191599976-1-21-2020-54-CC-TTRN-BL2R9A-20200121114914

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191599976
Report Date: 01/21/2020
Date Signed: 01/21/2020 11:49:44 AM

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:	NIEMES HEADSTART/STATE PRESCHOOL		FACILITY NUMBER:	191599976
ADMINISTRATOR:	LIDA BELTROCCO		FACILITY TYPE:	850
ADDRESS:	16715 S JERSEY AVENUE		TELEPHONE:	(562) 229-7958
CITY:	ARTESIA	STATE: CA	ZIP CODE:	90701
CAPACITY:	40	CENSUS: 25	DATE:	01/21/2020
TYPE OF VISIT:	Annual/Random	ANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Education Coordinator		TIME COMPLETED:	10:20 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	Licensing Program Analysts (LPAs) Tiffanie Tran and Mayra Rivera arrived at the above facility to conduct an unannounced annual random inspection. LPAs met with Education Coordinator and we toured the facility inside and outside. LPAs observed all posting requirements for operation on the posting board LIC 203A-License, LIC-9213-Notice of site visit, LIC 610 A-Emergency Disaster Plan, LIC 9148-Earthquake Preparedness Check List, PUB 394-Notification of parent’s rights poster, LIC 613A- Personal Rights, PUB 269- Child Car Seat Law, Menus, and Activity Schedule. The facility obtained current pediatric CPR and First Aid for all facility staff members. All center staff that was present during today’s visit had fingerprint cleared and associated to the designated license number. The facility operates two full-day session (8:30AM – 2:30 PM; Monday - Friday). LPAs inspected the furniture and equipment for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Storage for children's belongings, isolation area was inspected. Children napping equipment observed to be clean and good condition. Age appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, paper towels, area safety and sanitation. LPAs observed both classrooms trash cans did not have a tight lid. First aid supplies, smoke detectors; carbon monoxide/fire extinguishers were observed. A review of medication policy, including administering, labeling, storage, and records was made. Per staff, there is only a child enrolled required spacer to asthma as needed Sign in and out sheet procedures were reviewed. The facility roster was up to date and fire and emergency disaster drills were conducted monthly. Emergency disaster plan is updated and reflected to the current operation. Children and staff records were reviewed and in good order. All food items and snacks are delivered daily to the facility from the Elementary School. Water is accessible indoor and outdoor by use of water fountain. Outdoor play area was all fenced. Staff entrance needed a safety latch. LPAs advised outdoor structure poles must have padded cover. Equipment was inspected for safety, cushioning material, good repair and age appropriateness. LPAs observed shade as well as drinking water was provided. Play area was inspected for hazards and inaccessibility to bodies of water.

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie Tran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2020

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: NIEMES HEADSTART/STATE PRESCHOOL	FACILITY NUMBER: 191599976
	VISIT DATE: 01/21/2020

NARRATIVE

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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

Type B deficiency was cited during today’s inspection. Exit interview conducted the following was discussed with the licensee:

Licensee was informed of responsibility to report suspected Child Abuse by calling the Child Abuse Hotline at 1-800-540-4000. Also call the Community Care Licensing office and follow up with a written Unusual Incident/Injury Report (LIC 624B). Licensee is reminded that smoking is prohibited on the premises. The facility was informed that the presence of teachers in the facility without Criminal Record Clearance or Exemption will be cited and civil penalty assessed for $100 per day. The facility may find additional information and forms on the Department’s website at www.ccld.ca.gov including information on the Live Scan application (LIC 9163). Appointments can be made for Live Scan at 1-800-315-4507. LPA reminded that it is the facility responsibility to know the regulations as well as anyone who assists in providing care. Site supervisor was advised on how to access quarterly reports, forms, and regulations for Child Care online at www.cdss.ca.gov. LPA also advised to read the Child Care quarterly updates every season as the come out to stay informed of any changes or updates to the regulations. LPA informed the Child Care Advocate Program (CCAP) provide many other helpful resources to the licensees and the public. Facility may also register on CCAP website for the new quarterly report to be notified. CCAP’s direct contact information is as followed: Phone number: (916) 654-1541 Email Address: childcareadvocatesprogram@dss.ca.gov Beginning January 1, 2018, Health and Safety Code 1596.8662 requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Existing licensees must meet requirements by March 30, 2018. New employees shall have 90 days from date of employment to complete training as required. This training requirement may be met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules. Website: www.mandatedreporterca.com

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie Tran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2020

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: NIEMES HEADSTART/STATE PRESCHOOL	FACILITY NUMBER: 191599976
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/21/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 01/31/2020 Section Cited	1 2 3 4 5 6 7	All containers used for storage of solid wastes shall have a tightfitting cover in good repair. This requirement is not met as evidenced by based on observation facility failed to maintain a trash can with tightfitting lid in both classrooms which poses a potential health and safety risk to 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: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie Tran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2020

LIC809 (FAS) - (06/04)

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