher.

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.htm Report Continues - Page 2 of 3

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2022

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ERNIE PYLE SCHOOL-BELLFLOWER U.S.D.	FACILITY NUMBER: 191597512
	VISIT DATE: 09/14/2022

NARRATIVE

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The following were discussed with the Facility Representative:
No Licensee (or facility representative) was reminded that all adults 18 and over in the facility, 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 licensed facility. 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.

The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and Carbon Monoxide detectors should be checked and batteries replaced as needed.

Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your location.

LPA advised of the requirement to report Unusual Incidents and/or injuries to the parent/guardian and to CCL within the time frame specified by the regulation.

Based on this information, the following deficiencies on the attached LIC 809D 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.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted and report was reviewed with the Facility Representative, Teacher Stephanie Garcia.

Report Ends - Page 3 of 3

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2022

LIC809 (FAS) - (06/04)

Page: 3 of 5

Document Has Been Signed on 09/14/2022 11:17 AM - 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: ERNIE PYLE SCHOOL-BELLFLOWER U.S.D.	FACILITY NUMBER: 191597512
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/14/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on LPA record review and interview, LPA did not observe a current mandated reporter training. Teacher states they have not yet taken a current mandated reporter training. This poses a potential health, safety, and personal rights risk to children in care.
	POC Due Date: 10/14/2022
	Plan of Correction
1 2 3 4	Facility Representatives states they will complete training and have Director provide proof to LPA by POC date.

Type B

Section Cited

CCR

101216(f)

Personnel Requirements

(f) At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review and interview, LPA did not observe a current pediatric first aid/cpr for any staff present at the facility (expired on 02/2022). Per Teacher they have not taken a current one. Director states she has scheduled an upcoming training for all staff. This poses a potential health, safety, and personal rights risk to children in care.
	POC Due Date: 10/14/2022
	Plan of Correction
1 2 3 4	Facility Representative states they will complete trainin gand have DIrector provide proof to LPA by POC date.

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: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2022

LIC809 (FAS) - (06/04)

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