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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191671293
Report Date: 09/21/2023
Date Signed: 09/21/2023 11:45:36 AM


Document Has Been Signed on 09/21/2023 11:45 AM - 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: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: 30DATE:
09/21/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Candice PearsonTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Warren Birks conducted an unannounced Required 1 year inspection. LPA met with Director Candice Pearson who guided analyst on tour of the facility. This is a preschool program serving children ages two to six years old. The facility operates Monday through Friday from 6:30am to 6:00pm. The facility indoors and outdoors is completely separate from a Church building on the same premises.

The entrance to the facility is latched and parents and visitors enter on the Northside of the school and their are doorbells by the entrance. . Between approximately 9:00am and 9:30am all areas identified on the Facility Sketch were inspected. The classrooms were empty as everyone was on the playground. LPA observed the following ratios outdoors: Three teachers and 30 children. After playtime the children attend the following classrooms: Willow, Ceiba, Cherry Blossoms, Magnolias, Maples, Pines. LPAs observed teacher-child ratios in compliance and staff fingerprints have the required clearances at this time.



LPA observed telephone service, heating, lighting and ventilation to be satisfactory. Children have adequate cubby storage for their belongings. Napping cots are stored appropriately with bedding removed. The facility provides sheets and blankets and weekly laundering. LPA observed drinking water containers with cups available in the classrooms. Age appropriate restrooms, sinks and toilets were inspected for good repair, water temperature, toilet paper, safety and sanitation. All available toilets and sinks are in operable condition. LPA observed semi-inaccessible items such as hand sanitizer and cleaners in inaccessible areas (5ft) or locked cabinets. A technical violation was assessed. The indoor classrooms have surfaces that appear to be clean and safe and there are age appropriate toys and reading material for children to use. There are first aid supplies in each classroom. Other hazardous items including including medicine and cleaning compounds are stored in inaccessible areas such as high cabinets and inaccessible office cabinets. The office is used as an isolation area for ill children and there is child recliner for rest.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:
DATE: 09/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/21/2023
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: ST. LUKE'S PRESCHOOL
FACILITY NUMBER: 191671293
VISIT DATE: 09/21/2023
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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.htmand chairs for rest if necessary. Parents are contacted immediately if children are ill. Director Pearson indicated there are no weapons or bodies of water at the facility and LPA did not observe any.

The outdoor play area is completely surrounded by gates approximately 5 feet high. Areas around and under climbing equipment have wood chip material to cushion a fall. All play equipment, toys, materials and surfaces accessible to children appear to be age appropriate and toxic free. Snacks were reviewed for availability, quantity, expiration dates and appropriateness for children in care. The facility has AM and PM snacks for all children if necessary however the parents provide snacks and lunch for their children. LPA observed the food and kitchen area appear to be in safe and sanitary condition. LPA informed Director to constantly assess expiration dates on food items and to continue to document dates. LPA observed drinking water available (indoors and outdoors) and trash receptacles have tight fitting covers. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are locked and/or inaccessible. The facility has one or more functioning smoke detectors and carbon monoxide detectors that meet statutory requirements. LPA observed a fire extinguisher due for service February 2023. The facility does has not been lead tested before the January 1st, 2023 required date. Director indicated she will schedule and submit evidence of testing.



LPA observed the facility has sign in and sign sheets to ensure children are being properly signed in and signed out by the authorized representative. LPA conducted a Children's Records Review for completeness and to ensure children have proper forms such as Identification and Emergency forms, Immunization records, Health History, Personal Rights, Parents Rights etc.on file.

At approximately 10:00am Staff Records were reviewed to ensure the following: Criminal record clearance or criminal record exemption, education credits, current CPR/First Aid and health preventative practices, proof of immunization against pertussis and measles and influenza and/or flu declination. LPA observed at least one staff member to have current CPR (Expiration Oct 2023). All staff have the required Mandated Reporter training and at least one staff had current expires CPR October 2024.

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.

SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2023
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: ST. LUKE'S PRESCHOOL
FACILITY NUMBER: 191671293
VISIT DATE: 09/21/2023
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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. Mandatory forms for the children’s files and staff files, requirements for fire drills, earthquake drills (last drill July 2022) and documentation were discussed. Role and responsibilities of being a Mandated Reporter were reviewed. The Director was advised how to access forms and Regulations online at www.ccld.ca.gov. Director was made aware that it is his/her responsibility to know the regulations as well as anyone who assists in providing care. LPA advised that inaccessibility of hazards must be constantly reassessed depending on the children in care.


LPA advised Director that all adults 18 years of age and older providing Care & Supervision and having a continuous presence in the facility shall adhere to a criminal background clearance with the Department of Justice, FBI and Child Abuse Index Check. LPA informed Director to log onto web site www.ccld.ca.gov to access forms, regulations and quarterly updates. Records for all children and staff must be maintained for three (3) years after separation from the facility. Report Unusual Incidents and/or injuries to the parent/guardian immediately and to Child Care Licensing within 24 hours and/or the next business day. Visit www.shotsforschool.org for immunization information. All care for children require supervision at all times. If away from the facility, staff must be with children at all times (especially when outdoors). There were no violations of Title 22 requirements at this time.

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.

The Notice of Site Visit (LIC 9213 –must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00 Exit interview was conducted with Director Candace Pearson and a copy of Appeal Rights (LIC 9058) was discussed and provided

SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 09/21/2023 11:45 AM - It Cannot Be Edited

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: 09/21/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.16(a)(1)
Lead Testing
(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview, the licensee did not comply with the section cited above: facility did not get lead testing prior to January 1, 2023 which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/23/2023
Plan of Correction
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Director indicated she will submit lead testing scheduling and results.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:
DATE: 09/21/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/21/2023
LIC809 (FAS) - (06/04)
Page: 4 of 4