191597634-4-24-2023-33-CC-CRES-CQT4FG-20230411190354

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191597634
Report Date: 03/07/2023
Date Signed: 04/24/2023 11:54:23 AM

Document Has Been Signed on 04/24/2023 11:54 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
L.A. DAY CARE-EAST, 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: 32	DATE:	03/07/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:01 AM
MET WITH:	Ellen Head		TIME COMPLETED:	05:30 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) Cynthia Reyes, conducted an announced 1 year annual site Inspection. LPA met with Ellen Head, Director. The facility preschool program days & hours are Monday-Friday 6:30 AM-6 PM. This facility is located on the Hope Lutheran Church site. . LPA began the tour of the facility with Ellen, beginning in her office and went outside where the preschool parents will sign the child in/out outside between the director office and the rainbow class room door. LPA counted 32 children in care on this date and 4 were not signed in. Health checks are being conducted by staff when the child enters the class room and use of hand sanitizer is available. LPA did not observe a parent board visible for the parents with all the required licensing forms, however LPA did see some forms on a board inside each class room. The ill/isolation area is located in the Directors office and the staff rest room for an ill child to use is located in another room in the directors office. The ill/isolation area will have the child cot brought in for the child to rest if needed. No staff lounge/lunch area. Staff will use the directors office, outside or the small chapel of the church which is located on this campus. . Teacher-child ratios were observed to be in accordance with Title 22 Regulations. Staff names were recorded. All children were observed to be under supervision and observation, including visual supervision, of a teacher at all times. The licensed facility is within the conditions, limitations, and capacity specified on the license. Continued on page 2

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2023

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
	VISIT DATE: 03/07/2023

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Licensing staff was then guided through the Preschool class rooms (Rainbow P3 age 2/3 and Sunshine P4 age 4/5) Toys were observed to be age appropriate clean and safe. Furniture and equipment was inspected for age appropriateness and good repair. Napping equipment & cots, were also inspected and observed to be in good condition. Appropriate storage and cleanliness was observed. The preschool provides filtered water and children bring their own water bottles and can be filled. Individual storage space was observed to be available for each child.

The facility provides AM/PM snack and lunch is brought by the child or a hot lunch can be purchased by an outside vendor cater Tots. Menus were observed in the directors office on the refrigerator and where a small kitchen/preparation area is located. Containers used to discard food have tight fitting lids. There is a fully equipped first aid kit available in each room. Facility provides each child's linen for the week and the parents will take home to wash at the end of the week or as needed. Facility has extra linen and food available if needed.

Preschool children have a bathroom located between the two class rooms with 4 toilets and outside the bathroom in each class room has 2 sinks. LPA observed a folding down changing tables with in arms reach of a portable sink attached to the top of the wall and no water was in it at the time of inspection. . LPA observed all to be in good repair, water temperature, paper towels, toilet paper, and all areas inspected for safety and sanitation.

Heating, lighting and ventilation were evaluated. Building/Rooms are centrally heated and air conditioned. Overhead lights as well as natural light is used.

The tour continued as the LPA was guided to the Preschool outdoor play yards, where LPA observed the yard is self contained by a gate around it for separation from the other components on this site to prevent children from commingling.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2023

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: 03/07/2023

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Children will use their own labeled water bottles while outdoors and are refillable by filtered water provided by the school. LPA observed age appropriate outdoor toys and play equipment to be clean safe and in good repair, as well as adequate shade is available. All areas around play equipment and slides are cushioned with material to absorb a fall. LPA advised the Director Ellen that the preschool children need to be within the direct care and supervision, including visual observation and supervision of the teacher(s) at all times.

Director Ellen 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.

Children’s Records were reviewed on this date for completeness; and Inspection of required forms were made and documented on the LIC 857. LPA reviewed Staff records, which were documented on the LIC 859. All staff had proof against TB, measles, pertussis, and influenza, as well as current Mandated reporter.

There is at least one person trained in EMS (emergency medical services) Pediatric CPR and First Aid present during this inspection. Pediatric CPR & First Aid is documented for staff who have it and is current for the Director. No transportation is being conducted by the facility for preschool children.

Children's roster was reviewed and is current and number of total enrolled at this time was documented. Disaster drill log was available, conducted on 01/27/2023 and documented. Consultation was conducted with Director Ellen, regarding maintaining the Roster and disaster drills as they were not available for review during the last visit on 01/23/2023. LPA advised to have ready by the next inspection of the facility. (Today 03/07/2023)

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2023

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: 03/07/2023

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First Aid supplies were observed in each classroom and were observed to contain the required first-aid supplies. According to Staff, medication is only administered to a child when accompanied with a doctor's note and if any lifesaving medication, it is stored in a locked area in the directors office or office refrigerator.

Medication: This facility provides Incidental Medical Services – IMS. No children at this time to review storage of medication and equipment/supplies, and no review of 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

Update: Effects of Lead Exposure and the following Provider Information Notices (PINs) Required Lead Testing: PIN 20-01 CCP Effects of Lead Exposure, and Guardian User Account Access - PIN 20-20-CCLD. were discussed.

Carbon monoxide detectors and smoke detectors are present and are in operable condition in the facility. Smoke and Carbon Monoxide detectors should be checked and batteries replaced as needed. The fire extinguisher type 2A-10BC (Service date 11/23/2022) must be serviced annually or as often as necessary. Hazardous items including poisonous cleaning compounds were observed to be stored inaccessible to children.

AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018 any person who works in a child care facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2023

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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: HOPE LUTHERAN PRESCHOOL	FACILITY NUMBER: 191597634
	VISIT DATE: 03/07/2023

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Access forms, regulations and quarterly updates on the Child Care Licensing website at www.ccld.ca.gov. Reporting Unusual Incidents: MPROIncidentReports@dss.ca.gov. CCL Resources for Parents & Providers: https://ccld.childcarevideos.org/ Provider Information Notices (PINs): https://www.cdss.ca.gov/inforesources/community-care-licensing/policy/provider-information-notices/child-care

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.

LPA advised that the changing table used to change diapers in the Rainbow room needs to be placed with in arms reach of a sink and the portable sink on the wall is not useable.

At this time, the licensee is not in compliance in the preschool program with California Code of Regulations Title 22. See Deficiencies cited on the 809D page and Technical Assistant pages.

Continuation Inspection will be completed at another date and time for documentation of Citation and Technical Assistance due to computer malfunction issues. All citation will be completed at that time.

Exit interview was conducted with Ellen Head, Director and a signed copy of this report and the notice of site visit was provided on this date.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 04/24/2023 11:54 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
L.A. DAY CARE-EAST, 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: 03/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101238(g)

Buildings and Grounds

(g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on LPA observation, the licensee did not comply with the section cited above. LPA observed several containers of Clorox wipes in an unlocked cabinet as well as in another cabinet bug spray, lotion, perfume and a staff water bottle and soda (coke) container in the cabinet that had a broken door that was not on the cabinet in the sunshine class room, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/17/2023
	Plan of Correction
1 2 3 4

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: Brandi VanOosten	TELEPHONE: (323) 981-3439
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 04/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2023

LIC809 (FAS) - (06/04)

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