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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191671293
Report Date: 09/05/2019
Date Signed: 09/05/2019 12:36:47 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:ST. LUKE'S PRESCHOOLFACILITY NUMBER:
191671293
ADMINISTRATOR:CANDICE PEARSONFACILITY TYPE:
850
ADDRESS:5633 E. WARDLOW ROADTELEPHONE:
(562) 420-7308
CITY:LONG BEACHSTATE: CAZIP CODE:
90808
CAPACITY:61CENSUS: 45DATE:
09/05/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:42 AM
MET WITH:Candice PearsonTIME COMPLETED:
12:49 PM
NARRATIVE
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An unannounced Annual Random inspection was conducted by Licensing Program Analyst (LPA) Timothy Fields. LPA met with Director Candice Pearson and was guided on a complete tour of the facility. Operating hours are 6:30am - 6pm, Monday - Friday. LPA was informed meals are provided by an outside vendor, Family Style Catering.

Children have the option to purchase a meal plan or bring food from home. LPA reviewed the menu along with the required posted licensing documents and sign in/out sheets adjacent to the office. Medication is not administered to children in care. When observed to be sick children are isolated in the office. First aid kits were inventoried.

Four classrooms are used to operate the preschool program. Large partitions are used to divide one classroom into three sections. In the Moonbeam section LPA observed one teacher supervising nine students, in the Rainbow section LPA observed one teacher supervising five children, and in the Sunbeam section LPA observed 11 children supervised by one teacher and one substitute teacher.

In the Clouds classroom LPA observed one teacher supervising four children, in the Stars classroom LPA observed one teacher supervising 10 children, and in the Rain Drops classroom LPA observed six children supervised by one teacher.

Each classroom was inspected for cleanliness and good repair. LPA observed age appropriate toys and equipment. Lighting was in operable condition. LPA inspected children's individual storage space. Floor rugs were in need of cleaning in the Rain drops and Sunbeam classrooms. LPA observed visible dirt stains throughout the rugs.
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SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Timothy FieldsTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:

DATE: 09/05/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2019
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 5
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: ST. LUKE'S PRESCHOOL
FACILITY NUMBER: 191671293
VISIT DATE: 09/05/2019
NARRATIVE
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After a complete inspection of the facility, the following deficiencies were observed according to California Code of Regulations Title 22 Division 12 during today's visit as indicated on the 809D.
  1. The facility has a kitchen staff named Aline Jones employed through the catering vendor Family Styles. Ms. Jones prepared meals in the facility from 8am - 12pm, Monday - Friday. Ms. Jones has been working in the facility for approximately 5 years without a criminal record clearance through the Caregiver Background Check Bureau. A $500 civil penalty was assessed.
  2. The rugs in the Sunbeam and Rain drops classrooms had visible dirt stains.
  3. Sleeping equipment stored in the sectioned classroom was not stored properly. Linen was in contact with one another.

*** Toward the conclusion of the inspections the facility had a drain in the Rain drops classroom and the adjacent bathroom backup causing water to overflow. A plumber was contacted during the inspection. Director states documentation supporting the backup was fixed will be submitted by 9/9/19. Children were moved to the sectioned classroom.

Exit interview conducted with director. Appeal Rights provided and explained. Notice of Site Visit must be posted for (30) days. Failure to do so may result in a $100.00 civil penalty.

INTERNET ADDRESS: http://www.ccld.ca.gov – To access licensing forms, updates and Title 22.

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SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Timothy FieldsTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:

DATE: 09/05/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2019
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: ST. LUKE'S PRESCHOOL
FACILITY NUMBER: 191671293
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/05/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/09/2019
Section Cited

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Criminal Record Clearance:
(1) Obtain a California clearance or a criminal record exemption as required by the Department .

The requirement is not met as evidenced by Kitchen staff Aline Jones working in the
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facility without a criminal record clearance for approximately 5 years. Hours 8am - 12pm, Monday - Friday. This poses an immediate risk to the health and safety of children in care. $500 civil penalty was assessed.
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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) 981-3350
LICENSING EVALUATOR NAME: Timothy FieldsTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:
DATE: 09/05/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/05/2019
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: ST. LUKE'S PRESCHOOL
FACILITY NUMBER: 191671293
VISIT DATE: 09/05/2019
NARRATIVE
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Sleeping equipment was not properly stored in the sectioned classroom. The linen was touching while stored on the individual cots. Children have the option to bring their water from home or the facility will provide drinking water.

LPA inspected the kitchen adjacent to the sectioned classroom. The area was observed to be clean and in operable condition. Food was items were observed to be in good quality during todays inspection. Outdoor area and equipment was inspected for safety, cushioning material, good repair and age appropriateness. Required shade and fencing were inspected. Play area was inspected for hazards and inaccessibility to bodies of water.

Teacher child ratios were observed and staff names recorded. Staff and children records were reviewed for completeness including but not limited to Criminal Record Clearances for adults, staff qualifications and verification of CPR/First Aid.

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

The licensee shall require each recipient (Parent/guardian) of a licensing report documenting a Type A citation resulting from a complaint investigation and any licensing document pertaining to a conference, and any summary of an accusation indicating the Department’s intent to revoke a license, to sign LIC 9224 form, indicating that he or she has received the documents and the date they were received.The licensee shall keep verification of receipt in each child’s file.

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SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Timothy FieldsTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:

DATE: 09/05/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2019
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: ST. LUKE'S PRESCHOOL
FACILITY NUMBER: 191671293
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/05/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/09/2019
Section Cited

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General Sanitation:
Carpeted floors and large throw rugs that cannot be washed shall be vacuumed at least daily and cleaned at least every six months, or more often if necessary.

The requirement is not met as evidenced by
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The rugs in the Sunbeam and Rain drops classrooms had visible dirt stains. This poses a potential risk to the health and safety of children in care.
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Type B
09/09/2019
Section Cited

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Napping Equipment:

Bedding shall be individually stored so that each child's bedding is identifiable and no child's used bedding comes into contact with other bedding.

The requirement is not met as evidenced by
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Sleeping equipment stored in the sectioned classroom was not stored properly. Linen was in contact with one another. This poses a potential risk to the health and safety of
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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) 981-3350
LICENSING EVALUATOR NAME: Timothy FieldsTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:
DATE: 09/05/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/05/2019
LIC809 (FAS) - (06/04)
Page: 5 of 5