191607802-3-28-2022-54-CC-AMOY-CCXQNQ-20220328121930

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191607802
Report Date: 03/28/2022
Date Signed: 03/28/2022 06:56:38 PM

Document Has Been Signed on 03/28/2022 06:56 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:	FURGESON ELEMENTARY SCHOOL--STATE PRESCHOOL		FACILITY NUMBER:	191607802
ADMINISTRATOR:	LAURA HERNANDEZ		FACILITY TYPE:	850
ADDRESS:	22215 ELAINE AVENUE		TELEPHONE:	(562) 421-8285
CITY:	HAWAIIAN GARDENS	STATE: CA	ZIP CODE:	90716
CAPACITY:	24	CENSUS: 5	DATE:	03/28/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:50 AM
MET WITH:	Connie Guzman, Teacher		TIME COMPLETED:	12:25 PM

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Licensing Program Analyst (LPA) Alicia Mooberry conducted an unannounced required 1 year inspection to the above facility on 3/28/22. Upon arrival at 9:50 LPA met with Connie Guzman, Teacher, who provided a tour of the facility. LPA provided the LIC 125 Entrance Checklist upon arrival to help facilitate the inspection. This facility is located within Furgeson Elementary School in the city of Hawaiian Gardens.

This is a preschool program that has 1 classroom. The facility operates from Monday through Friday, currently there is an AM class from 8:30-11:30. Upon arrival the following were present: Staff #1, and 5 children.

All areas identified on this report were inspected. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Storage for children's belongings, isolation area for ill children were inspected.

Availability of drinking water was observed indoors, each child has a water bottle. Appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, paper towels, and general sanitation. Disinfectants, cleaning solutions, medication and other dangerous items to children, were observed in overhead cabinet inaccessible to children. There are no poisons stored at the facility.

First Aid supplies were observed and inventoried. Carbon monoxide detectors and smoke detector was observed. The required 2A10BC fire extinguisher was last serviced on 07/2021. Fire/Earthquake drill log last drill conducted on 02/2022.

Children’s emergency information was reviewed. Staff files were not reviewed as staff files are kept at the off site at Main Office and will be reviewed at a later date. If there are any deficiencies during that review, this report may be amended. Per teacher, there are currently no children on medication.

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SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia Mooberry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2022

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: FURGESON ELEMENTARY SCHOOL--STATE PRESCHOOL	FACILITY NUMBER: 191607802
	VISIT DATE: 03/28/2022

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All staff is fingerprint cleared, as a condition of employment through the school district. Staff #1 provided proof of current Pediatric First Aid and CPR certification. Menus were posted. This facility has all meals and snacks delivered.

Care and supervision were evaluated to determine if the basic needs of children are met and appropriate.

This facility uses the play area directly in front of the classroom, there is a waiver for staggered outdoor play schedule with the Kindergarten class. The Kindergarten and the Preschool classrooms do not go out at the same time to play. The outdoor play equipment was inspected for safety, free of sharp, loose pointed parts, good repair and age appropriateness. The surface of the outdoor activity area was observed to be maintained in a safe condition, and free of hazards. All areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with material that absorbs a fall. Required shade, drinking water and fencing were inspected. Drinking water was available outdoors for children to drink freely via a water drinking station; fountain and dispenser. Play area was inspected for hazards and inaccessibility to bodies of water; no bodies of water or hazards were observed.

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

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 roster was reviewed and is current. Sign-In and Sign-Out sheets were reviewed. Children present were signed in.

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

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SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia Mooberry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2022

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: FURGESON ELEMENTARY SCHOOL--STATE PRESCHOOL	FACILITY NUMBER: 191607802
	VISIT DATE: 03/28/2022

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The facility is implementing the latest COVID-19 guidelines by the LA Public Health Department.

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.

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 Teacher Connie Guzman

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SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia Mooberry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2022

LIC809 (FAS) - (06/04)

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