191605040-5-31-2022-54-CC-RRAS-CEXNFB-20220531102515

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191605040
Report Date: 05/31/2022
Date Signed: 05/31/2022 10:25:20 AM

Document Has Been Signed on 05/31/2022 10:25 AM - 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-STEVENSON CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	191605040
ADMINISTRATOR:	KATHLEEN WOODS		FACILITY TYPE:	850
ADDRESS:	515 LIME AVENUE		TELEPHONE:	(562) 436-4500
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90802
CAPACITY:	44	CENSUS: 16	DATE:	05/31/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Mom Khit, Corodinating Teacher		TIME COMPLETED:	10:45 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) Rita Ramos and Katrina Chicote conducted an unannounced annual inspection to the above facility on 05/31/22. LPAs arrived at the facility at 9AM identified selves and met with Mom Khit, Coordinating Teacher, who guided analyst on a tour of the facility. LPAs provided representative with a copy of the LIC 125 Entrance Checklist to help facilitate the inspection. This is a preschool program which consists of 2 classrooms; Room 32 and Room 33. Facility operation hours are Monday to Friday from 8:30AM to 11:30AM. This facility is located within Stevenson Elementary School in the city of Long Beach. All areas identified on this report were inspected. Upon arrival, the following staff were present during this inspection: Room 33: Staff #1, #2, #3, #4, and #5 with 16 preschoolers. There were no children in care in Room 32. The facility was observed to be within the license capacity and limitations. The following was observed during the tour of the facility: Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Children have their own cubby to store their belongings. Children do not nap at this facility due to part day enrollment. Per Coordinating Teacher, the isolation area is located in the nurse's office. Age appropriate sinks and toilets were inspected for availability and good repair in all restrooms. General sanitation was observed. Availability of indoor drinking water was observed in classrooms. 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. Carbon monoxide detectors were observed and tested to ensure that they are operable. ---Pagr 1 of 3

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Rita Ramos	TELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2022

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: LBUSD-STEVENSON CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 191605040
	VISIT DATE: 05/31/2022

NARRATIVE

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All meals and snacks at this facility are delivered to the classrooms. All meals and snacks are provided by the Long Beach Unified School District. Children are provided with a full lunch. Trash cans used to discard food have tight fitting lids or solid waste bags shall be discarded immediately after each meal.

At 9:12 AM while observing the outdoor area LPAs observed lunch tables outside of the gated play area. Per Coordinating Teacher the children eat outdoors weather permitting. LPAs advised Coordinating Teacher that whenever there is a change in the program or space to be used by children, the department needs to be notified. LPAs provided an advisory note during the inspection. Outdoor playground equipment is in a 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, slides, and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard. Availability of outdoor drinking water is provided via disposable water bottles due to COVID-19 as a precautionary measure. LPAs advised that no children shall be left without the supervision of a teacher at any time.

All floors were observed to be clean and safe. All materials accessible to children were observed to be toxic-free There are no firearms stored on the premises. There are no pools or bodies of water at the facility.

There is at least one person trained in CPR and Pediatric First Aid present during this inspection.

Children’s Records were reviewed for completeness. Inspection of required forms was made and documented on the LIC 857.

LPAs also reviewed staff records. 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. LPAs did not review confidential staff files during the inspection due to the staff confidential files being stored at the administrative office.

Children's roster was reviewed and is current. Sign-In and Sign-Out sheets were reviewed. During the inspection LPAs observed that one child present was not signed in. LPAs provided a technical violation during the inspection. Disaster drill log was available, last drill was conducted on 04/27/22. --Page 2 of 2

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Rita Ramos	TELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2022

LIC809 (FAS) - (06/04)

Page: 2 of 3

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-STEVENSON CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 191605040
	VISIT DATE: 05/31/2022

NARRATIVE

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Menus were observed to be posted.

First Aid supplies were observed in the classroom in a bag. According to Coordinating Teacher, there are currently no children on medication.

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

LPAs advised the Coordinating Teacher to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

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.

There were no deficiencies cited during today’s inspection.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Coordinating Teacher, Mom Khit.

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SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Rita Ramos	TELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2022

LIC809 (FAS) - (06/04)

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