191805782-9-6-2024-54-CC-PBON-D8USRN-20240906140638

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191805782
Report Date: 09/06/2024
Date Signed: 09/06/2024 02:07:13 PM

Document Has Been Signed on 09/06/2024 02:07 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:	CARVER STATE PRESCHOOL		FACILITY NUMBER:	191805782
ADMINISTRATOR:	MARIANA GODINEZ		FACILITY TYPE:	850
ADDRESS:	1425 E. 120TH ST.		TELEPHONE:	(310) 898-6150
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90059
CAPACITY:	40	CENSUS:	DATE:	09/06/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Patrica Allen, Lead Teacher		TIME COMPLETED:	02:15 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	Licensing Program Analysts (LPAs) Portia Bowden and Jeanette Estrada arrived at the above facility to conduct an unannounced Annual Inspection. Upon arrival at 9:30 AM, LPAs met with Lead Teacher Patricia Allen, and provided LIC 125 (Child Care Center entrance check list). At time of visit there were 17 children present and four staff present. The current total enrollment is 20.This facility has two preschool programs, one full day, operating 8:00AM to 3:00PM in Room K-E and an AM program, operating from 8:00AM to 11:00AM in Room K-F. Facility is on the campus of Carver Elementary. All individuals present have obtained a criminal record clearance or criminal record exemption as a condition of employment with Compton Unified School District. At 10:00am, LPAs toured Classrooms K-E and K-F. Classroom K-F did not have a working Air conditioning unit. Outside temperature was 93 degrees while inside temperature was significantly hotter. LPAs observed children in care to be visibly perspiring. LPAs observed a standing fan that was not providing relief. At 12:30PM LPAs observed standing fans to be off while children were napping. LPAs observed child with thick blanket using hands to fan face as she stated she was hot. At 12:35PM Classroom K-F was moved to K-E to provide Air Conditioning for children in care. LPAs observed outside temperature at the time to be 97 degrees. Classroom furniture was in good condition, free of loose, sharp and/or pointed parts. The floors and surfaces in the classrooms were clean and safe. At 10:05AM LPAs observed a sink cabinet in the classroom with two sinks and a child lock on the cabinet doors. At 10:10 am, LPA's observed a water cooler connected to the main water line in the bathroom. Per lead teacher Allen, children are not allowed to access the unit, staff fill up water bottles children bring from home. At 10:30AM LPA's observed hot water spout on water cooler with a child lock making it inaccessible to children. ----------------PAGE 1 of 4-----------------------------------

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Portia Bowden	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2024

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

FACILITY NAME: CARVER STATE PRESCHOOL	FACILITY NUMBER: 191805782
	VISIT DATE: 09/06/2024

NARRATIVE

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At 10:45am LPAs observed operable water fountains in each classroom, per S1 these are never used for drinking. At 10:47 LPAs observed 32 cubbies for children to store personal belongings separate from each other. At 10:50am, Full day classroom, K-E was observed to have 16 cots for napping. Per S2 blankets are brought by families and taken home to be washed once a week. Per S1 and S2 there are currently no children with medication. At 10:52 LPAs observed a fully stocked First aid Kit in both classrooms.

At 10:55AM, LPAs toured the children’s restrooms. Each classroom has two restrooms with 1 small child toilet and one sink. LPAs observed a changing table in the first restroom in the K-E classrom and four tricycles in the second restroom. In classroom K-F LPAs observed cots stacked on wall of one restroom. Per S2 children in care use that restroom.At 11:00AM, LPAs observed outdoor play area to be under construction. LPAs were unable to find Unusal Incident Report for construction. Per S1 children in care are taken in front of bungalow classrooms for outdoor play. LPAs observed age appropriate toys and material for children in a cart. Per S1 Children's water bottles are filled by staff and taken outside for children to access.

At 11:10 AM, LPAs reviewed Sign In/Out sheets located in each classroom. All children present were signed in with the guardian's full signature, date, and time of drop off.

At 11:15AM, LPAs observed required posted documentation which included, Facility License, Publication (PUB) 393- Notification of Parent Rights, PUB 269- Child Passenger Restraint System, Licensing Form LIC 613A- Notification of Personal Rights. Facility records were reviewed for 9148- Earthquake Preparedness form and (LIC) 610- Facility Disaster Plan. Disaster drills are conducted in conjunction with School, last drill conducted in June 2024 prior to school year ending.

At 11:20AM Children’s records were reviewed. Children’s records were reviewed for Licensing Form (LIC) 700- Emergency Identification Record, LIC 627- Consent for Medical Treatment, Immunization Records, LIC 995 Notification of Parents’ Rights, LIC 701- Physician’s Report, LIC 613A- Personal Rights, and signed Admissions Agreement. 2 out 7 children's files were missing a LIC 701 Physicians reports.

At 11:25 AM Staff records were reviewed. Per S1 all personnel files are held at the Compton Unified District Office. LPAs observed Valid Mandated Reporter Training for all Staff on site as well as a current Pediatric CPR/First Aid Certification for S1. LPAs reminded facility staff that a copy of staff records should be kept on site.
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SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Portia Bowden	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2024

LIC809 (FAS) - (06/04)

Page: 7 of 7

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: CARVER STATE PRESCHOOL	FACILITY NUMBER: 191805782
	VISIT DATE: 09/06/2024

NARRATIVE

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At 11:25 AM Staff records were reviewed. Per S1 all personnel files are held at the Compton Unified District Office. LPAs observed Valid Mandated Reporter Training for all Staff on site as well as a current Pediatric CPR/First Aid Certification for S1 and S2. LPAs reminded facility staff that a copy of staff records should be kept on site. LPAs did not observe a waiver on file for Staff records to be kept of site.

Per S1 facility provides Breakfast and lunch from the elementary campus cafeteria. Food is not cooked at the facility. Prepackaged food is delivered daily. Extra food is discarded at the end of the day. Per S1 parents are provided menus and other pertinent information through Parent Square App. At 11:45AM LPAs observed the cafeteria area to be well maintained, free of litter, insects and rodents. At 11:50 AM, LPAs observed Carbon Monoxide detectors wired with smoke/fire alarm.

During inspection all children were observed to be treated with dignity and respect, they were observed to be receiving safe, healthful and comfortable accommodations, furnishings and equipment, and free from corporal and/or unusual punishment.

Facility unable to provide proof of lead testing. LPAs referred Facility Representative to the Department website for lead: Lead Toxicity Prevention and Water Testing Information and PIN 21-21-CCP to obtain additional information and resources.

Facility Representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Portia Bowden	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2024

LIC809 (FAS) - (06/04)

Page: 6 of 7

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: CARVER STATE PRESCHOOL	FACILITY NUMBER: 191805782
	VISIT DATE: 09/06/2024

NARRATIVE

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This facility provides Incidental Medical Services – IMS. Per S1 there are no children in care requiring medicine at this time.

For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

One type A and Three type B deficiencies are being cited today on page LIC 809D. A notice of site visit was given to Facility Representative and must remain posted for 30 days.

A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon their return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled child for the next 12 months. A signed Acknowledgement of Receipt (LIC9224) shall be in each child’s file, acknowledging receipt.

Exit interview conducted and report was reviewed with S1 Lead teachers Patricia Allen and appeal rights given.

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SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Portia Bowden	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2024

LIC809 (FAS) - (06/04)

Page: 5 of 7

Document Has Been Signed on 09/06/2024 02:07 PM - 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CARVER STATE PRESCHOOL	FACILITY NUMBER: 191805782
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/06/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

101239(a)(1)(A)

Fixtures, Furniture, Equipment and Supplies

(A) In areas of extreme heat, the maximum shall be 20 degrees F (11.1 degrees C) less than the outside temperature. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation the licensee did not comply with the section cited above in that the inside temperature was significantly hotter than the outside temperture of 97 degrees, which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 09/07/2024
	Plan of Correction
1 2 3 4	Classroom K-F was moved to Classroom K-E which has an operable air conditioning unit. A plan for additional days of extreme heat shall be submitted by POC due date. Additional days of extreme heat are projected for Monday 9/9/24.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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 Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Portia Bowden	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2024

LIC809 (FAS) - (06/04)

Page: 2 of 7

Document Has Been Signed on 09/06/2024 02:07 PM - 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CARVER STATE PRESCHOOL	FACILITY NUMBER: 191805782
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/06/2024

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
1 2 3 4	Based on observation, interviews and record review, the licensee did not comply with the section cited above in that facility was unable to provide proof of lead testing which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/20/2024
	Plan of Correction
1 2 3 4	Facility will submit proof that lead testing has been completed or an appointment for lead testing will be submitted

Type B

Section Cited

HSC

1596.7995(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 3 out of 4 staff were missing immunization records which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/20/2024
	Plan of Correction
1 2 3 4	Staff will submit proof of required immunizations to LPA via Email.

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 Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Portia Bowden	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2024

LIC809 (FAS) - (06/04)

Page: 3 of 7

Document Has Been Signed on 09/06/2024 02:07 PM - 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CARVER STATE PRESCHOOL	FACILITY NUMBER: 191805782
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/06/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101220(a)

Child's Medical Assessments

(a) Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child. This medical assessment enables the licensee to assess whether the center can provide necessary health-related services to the child. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 2 out of 7 children records were missing a physicians report, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/20/2024
	Plan of Correction
1 2 3 4	Physicians reports will be submitted to LPA via Email.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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 Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Portia Bowden	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2024

LIC809 (FAS) - (06/04)

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