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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191598114
Report Date: 11/03/2023
Date Signed: 11/03/2023 03:17:18 PM


Document Has Been Signed on 11/03/2023 03:17 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:KINGSLEY/CHILD DEVELOPMENT CENTERFACILITY NUMBER:
191598114
ADMINISTRATOR:KYM ALLENFACILITY TYPE:
850
ADDRESS:1170 WASHINGTON STREETTELEPHONE:
(909) 397-4609
CITY:POMONASTATE: CAZIP CODE:
91767
CAPACITY:48CENSUS: 0DATE:
11/03/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH: Licensing and Facility Planner Kym AllenTIME COMPLETED:
03:35 PM
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On 11/03/23 licensing Program Analysts LPA(s) Mary Silva and Stephanie Li conducted an unannounced annual inspection. Upon arrival at 1:30 pm, LPA(s) were greeted by Teacher Victor Garcia and Paraprofessional Christina Gutierrez, to whom the purpose of the visit was explained. LPA(s) checked in the front office prior to entering the preschool. Licensing and Facility Planner, Kym Allen joined the inspection at approximately 2:00pm. LPA(s) were led on a tour of the facility. This is a preschool program which consists of one classroom (Room 70). Per Licensing and Facility Planner Kym Allen, 12 children are enrolled. Hours of operation for this facility are Monday-Friday 7:30am-2:00pm, early release is every 1st Friday of the month at 1:00pm. There were no children present during this inspection.
This program operates on the grounds of Kingsley Elementary School.

Licensing staff observed all required forms/publications to be posted by the front entrance. Snack menus were reviewed to ensure that they are being posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request. Facility provides breakfast, lunch and snacks.

PHYSICAL PLANT: All areas were identified on the Facility Sketch were inspected. The following classroom were inspected: Room 70: no children present and two staff. The Licensee is within the conditions, limitations, and capacity specified on the license. Napping equipment (mats/cots) and bedding were inspected for good condition, appropriate storage, and cleanliness. The preschool program facility washes the sheets weekly. Page 1 of 4

SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Mary SilvaTELEPHONE: (323) 558-2711
LICENSING EVALUATOR SIGNATURE:
DATE: 11/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/03/2023
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 4


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: KINGSLEY/CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191598114
VISIT DATE: 11/03/2023
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Storage for children's belongings were inspected. All toilets and washing facilities are in safe and sanitary operating conditions. First Aid supplies are available and complete. Drinking water was readily available indoors. Program provides drinking water for children.

At this time, the front section of room by the entry is used as an isolation area, and one restroom in the classroom will be used if needed.

Licensing staff observed disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Classroom furniture and equipment are in good condition, free of sharp, loose, or pointed parts. All floors are clean and safe. All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids. The facility was observed to be free of flies, other insects, and rodents.

Licensing staff observed the valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced in September 2023 per service tag. Per State Fire Marshall standards, fire extinguishers shall be serviced annually. Facility does have a functioning carbon monoxide. The district smoke detectors are connected to the fire department and meet the statutory requirements. Kym Allen states there are no weapons, firearms, or bodies of water on the premises.

OUTDOORS: At 2:30pm, licensing staff reviewed the outdoor play area. Outdoor playground equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard. Drinking water is readily available outdoors.

FACILITY RECORDS: Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. Disaster drills have been conducted at least every six months.

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SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Mary SilvaTELEPHONE: (323) 558-2711
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: KINGSLEY/CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191598114
VISIT DATE: 11/03/2023
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There is at least one person trained in CPR and Pediatric First Aid present during this inspection. Staff files are located & maintained at the main office location at 1460 E. Holt Street, Pomona, CA 91767 and will be reviewed at a later date.


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/.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation)
for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For childcare center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). Preschool program conducted lead testing and posted results. No lead exceedance was detected.

Facility representative 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.

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SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Mary SilvaTELEPHONE: (323) 558-2711
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: KINGSLEY/CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191598114
VISIT DATE: 11/03/2023
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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.

Facility representative 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.


At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative.



Exit interview was conducted with the Licensing and Facility Planner Kym Allen, report and appeal rights were given. Page 4 of 4
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Mary SilvaTELEPHONE: (323) 558-2711
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2023
LIC809 (FAS) - (06/04)
Page: 4 of 4