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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191670550
Report Date: 08/09/2021
Date Signed: 08/09/2021 05:33:12 PM

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-BURBANK CHILD DEVELOPMENT CENTERFACILITY NUMBER:
191670550
ADMINISTRATOR:RESHON MOUTRAFACILITY TYPE:
850
ADDRESS:535 JUNIPERO AVETELEPHONE:
(562) 438-4108
CITY:LONG BEACHSTATE: CAZIP CODE:
90814
CAPACITY:74CENSUS: 4DATE:
08/09/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:40 PM
MET WITH:Cristabel Rodriguez, Program CoordinatorTIME COMPLETED:
05:45 PM
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Licensing Program Analyst (LPA) Rita Ramos conducted an unannounced required 1 year inspection on 08/09/21 at 2:40 PM. LPA met with Cristabel Rodriguez, Program Coordinator, who provided LPA a tour of the facility. Also present during the inspection was Tiffany Sanchez, Coordinating Teacher. The facility is located within Burbank Elementary School in the city of Long Beach. There were 4 children present with 3 staff upon arrival.

This facility is currently licensed for a capacity of 74 in Rooms B-24, Room 2 and Room 3. Licensee submitted a request to add Room B-25 but not change the capacity. This program will serve children ages 2 years to 5 years. This program will operate Monday - Friday from 6:30AM to 5:30PM in Rooms 3 and B-24. Licensee would like to licensee Room B-25 for a part- day program that will operate from 8AM to 11AM and use the currently licensed Room 2 as a resource room for small group activities.

All areas identified on the facility sketch were toured both indoors and outdoors; measurements were taken.

This facility utilizes and electronic Sign-In and Sign-Out process via tablets which are located in the classrooms. Sign-In and Sign-Out sheets were readily available to print during the inspection. A health check is conducted prior to children signing in on a daily basis. There is drinking water readily available in the classrooms via a water jug and disposable cups. There is an operable water faucet in the classrooms as well, however, due to COVID-19, the facility will, at this time, provide clean and readily accessible water via the water jug and disposable cups.



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. Linen is taken home each week to be washed for those children who are enrolled in the -----Page 1 of 3
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Rita RamosTELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 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-BURBANK CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191670550
VISIT DATE: 08/09/2021
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Full-Day program. Napping equipment (cots) were observed in a separate storage room. Per Program Coordinator, the isolation area is located in the nurse's office. Age appropriate sinks and toilets were inspected for availability and good repair in all restrooms. LPA observed that facility does have a carbon monoxide detector, smoke detector, and a serviced fire extinguisher.

Disinfectants, cleaning solutions, and other items that are dangerous were observed to be inaccessible. Program Coordinator, states that there are no poisons stored at the facility.

This program provides a breakfast, lunch, and snack for children enrolled (Full-Day Program). If room addition is granted, children in the Part-Day program will be provided with a full breakfast. A weekly menu is available and posted.

All kitchen areas/food preparation areas and food storage areas were observed to be clean and are free of litter, rubbish, rodents, and/or any other vermin. All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids. The facility was observed to be free of flies, other insects and rodents.

Outdoor playground equipment is in a safe condition, free of sharp, loose or pointed parts. LPA Ramos advised Program Coordinator that the children need to be within the direct care and supervision, including visual supervision of the teacher(s) at all times. 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. Availability of outdoor drinking water was observed via faucets, however, due to COVID-19, water jugs and disposable cups will be made available. There are no bodies of water on the premises.

Per Coordinating Teacher, medication is stored in each classroom in locked metal boxes. Currently, there are no children in care that are on medication. First aid kits are available in each classroom and were observed to contain the required first-aid supplies.



All individuals present 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 roster was reviewed and its current. ---Pg 2 of 3
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Rita RamosTELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2021
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-BURBANK CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191670550
VISIT DATE: 08/09/2021
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Children's records were reviewed. The name, address, and telephone number of child’s authorized representative are on file. 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 other staff forms are stored in the administrative office. Children's roster was reviewed and is current. Sign-In and Sign-Out sheets were reviewed. Children present were signed in.

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. UPDATE: LPA provided the Licensee/Director/Principal with a copy of the Effects of Lead Exposure form during the inspection and discussed the following Provider Information Notices (PINs) Required Lead Testing: PIN 20-01 CCP Effects of Lead Exposure, and Guardian User Account Access - PIN 20-20-CCLD.


During this inspection LPA also took measurements: Room B-24 and B-25 each have space for 24 children, Room 3 has space for 25, and Room 2 has space for 11. Licensee requested to add Room B-25 and not change their capacity. Based on the measurements, the facility may be approved to continue their capacity of 74.

This facility requested a waiver to allow preschool children to eat in the cafeteria, a waiver to share the outdoor yard near Rooms B-24 & B-25 with elementary school children, and a waiver to use the elementary school restrooms, which are all pending approval. A fire clearance for a capacity of 74 was granted.


There were no deficiencies cited during today’s inspection. The Notice of Site Visit (LIC 9213) – must remain posted for 30 days. Exit interview was conducted with Cristabel Rodriguez, Program Coordinator, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role. ---Page 3 of 3
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Rita RamosTELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3