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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191605376
Report Date: 04/26/2022
Date Signed: 04/26/2022 01:28:45 PM


Document Has Been Signed on 04/26/2022 01:28 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:UNITED FAITH COMMUNITY DAY CARE CENTERFACILITY NUMBER:
191605376
ADMINISTRATOR:CAROL SANDERSFACILITY TYPE:
850
ADDRESS:6934 LONG BEACH BLVD.TELEPHONE:
(310) 639-0434
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY:24CENSUS: 10DATE:
04/26/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:Director - Carol SandersTIME COMPLETED:
01:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Randy Derraco conducted an unannounced annual inspection on 04/26/22 at 08:55 am. LPA met with S1, who guided analyst on a tour of the facility. Director, Carol Sanders, arrived at the facility at 9:30 am and continued the tour with LPA. This is a preschool program which consists of two classrooms. Facility operation hours are Monday to Friday from 6:30 AM to 6:00 PM.

All areas identified on this report were inspected. Upon arrival, the following staff were present during this inspection: Room 1 - S1 observed with 5 children in care. LPA observed 5 additional children being dropped off for care at 9:30 am, 9:45 am, and 10:00 am. Teacher-child ratios were observed to be in accordance with Title 22 Regulations. All children were observed to be under visual supervision of a teacher at all times. LPA observed a separate class room with three children and another teacher. Director provided a copy of private school affidavit to LPA.

The following was observed during the tour of the facility:

Children's roster was reviewed and is current. Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. Children present were signed in. Disaster drill log was not available. LPA advised Director that a citation under California Code of Regulations (CCR) section 101174(d)(2) will be issued. LPA observed all required postings at the front entrance.

Furniture and equipment were inspected for age appropriateness and good repair. LPA observed material and equipment to be free of sharp, loose, or pointed parts. Telephone service, heating, lighting and ventilation were evaluated and are operable. Children have their own cubby to store their belongings. Linens are washed by the facislity weekly at the Director's home. Napping equipment (mats) were observed in


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SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy DerracoTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:
DATE: 04/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/26/2022
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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Document Has Been Signed on 04/26/2022 01:28 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: UNITED FAITH COMMUNITY DAY CARE CENTER
FACILITY NUMBER: 191605376

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/26/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101170(e)(1)
Criminal Record Clearance
(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department or

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 05/05/2022
Plan of Correction
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Director states will email proof of background clearance to LPA.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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 CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy DerracoTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:
DATE: 04/26/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/26/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/26/2022 01:28 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: UNITED FAITH COMMUNITY DAY CARE CENTER
FACILITY NUMBER: 191605376

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/26/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101170(e)(1)
Criminal Record Clearance
(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department or

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date:
Plan of Correction
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4
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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 CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy DerracoTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:
DATE: 04/26/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/26/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/26/2022 01:28 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: UNITED FAITH COMMUNITY DAY CARE CENTER
FACILITY NUMBER: 191605376

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/26/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101174(d)(2)
Disaster and Mass Casualty Plan
(d) Disaster drills shall be conducted at least every six months. (d) Disaster drills shall be conducted at least every six months. (2) The drills shall be documented. This documentation shall be kept in the child care center for at least one year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/05/2022
Plan of Correction
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LIcensee states will email a copy of disaster drill log to LPA via email.
Type B
Section Cited
CCR
101218.1(c)
Admission Procedures and Parental and Authorized Representative's Rights
(c) The licensee shall post the PUB 393 (8/02), Child Care Center Notification of Parents' Rights Poster in a prominent, publicly accessible area in the child care center at all times.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/03/2022
Plan of Correction
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no citiation issued. please disregard this citiation. (See LIC 812)

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 CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy DerracoTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:
DATE: 04/26/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/26/2022
LIC809 (FAS) - (06/04)
Page: 4 of 6


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: UNITED FAITH COMMUNITY DAY CARE CENTER
FACILITY NUMBER: 191605376
VISIT DATE: 04/26/2022
NARRATIVE
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separate storage area. Per Director, the isolation area is located in the office. Age appropriate sinks and toilets were inspected for availability and good repair in all restrooms. General sanitation was observed.

Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. According to the Director, medication is not administered at the child care center. Poisons are stored in a locked closet in Room 1. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. First Aid supplies were observed in the classroom.

Menus were reviewed to ensure that they are being posted at least one week in advance and visible to an authorized representative. The facility provides breakfast, snack, and lunch. LPA observed that water is readily available indoors via designated water bottles.

All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish, rodents, and/or any other vermin. All storage containers for solid waste, including moveable bins have tight-fitting covers that are kept on, and in good repair. All foods/beverages are stored in covered containers at 45˚ (F) or less.

Outdoor play equipment was observed to be in good condition, free of sharp, loose or pointed parts. Outdoor activity space surface is maintained in a safe condition as is free of hazards. Areas around and/or under climbing equipment, swings and slides have cushioning material to absorb a fall. The outdoor area had adequate shade. LPA observed that water is readily available outdoors via designated water bottles. The Director states that there are no bodies of water on the premises and LPA did not observe any bodies of water during this visit.

LPA observed that S1 did not obtain criminal record clearance. LPA reviewed State of California Department of Justice printout, dated 06/02/20 for S1, which indicates that "applicant employer's OCA number is missing" therefore fingerprints were rejected. LPA advised Directed that a citation under CCR section 101170(e)(1) will be issued accompanied by a Civil Penalty of $500. There is at least one person trained in CPR and Pediatric First Aid present during this inspection.

Children’s and Staff’s Records were reviewed and are complete.

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SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy DerracoTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:

DATE: 04/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2022
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: UNITED FAITH COMMUNITY DAY CARE CENTER
FACILITY NUMBER: 191605376
VISIT DATE: 04/26/2022
NARRATIVE
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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.html
LPA advised the Director to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

The following deficiencies listed on the attached deficiencies page LIC809D are being cited in accordance with California Code of Regulations Title 22. A violation regarding an uncleared adult working in the facility warrants an immediate civil penalty of $500.00 and is hereby assessed (see LIC 421CR).

Upon receipt of this report, the licensee shall post ANY licensing report documenting a type “A” citation. This must remain posted for 30 days during hours of operation. In addition to posting this report, the licensee will also provide copies to the parents of the children in care and any newly enrolled children for up to one year.

A copy of the LIC 9224 - Acknowledgement of Receipt of Licensing Reports was provided.

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

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted, appeal provided, and report was reviewed with the Director Carol Sanders.

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SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy DerracoTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:

DATE: 04/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2022
LIC809 (FAS) - (06/04)
Page: 6 of 6