191607980-12-7-2021-54-CC-RRAS-C9GQL7-20211207111529

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191607980
Report Date: 12/07/2021
Date Signed: 12/07/2021 11:15:38 AM

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-HOLMES CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	191607980
ADMINISTRATOR:	CHRISTINA CORTEZ		FACILITY TYPE:	850
ADDRESS:	5020 BARLIN AVENUE		TELEPHONE:	(562) 531-8519
CITY:	LAKEWOOD	STATE: CA	ZIP CODE:	90712
CAPACITY:	21	CENSUS: 12	DATE:	12/07/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:55 AM
MET WITH:	Caroline Eskandar & Christina Cortez		TIME COMPLETED:	11:35 AM

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Licensing Program Analyst (LPA) Rita Ramos conducted an unannounced required 1 year inspection to the above facility on 12/07/2021. LPA arrived at the facility at 8:55AM, identified self and met with Caroline Eskabar, Teacher, who guided analyst on a tour of the facility. LPA provided Teacher a copy of the LIC 125 Entrance Checklist to help facilitate the inspection. This is a preschool program which consists of 1 classroom; Room B-36. This facility is located within Oliver Wendell Holmes Elementary school in the city of Lakewood. This facility operates 2 part day sessions from Monday through Friday. The am session is from 8AM to 11AM and the PM session is from 12PM to 3PM. LPA was later met by Coordinating Teacher, Christina Cortez.

All areas identified on this report were inspected. Upon arrival, the following staff were present during this inspection: Room B 36: Staff #1, #2 and #3 with 12 preschoolers. 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 at this facility do not nap due to part day enrollment. Per Coordinating Teacher, the isolation area is located in Room B- 26 . 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 the 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 detector was observed and tested to ensure that it is operable. Children at this facility are escorted to the elementary school cafeteria to receive full meals. LPA and Coordinating Teacher toured the cafeteria. Food storage areas were observed to be clean---Pg 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: 12/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2021

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-HOLMES CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 191607980
	VISIT DATE: 12/07/2021

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and free of litter, rubbish, rodents, and/or any other vermin. Trash cans used to discard food have tight fitting lids.

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. Per Coordinating Teacher, water igloos are brought out when children are outdoors to drink water. LPA 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.

All staff and employees have obtained a criminal record clearance or criminal record exemption as a condition of employment with the Long Beach Unified School District. There is at least one person trained in CPR and Pediatric First Aid present during this inspection.

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

LPA 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 on sanitation principles, housekeeping, including universal health precautions. LPA did not review confidential or medical information due to documents being stored at the administrative office.

Children's roster was reviewed and is current. This facility utilizes electronic sign-in and out. Children present were signed in. Disaster drill log was available, last drill was conducted on 11/17/21.

Menus were observed to be posted. Preschoolers from the AM session are provided with a full breakfast and preschoolers from the PM session are provided with a full lunch. First Aid supplies were observed in the classroom in a box. According to Teacher, medication is only administered to a child when accompanied with a doctor's note and is stored in the classroom.-----Page 2 of 3

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Rita Ramos	TELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:	DATE: 12/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2021

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-HOLMES CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 191607980
	VISIT DATE: 12/07/2021

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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 advised the licensee 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, Christina Cortez.

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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: 12/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2021

LIC809 (FAS) - (06/04)

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