191606624-6-21-2022-54-CC-TTRN-CFLUHB-20220621153540

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191606624
Report Date: 06/21/2022
Date Signed: 06/21/2022 03:35:47 PM

Document Has Been Signed on 06/21/2022 03:35 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:	ALOHA HEAD START/STATE PRESCHOOL		FACILITY NUMBER:	191606624
ADMINISTRATOR:	LISA REYNOSO		FACILITY TYPE:	850
ADDRESS:	11737 E. 214TH STREET		TELEPHONE:	(562) 229-7932
CITY:	LAKEWOOD	STATE: CA	ZIP CODE:	90715
CAPACITY:	20	CENSUS: 0	DATE:	06/21/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:35 PM
MET WITH:	Cynthia Santos, CDC Coordinator		TIME COMPLETED:	04:00 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	About 1:35 PM, Licensing Program Analyst (LPA) T. Tran conduct an unannounced a required visit at the above licensed facility. About 1:50 PM, LPA met with Cynthia Santos, CDC Coordinator and toured the facility. Per facility representative, there were no children and staff on site due to summer break. LPA did not observe any children or staff during today’s visit. LPA did not observe any requirements posting due to the facility is not in operation for the Summer. LPA observed the consolidated Covid-19 CHHS postings by the main entrance gate. No staff and children files were reviewed. 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 LPA recommended facility to stay updated with information related to Covid-19 from the California Department of Public Health (CDPH) guidelines, including Centers for Disease Control and Prevention (CDC) guidelines to help prevent and protect staff and children in care. LPA advised to read the Child Care quarterly updates every season as the come out to stay informed of any changes or updates to the regulations and PINs. LPA informed the Child Care Advocate Program (CCAP) provide many other helpful resources to the licensees and the public. Visit www.cdss.ca.gov to receive important updates. LPA informed the effects of lead exposure for children between ages 1-6 years old are the most at risk for lead poisoning. A copy of lead exposure was provided.

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie Tran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 06/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2022

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: ALOHA HEAD START/STATE PRESCHOOL	FACILITY NUMBER: 191606624
	VISIT DATE: 06/21/2022

NARRATIVE

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LPA informed of released PIN 21-15 CCLD related to Kidde Trusense Smoke & combination Smoke/Carbon.
Facility was reminded that smoking is prohibited on the premises.

Facility was informed of responsibility to report suspected Child Abuse by calling the Child Abuse Hotline at 1-800-540-4000. Also call the Community Care Licensing office and follow up with a written Unusual Incident/Injury Report (LIC 624B).

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/process.Facility representative was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

No deficiency was cited at this time. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the facility representative, Cynthia Santos.

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie Tran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 06/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2022

LIC809 (FAS) - (06/04)

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