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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191600443
Report Date: 04/27/2022
Date Signed: 04/27/2022 01:17:45 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 04/27/2022 01:17 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754



FACILITY NAME:BARBARA AND RAY ALPERT JEWISH COMMUNITY CENTERFACILITY NUMBER:
191600443
ADMINISTRATOR:KEILES, LINDAFACILITY TYPE:
850
ADDRESS:3801 EAST WILLOW AVENUETELEPHONE:
(562) 426-7601
CITY:LONG BEACHSTATE: CAZIP CODE:
90815
CAPACITY:210CENSUS: 133DATE:
04/27/2022
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Sandra OlivaTIME COMPLETED:
01:30 PM
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Licensing Program Analyst (LPA) Warren Birks conducted a Case Management Annual continuation inspection. LPA met Human Resources Manager Sandra Oliva who assisted analyst with the inspection. The purpose of the inspection is to review staff records and complete a staff interview for the previous March 29, 2022 annual inspection.

This is a Preschool Program serving children two (2) through entry into first grade. The facility is housed on the site of the Barbara and Ray Alpert Jewish Community Center and consist of 13 class rooms (10 are in use currently). The current hours of operation are: Monday through Friday 8:00am to 4:00pm. The preschool program (indoors and outdoors) is physically separate from other programs and activities on the grounds. There is no commingling with other programs. Note: The Administrator listed is not associated with the facility and the typo that has been directed to the clerical IT department.

LPA reviewed staff records for staff #7 through #12. LPA observed items such as appropriate documentation of education credits, Criminal Record Clearance documents, Health Screenings, Personnel Records, Verification of current CPR/First Aid and health preventative practices, proof of immunization against pertussis and measles and influenza and/or flu declination available, Employee Rights, Mandated Reporter Training, etc. LPA observed staff records to be in compliance at this time. There were no citations issues at this time

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. Failure to maintain posting as required will result in a civil penalty of $100.00 Exit interview was conducted with Human Resources Manager Sandra Oliva and a copy of Appeal Rights (LIC 9058) was discussed and provided

SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:
DATE: 04/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/12/2022
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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