191805636-9-28-2023-54-CC-KCHE-CW4U6N-20230928151837

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191805636
Report Date: 09/28/2023
Date Signed: 09/28/2023 03:19:56 PM

Document Has Been Signed on 09/28/2023 03:19 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	ADAMS CHILD DEVELOPMENT PROGRAM		FACILITY NUMBER:	191805636
ADMINISTRATOR:	KAYACAN, GABRIELA		FACILITY TYPE:	850
ADDRESS:	2225 W. ADAMS BLVD.		TELEPHONE:	(323) 735-1424
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90018
CAPACITY:	41	CENSUS: 12	DATE:	09/28/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Gabriela Kayacan, Director		TIME COMPLETED:	03:45 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 09/28/2023 at 1:00 PM an Unannounced Required – 1 Year Inspection was conducted by Licensing Program Analyst (LPA) Katrina Chicote. LPA announced purpose of visit and initially met with Facility Representative and was later joined by Gabriela Kayacan, Director. Facility is currently licensed for a capacity of 41, per Director they currently have 40 children enrolled. The program currently operates Monday thru Friday from 8:00 AM to 4:00 PM, offering part time program sessions M, W, Th 9:00 AM to 12:00 PM and 12:30 PM to 3:30 PM. LPA was taken on a guided tour of the facility of both indoors and outdoors. The facility is made up of three classrooms: RM-1 Mommy and Me, RM-2, and RM-3. Required postings were observed at lobby of facility and inside each classroom. At the initial start of the site visit, LPA observed RM-1 Mommy and Me Room to have two children accompanied by an Authorized Representative with one teacher, RM-2 to have five children with four staff, and RM-3 to have six children with four staff, totaling 11 children and nine teachers present during today's inspection. Beginning at 1:20 PM, furniture and equipment were inspected for age appropriateness and good repair in each classroom. LPA observed surface of classrooms to be safe and clean, and child size tables and chairs available for children well maintained. LPA observed various toys available to engage children available that are well maintained free of loose and sharp parts. Telephone service, heating, lighting and ventilation were evaluated. There were cubbies observed as storage for children's belongings. Per Director, facility does not provide a nap time due to limited program offering but they do allow children to nap based on child's individual needs. Availability of drinking water was reviewed. LPA observed water pitchers with paper cups available for drinking water with a dispenser for refills in the Kitchen. Age appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, area safety and sanitation. LPA observed bathrooms available for RM-2 and RM-3 that each had two toilets and three sinks. LPA observed walk up diaper changing table in each classroom within arm's reach of a sink. Report Continues - Page 1 of 3

SUPERVISOR'S NAME: Denise Gibbs	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2023

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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ADAMS CHILD DEVELOPMENT PROGRAM	FACILITY NUMBER: 191805636
	VISIT DATE: 09/28/2023

NARRATIVE

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LPA observed a first aid kit is kept hanging on the wall in each classroom. Per Director, dual carbon monoxide detectors and smoke detectors were installed in the facility. LPA observed monitors to be plugged near the ceiling and was unable to test it at time of inspection. Director states she can hear the monitor beep from time to time. LPA observed fire extinguishers present at the facility and have been serviced. Per Director, disaster drill is conducted every month and logged. LPA observed disaster drill log last drill conducted on 07/18/2023. Per Director, isolation area for sick children is in Teacher's Office. Per Director, hazardous items including poisonous cleaning compounds are not present at the facility and they only use bleach-water or apple cider vinegar-water solutions for cleaning. LPA observations did not observe these items.

Snack/lunch menus were reviewed and observed posted in each classroom. Per Director, facility proves AM Program AM Snack and Lunch and PM Program PM Snack and Lunch. Food is delivered from a food delivery service and not made at the facility. LPA did observe food preparation area and was toured for safety, cleanliness and proper equipment.

Beginning at 1:32 PM, outdoor equipment was inspected for safety, cushioning material, good repair and age-appropriateness. LPA observed three play areas available in outdoor play area which is accessible through glass doors in each classroom. LPA observed an area with bicycles and bike path that has cushioning material flooring, an area with multi-level play structure that has a slide and climbing equipment with mulch cushioning material below to absorb falls, and another area that has turf grass and planters for gardening. LPA observed all surfaces of outdoor play area to be maintained and free of hazards at time of inspection. Required shade and fencing were inspected. LPA observed a retractable awning providing shade around bike path area and multi-level play structure to be covered with shade. LPA advised that the children need to be within the direct care and supervision, including visual supervision of the teacher(s) at all times. The children have access to water cooler for drinking water. Play area was inspected for hazards and inaccessibility to bodies of water; no bodies of water or hazards observed.

Teacher-child ratios were observed and staff names recorded. Care and supervision was evaluated to determine if the basic needs of children are met and appropriate. Sign-in and out sheets and procedures were reviewed. LPA observed all children present signed in during today's inspection. Personal Rights of children were observed by LPA.

CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES: LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.
Report Continues - Page 2 of 3

SUPERVISOR'S NAME: Denise Gibbs	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2023

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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ADAMS CHILD DEVELOPMENT PROGRAM	FACILITY NUMBER: 191805636
	VISIT DATE: 09/28/2023

NARRATIVE

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Beginning at 2:15 PM, staff and children’s records were reviewed for completeness. Inspection of required forms was made and documented on the LIC 857 for children and the LIC 859 for staff. Criminal Record Clearances were reviewed for adults. CPR card expires in 04/2025 for Staff #3. Staff present did have proof of the AB 1207 Mandated Reporter Training certificate on file.

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

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Facility Representative was reminded that all adults 18 and over in the facility, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed facility. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA advised of the requirement to report Unusual Incidents and/or injuries to the parent/guardian and to CCL within the time frame specified by the regulation.

The facility was found in compliance per Title 22 regulations, there will be no deficiencies cited today.
A notice of site visit was given and must remain posted for 30 days.

Exit interview was conducted and report was reviewed with the Facility Representative, Gabriela Kayacan.
Report Ends - Page 3 of 3

SUPERVISOR'S NAME: Denise Gibbs	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2023

LIC809 (FAS) - (06/04)

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