191597634-9-25-2019-33-CC-ABAY-BGCT2T-20190925142118

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191597634
Report Date: 09/25/2019
Date Signed: 09/25/2019 02:21:33 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:	HOPE LUTHERAN PRESCHOOL		FACILITY NUMBER:	191597634
ADMINISTRATOR:	HEAD, ELLEN		FACILITY TYPE:	850
ADDRESS:	1041 E. FOOTHILL BLVD.		TELEPHONE:	(626) 335-5315
CITY:	GLENDORA	STATE: CA	ZIP CODE:	91740
CAPACITY:	48	CENSUS: 45	DATE:	09/25/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Ellen Head		TIME COMPLETED:	02:25 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 unannounced Random site Inspection was conducted on this date, by Cynthia Reyes & Alicia Bailey LPAs. All areas identified on the Facility Sketch were inspected and checked the following: Fingerprint clearances, staff/child ratio, children and staff records, food preparation area, storage and refrigeration, rest rooms, equipment, outside play area and over all conditions of facility. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Napping equipment and bedding was inspected for good condition, appropriate storage and cleanliness. Bedding identification were inspected. Storage for children's belongings and an isolation area with a sink, toilet, and mats/cots was inspected. Availability of drinking water was reviewed. Age appropriate sinks and toilets were inspected for availability, good repair, changing table is located in smaller children preschool bathroom however is not in arm reach to a sink( changing pad maybe use on the floor next to the sink) water temperatures, toilet paper, paper towels, area safety and sanitation. First Aid supplies were inventoried. A review of medication policy, including administering, labeling, storage, and records was made. (Please contact your analyst for regulations if considering using Nebulizer or administering Blood-Glucose testing.) Incidental Medical Services was discussed. A notice of site visit was posted today and licensee was explained that it must remain posted for a period or 30 days. Failure to keep poster posted will result in a $100.00 civil penalty. Day care days and hours are: M-F 630 AM- 6 PM.

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Alicia Bailey	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2019

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: HOPE LUTHERAN PRESCHOOL	FACILITY NUMBER: 191597634
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/25/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/09/2019 Section Cited	1 2 3 4 5 6 7	INFANT CARE CENTER FIXTURES, FURNITURE, EQUIPMENT AND SUPPLIES Infant changing tables shall while in use, be placed within arm's reach of a sink. All Though program is a preschool, changing tables are used for youner preschoolers.This requirement is not met as evidence by: LPA 's observe the changing tables attach to the wall in the smaller preschool bathroom and per observation and staff interview the sink is not use within arm reach. This poses a potential health and safety risk to the 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: Karen Chambers	TELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Alicia Bailey	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2019

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: HOPE LUTHERAN PRESCHOOL	FACILITY NUMBER: 191597634
	VISIT DATE: 09/25/2019

NARRATIVE

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AB1207 Mandated Child Abuse Reporting – Implementation was discussed with Licensee. Website provided: http://mandatedreporterca.com/

Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

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

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Alicia Bailey	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2019

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: HOPE LUTHERAN PRESCHOOL	FACILITY NUMBER: 191597634
	VISIT DATE: 09/25/2019

NARRATIVE

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Snacks are provided and lunch may be purchased from company provided by the school. Menus were observed in Directors office and not visible to parents, this was discussed with Director Ellen Head. Food and snacks were reviewed for availability, quantity and appropriateness to children in care. Food preparation areas were toured for safety, cleanliness and proper equipment. A review of cleaning and food supply storage areas was made. Outdoor equipment was inspected for safety, cushioning material, good repair and age appropriateness. Required shade, drinking water and fencing were inspected. Play area was inspected for hazards and inaccessibility to bodies of water. Teacher child ratios were observed and staff names recorded. Care and supervision was evaluated to determine if the basic needs of children are met appropriately. Emergency disaster plans and other site operations. Sign in and out sheets and procedures were reviewed with staff, policy of checking children for illnesses.

Staff and children records were reviewed for completeness including but not limited to Criminal Record Clearances for adults, Director Qualifications and verification of CPR/First Aid and health preventive practices documentation. Inspection of required forms was made. Children and Staff confidential name report (lic 811) was given and documented on this date. No weapons or bodies of water on premises. The smoke detectors, carbon monoxide & fire extinguisher are in operable condition.

The following deficiencies were observed in accordance to Title 22 of the California Code of Regulations. See 809D page Consultation was conducted on this date.

Upon receipt, Licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Alicia Bailey	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2019

LIC809 (FAS) - (06/04)

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