191604502-1-20-2023-54-CC-KCHE-CN9SRH-20230120130623

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191604502
Report Date: 01/20/2023
Date Signed: 01/20/2023 01:06:38 PM

Document Has Been Signed on 01/20/2023 01:06 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:	LBUSD-EDISON CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	191604502
ADMINISTRATOR:	KATHLEEN WOODS		FACILITY TYPE:	850
ADDRESS:	640 W. 7TH STREET		TELEPHONE:	(562) 437-6114
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90813
CAPACITY:	84	CENSUS: 16	DATE:	01/20/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Mom Khit, Coordinating Teacher (CT)		TIME COMPLETED:	01:45 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	On 01/20/2023 at 11:45 AM an unannounced Required – 1 Year Inspection was conducted by Licensing Program Analyst (LPA) Katrina Chicote. Facility is currently licensed for a capacity of 84 but currently have 19 enrolled. Licensing staff announced purpose of visit and initially met with S1, who granted entry to facility. CT, Mom Khit, was also present for inspection. Facility is located on Edison Elementary School campus in RMs 51 and 52. The program currently operates a Full Day program Monday thru Friday 6:30 AM to 5:30 PM. LPA singularly toured the facility of both indoors and outdoors. LPA observed required licensing postings on Parent Board in RM 51. At the initial start of the site visit, there is a total census of 16 children and a total census of four staff (S1, S2, S3, and S4) present. LPA observed children eating lunch upon arrival to facility. Beginning at 11:48 AM, furniture and equipment were inspected for age appropriateness and good repair. LPA observed floor and carpets to be free of hazards. LPA observed child size tables and chairs available for children well maintained. LPA observed learning stations for dramatic play, math, and science with toys well maintained free of loose and sharp parts and a quite play area with soft seating available for children. Telephone service, heating, lighting and ventilation were evaluated. There were cubbies observed as storage for children's belongings. Mats/cots were inspected. Per CT, linens are provided by the facility and taken home weekly for washing. Availability of drinking water was reviewed. LPA observed water coolers available for children and children's personal water bottles. Age appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, area safety and sanitation. LPA observed bathroom available in classroom that had three toilets and two sinks, a third sink available outside of the bathroom. Report Continues - Page 1 of 3

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 01/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2023

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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LBUSD-EDISON CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 191604502
	VISIT DATE: 01/20/2023

NARRATIVE

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Snack/lunch menus were reviewed and observed posted at time of inspection. All meals and snacks are provided by the Long Beach Unified School District. Children are provided with breakfast, lunch, and snack. Per CT, staff picks up lunch from cafeteria and LPA observed staff pick up lunch during inspection. Trash cans used to discard food have tight fitting lids.

A first aid kit is kept in the bathroom and was inventoried for supplies during inspection. At 11:50 AM, carbon monoxide detectors were tested and observed operable at time of inspection. LPA observed smoke detectors present in the facility and fire extinguishers have been serviced on 07/28/2022. LPA observed disaster drill log available, last drill conducted on 12/16/2022. Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Coordinating Teacher states that there are no poisons stored at the facility and no children requiring medications at this time. LPA observed that sick/isolation area is in RM 51 by office.

Beginning at 11:51 AM, outdoor equipment was inspected for safety, cushioning material, good repair and age-appropriateness. LPA observed age appropriate play structure that has cushioning material to absorb fall that is all well maintained. LPA observed bicycles, plastic playhouse, plastic dramatic play toys, sensory tables and other toys available for children to use outside that is well maintained. At 11:53 AM, LPA observed a portion of fence broken next to plastic playhouse that has a rod sticking out from fence. LPA discussed this observation with CT at time of inspection and potential health and safety risk to children in care. CT put in work order at time of inspection. Required shade and fencing were inspected. LPA advised CT that the children need to be within the direct care and supervision, including visual supervision of the teacher(s) at all times. The children have access to their water bottles and a water cooler during outside play. Play area was inspected for hazards and inaccessibility to bodies of water; no bodies of water were observed.

Teacher-child ratios were observed and staff names recorded. Care and supervision was evaluated to determine if the basic needs of children are met and appropriate. Sign-in and out sheets and procedures were reviewed. Facility uses electronic sign in and out, CT printed out sign in and out sheets during inspection and LPA observed all children present signed in at time of inspection. Personal Rights of children were observed by LPA.

Report Continues - Page 2 of 3

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 01/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2023

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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LBUSD-EDISON CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 191604502
	VISIT DATE: 01/20/2023

NARRATIVE

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Beginning at 12:25 PM, staff and children’s records were reviewed. Children’s Records were reviewed for completeness. Inspection of required forms was made and documented on the LIC 857. The review of Staff records was documented on the LIC 859.

Staff present did have proof of the AB 1207 Mandated Reporter Training certificate on file. All staff have been given on the-job training sanitation principles, housekeeping, including universal health precautions. LPA observed Pediatric First Aid/CPR expires on 12/2024 for S1. LPA did not review confidential staff files during the inspection due to the staff confidential files being stored at the administrative office. All staff and employees have obtained a criminal record clearance or criminal record exemption as a condition of employment with the Long Beach Unified School District.

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

Based on this information, the following deficiency on the attached LIC 809D is being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted and report was reviewed with the Facility Representative, Mom Khit.

Report Ends Page 3 of 3

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 01/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2023

LIC809 (FAS) - (06/04)

Page: 3 of 4

Document Has Been Signed on 01/20/2023 01:06 PM - 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LBUSD-EDISON CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 191604502
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/20/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101238.2(d)(2)

Outdoor Activity Space

(d) The surface of the outdoor activity space shall be maintained: (2) Free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on Based on LPA observation of outdoor play yard at 11:53 AM, LPA observed corner of fence to be broken with a rod poking out. This poses a potential health and safety risk to children in care.
	POC Due Date: 02/20/2023
	Plan of Correction
1 2 3 4	Facility Represntative states they have already put in a work order today and follow up with CDC office and provide photo via text to LPA once work is completed.

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: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 01/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2023

LIC809 (FAS) - (06/04)

Page: 4 of 4