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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191603200
Report Date: 03/17/2022
Date Signed: 03/17/2022 12:38:24 PM


Document Has Been Signed on 03/17/2022 12:38 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:FIRST BAPTIST CHURCH OF LAKEWOOD PRESCHOOLFACILITY NUMBER:
191603200
ADMINISTRATOR:MELISSA CLAYTONFACILITY TYPE:
850
ADDRESS:5336 ARBOR ROADTELEPHONE:
(562) 420-2833
CITY:LONG BEACHSTATE: CAZIP CODE:
90808
CAPACITY:75CENSUS: 68DATE:
03/17/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:34 AM
MET WITH:Melissa ClaytonTIME COMPLETED:
12:50 PM
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Licensing Program Analyst (LPA) Warren Birks conducted an unannounced Required - 1 Year Inspection. LPA met with Director Melissa Clayton who assisted analyst with a tour of the facility. This is a Preschool Program serving children two years nine months (2.9) through five (5) years old. The hours of operation are: Monday through Friday 7:00am to 5:00pm. Upon arrival LPA observed that the preschool operates on the grounds of a Kindergarten through eighth grade (K-8) school. The preschool program (indoors and outdoors) is physically separate and does not commingle with the K-8.

All areas identified on the Facility Sketch were inspected. From 8:40am to 9:20am LPA observed: Room 104 (1 staff and 10 children), Room 105 (2 staff and 15 children), Room 106 (2 staff and 14 children), Room 107 (2 staff and 17 children) and Room 108 (2 Staff and 12 children). From arrival through 10:00am LPA inspected all classrooms, outdoor areas, and furniture and equipment for age appropriateness and good repair. LPA observed telephone service, heating, lighting and ventilation to be satisfactory. Children have adequate cubby storage for their belongings. Napping cots are stored separately in the classrooms. LPA observed drinking water with drinking cups readily available in the classrooms. Age appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, safety and sanitation. All available toilets and sinks are in operable condition.



All indoor classrooms have surfaces that appear to be clean and safe. All materials and surfaces accessible to children are toxic free. Storage areas for poisons are locked in containers inaccessible to children. The office is used as an isolation area to care for ill children. Parents are contacted immediately if children are ill. Director Clayton indicated there are no weapons at the facility and LPA did not observe any.

At approximately 9:35am LPA observed outdoor play equipment to be in good condition, free of sharp, loose or pointed parts. The outdoor activity space surface is maintained in a safe condition and appears to be free of hazards. Areas around and/or under climbing equipment have rubber cushioning material to absorb a fall.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:
DATE: 03/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/17/2022
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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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: FIRST BAPTIST CHURCH OF LAKEWOOD PRESCHOOL
FACILITY NUMBER: 191603200
VISIT DATE: 03/17/2022
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All materials and surfaces accessible to children are toxic free. At this time this office is used as an isolation area to care for ill children. Children can rest on a cot or sit in a chair. Parents are contacted immediately if children are ill.

LPA reviewed snack menus that are posted at least one week in advance and visible to authorized representatives. The facility provides an AM and PM snack. At 12:00pm LPA observed food and snack preparation areas to which appeared to be clean, safe and having proper equipment. LPA observed an adequate amount of food available for children in care and snacks and drinks to be within expiration dates. LPA also observed drinking water available indoors and outdoors and trash receptacles that have tight fitting covers.

Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are locked and/or inaccessible. The facility has one or more functioning smoke detectors and carbon monoxide detectors that meet statutory requirements. The required 2A10BC fire extinguisher gauge is in the green and has been serviced within the last 12 months. The facility's last recorded disaster drill was in December 2021.

LPA observed sign in and sign out forms to ensure children are being properly signed in and signed out. LPA conducted a Children's Records Review to ensure children have Identification and Emergency forms, Immunization records, Health History, Personal Rights, Parents Rights etc. on file.

Staff Records were reviewed to ensure the following: Appropriate documentation of education credits, Criminal Record Clearance documents available, Verification of current CPR/First Aid and health preventative practices, proof of immunization against pertussis and measles and influenza and/or flu declination available.

LPA observed staff to have current CPR (Director Clayton expiration is August, 2023 and staff have current Mandated reporter training as well.

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 ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022
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: FIRST BAPTIST CHURCH OF LAKEWOOD PRESCHOOL
FACILITY NUMBER: 191603200
VISIT DATE: 03/17/2022
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Note: First Aid supplies were observed in each classroom. Director Clayton indicated that medication is only administered to children once parent's provide a doctor's note. All medications are stored in a locked box or inaccessible refrigerator for inaccessibility. LPA informed Director that fire extinguishers type 2A-10BC must be serviced at least annually. Smoke and Carbon Monoxide detectors should be checked and batteries replaced as needed. Any construction or remodeling should be reported to the Department before it occurs. .

Mandatory forms for the children’s files and staff files, requirements for fire drills, earthquake drills and documentation were discussed. Role and responsibilities of being a Mandated Reporter were reviewed. The Director was advised how to access forms and Regulations online at www.ccld.ca.gov. Director was made aware that it is his/her responsibility to know the regulations as well as anyone who assists in providing care. LPA advised that inaccessibility of hazards must be constantly reassessed depending on the children in care.



LPA advised Director Clayton that all adults 18 years of age and older providing Care & Supervision and having a continuous presence in the facility shall adhere to a criminal background clearance with the Department of Justice, FBI and Child Abuse Index Check. LPA informed Director to log onto web site www.ccld.ca.gov to access forms, regulations and quarterly updates. Records for all children and staff must be maintained for three (3) years after separation from the facility. Report Unusual Incidents and/or injuries to the parent/guardian immediately and to Child Care Licensing within 24 hours and/or the next business day. Visit www.shotsforschool.org for immunization information. All care for children require supervision at all times. If away from the facility, staff must be with children at all times (especially when outdoors). There were no violations of Title 22 requirements at this time.

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/tion-process.

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 Director Melissa Clayton 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: 03/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022
LIC809 (FAS) - (06/04)
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