191605040-1-10-2025-54-CC-JESA-DCT23V-20250110160257

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191605040
Report Date: 01/10/2025
Date Signed: 01/10/2025 04:03:24 PM

Document Has Been Signed on 01/10/2025 04:03 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	LBUSD-STEVENSON CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	191605040
ADMINISTRATOR/ DIRECTOR:	KATHLEEN WOODS		FACILITY TYPE:	850
ADDRESS:	515 LIME AVENUE		TELEPHONE:	(562) 436-4500
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90802
CAPACITY: 44	TOTAL ENROLLED CHILDREN: 7	CENSUS: 5	DATE:	01/10/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:45 AM
MET WITH:	Program Coordinator Linsdey Evans		TIME VISIT/ INSPECTION COMPLETED:	12:45 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	Licensing Program Analysts (LPAs) Jeanette Estrada and Portia Bowden conducted a visit to the facility for the purpose of conducting an annual inspection and to follow up on an Unusual Incident Report submitted on 11/13/24. LPAs met with Lead teacher Yohana De Leon and explained the reason for the visit. Program Coordinator Lindsey Evans arrived at a later time. This is a preschool program which consists of one classroom. This facility is located on the premises of Stevenson Elementary. The program offers care to children 2 to 5 years old and operates Monday through Friday 8:30 AM to 11:30 AM. There were five children and two staff present during the inspection. All areas available to children were inspected. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated and are operable. The facility has central air and heating. Lighting was observed to be in operable condition. LPA observed the required posted documents in the classroom. Children have access to cubbies in the classrooms to store their belongings. This program does not offer nap time since it is a half day program. The isolation area is in the nurse's office if they are on site or in the school age classroom next door since there are no children in the classroom during the time the preschool operates. There are two restrooms in the classroom. One has two toilets and two sinks and the other has one toilet, one urinal and two sinks. General sanitation was observed in all restrooms inspected. Availability of indoor drinking water was observed in the classrooms via a water container and personal water bottles. The facility tested for lead contamination in the water sources used for children on 6/27/23. Per results there were no action level exceedances at the facility. Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Disinfectants and cleaning solutions are stored in locked cabinets under the hand washing sink in the classroom. Medication is stored in a locked box in the classroom. There are no children enrolled who require medication at this time. LPA observed an operable carbon monoxide detector in the classroom. The facility is equipped with a centralized fire alarm system throughout the school. There are no poisons stored at the facility.

Karen Chambers	TELEPHONE: (323) 981-3350
Jeanette Estrada	TELEPHONE: (323) 229-6521
	DATE: 01/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2025

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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LBUSD-STEVENSON CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 191605040
	VISIT DATE: 01/10/2025

NARRATIVE

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The outdoor playground areas were evaluated. The outdoor area is fully enclosed.
Outdoor equipment is in a safe condition, free of sharp, loose or pointed parts. All areas around or under high climbing equipment 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 the water container and water bottles in the classroom which are taken out when children play outside and water fountains
Per facility representative there are no firearms stored on the premises. There are no pools or bodies of water at the facility.
Children’s Records were reviewed for completeness. Children's records contained all required documents and information.
Staff records were reviewed. Facility Representative was reminded Mandated Reporter training and pediatric first aid/cpr shall be completed every two years.
Children's roster was discussed. The program uses a QR code for sign in/ sign out procedures. A paper copy sign in/out sheet is available as a back up as well as an iPad.
Disaster drills are conducted every month and are documented. The last documented emergency drill was conducted on 12/11/24. This program provides lunch to children enrolled. Menus are posted once a month in the classroom where it is visible by the child's authorized representative. Menus are also provided to parents. Menus for the past 30 days are available upon request. Food is provided by the elementary school cafeteria and is delivered to the classrooms. Children with allergies are provided alternatives and allergy lists are maintained in the classroom. At this time, there are no children enrolled who have allergies
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During the inspection LPAs reviewed information regarding the unusual incident report submitted on 11/14/24. The incident occurred on 11/13/24. It was reported that Child 1 fell from one of the play structures and was holding their left arm. Staff attempted to catch Child 1 but were unable to. Staff tended to child and provided an ice pack and called their parent. Parent arrived within 5 minutes and child 1 was taken to the emergency room. Per Program coordinator Child 1 has not attended the program since the day of the incident due to not having medical clearance with no restrictions. There are no deficiencies issued at this time regarding the incident.

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Jeanette Estrada	TELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:	DATE: 01/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2025

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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LBUSD-STEVENSON CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 191605040
	VISIT DATE: 01/10/2025

NARRATIVE

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Facility Representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.
Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for
drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).
LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.
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 PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.
Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.
No citations were issued during today's inspection. A notice of site visit was given to Facility Representative and must remain posted for 30 days.
Exit interview conducted and report was reviewed with Program Coordinator Lindsey Evans.

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Jeanette Estrada	TELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:	DATE: 01/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2025

LIC809 (FAS) - (06/04)

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