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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191806104
Report Date: 08/19/2019
Date Signed: 08/19/2019 12:27:48 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:DOLORES MISSION WOMEN'S COOPERATIVE CHILD CARE CTRFACILITY NUMBER:
191806104
ADMINISTRATOR:DIANA RAMIREZFACILITY TYPE:
850
ADDRESS:157 S. GLESS ST.TELEPHONE:
(323) 881-0010
CITY:LOS ANGELESSTATE: CAZIP CODE:
90033
CAPACITY:30CENSUS: 12DATE:
08/19/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:55 AM
MET WITH:Azusena Mejia TIME COMPLETED:
12:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Judy Mora conducted an unannounced Annual Random inspection. LPA met with Lead Teacher, Azusena Mejia, who guided LPA on a tour of the facility. This is a preschool age program licensed for 30 children which operates Monday – Friday from 7:00 AM – 5:00 PM. Per Lead Teacher, there are currently 15 children enrolled. Facility Director, Morena Duran, was not present during this inspection.

All areas identified on the facility sketch were inspected. Upon arrival, LPA observed 12 children on the outdoor play ground with 03 staff. Teacher-child ratios were observed to be in accordance with Title 22 regulations. The Licensee is within the conditions, limitations, and capacity specified on the license. Staff names were recorded. All children were observed to be under visual supervision of a teacher at all times.

Furniture and equipment was inspected for good repair, free of sharp, loose, or pointed parts. All indoor classrooms were inspected to ensure that the floors have a surface that is safe and clean. LPA observed the area rug in the classroom to be noticeably soiled with dark spots on it. This is a potential risk to the health and safety of children in care. All toilets and hand washing facilities are in safe and sanitary operating conditions. All materials and surfaces accessible to children are toxic free. At this time, the office is used as an isolation area.
Snack menus were reviewed to ensure that they are being posted at least one week in advance and visible to an authorized representative. The facility provides AM snack, lunch and PM snack. All kitchen, food preparation, and storage areas are clean, free of litter, rubbish, and rodents/vermin. There is drinking water available in indoors and a drinking fountain is available outdoors. All storage containers for solid waste, including moveable bins, have tight fitting covers on and are in good repair. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are stored in an area inaccessible to children. They are kept in the kitchen area which is inaccessible. Storage areas for poisons are locked. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements.

*REPORT CONTINUES ON NEXT PAGE

SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Judy MoraTELEPHONE: (323) 981-3371
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2019
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 4
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: DOLORES MISSION WOMEN'S COOPERATIVE CHILD CARE CTR
FACILITY NUMBER: 191806104
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/19/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/29/2019
Section Cited
CCR
101226(d)(7)
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Health-Related Services
The licensee shall maintain the following first-aid supplies in a location accessible to staff but inaccessible to children:
Thermometer.
This requirement was not met as evidenced by LPA observing no thermometer in any first aid kit at the facility. This is a potential risk to the health and safety of children in care.
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Licensee states a thermometer will be purchased and kept at the facility. LPA will be sent a receipt for purchase or a photo of thermometer in the first aid kit by POC due date of 08/29/19.
Type B
08/29/2019
Section Cited
CCR
101238.3(b)
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Indoor Activity Space
The floors of all rooms shall have a surface that is safe and clean.
This requirement was not met as evidenced by LPA observing the area rug in the classroom to be noticeably soiled with dark spots on it. This is a potential risk to the health and safety of children in care.
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Licensee states the carpet will be cleaned or replaced and photos will be sent to LPA by POC due date of 08/29/19.
Type B
09/19/2019
Section Cited
CCR
101216(f)
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Personnel Requirements
At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities.
This requirement was not met as evidenced
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Licensee stated current certification for Pediatric First Aid and CPR will be sent to LPA by POC due date of 09/19/19.
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by staff file review. LPA observed that staff do not have a current Pediatric First Aid and CPR certification. This is a potential risk to the health and safety of children in care.
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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: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Judy MoraTELEPHONE: (323) 981-3371
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: DOLORES MISSION WOMEN'S COOPERATIVE CHILD CARE CTR
FACILITY NUMBER: 191806104
VISIT DATE: 08/19/2019
NARRATIVE
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LPA advised staff for facility file documents to be updated. LPA provided an LIC 610 Emergency Disaster Plan, LIC 308 Designation of Responsibility, LIC 500 Personnel Report and LIC 309 Administrative Organization. LPA advised that the above documents must be submitted to the Monterey Park Regional Office. LPA also advised staff to submit documentation for the current Site Supervisor.

REMINDER: Failure to obtain a criminal record background check clearances prior to initial presence in the facility will result in an immediate $100.00 dollar or more per day Civil Penalty.

The licensee’s email address was obtained during this visit. The licensee was advised that email is public information.

LPA advised the licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

The deficiencies listed on the following pages were observed by the LPA and are being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809D for deficiencies that are being cited and need to be cleared to protect the children’s health & safety.

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. Appeal Rights and Procedures were explained and provided.

*END OF REPORT

SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Judy MoraTELEPHONE: (323) 981-3371
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: DOLORES MISSION WOMEN'S COOPERATIVE CHILD CARE CTR
FACILITY NUMBER: 191806104
VISIT DATE: 08/19/2019
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Outdoor play equipment was observed to be in good condition, free of sharp, loose or pointed parts. Outdoor activity space surface is maintained in a safe condition as is free of hazards. Lead Teacher states that there are no bodies of water on the premises and LPA did not observe any bodies of water during this visit. Areas around and/or under climbing equipment and slides have rubber cushioning material to absorb a fall. Lead Teacher states there are no weapons or firearms on the premises.

Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. All children were observed to be signed in. Staff Records were reviewed to ensure that a health screening report is on file. Children’s Records were reviewed to ensure that Identification and Emergency form and a medical assessment are on file. Criminal Records Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed. LPA observed that staff do not have a current Pediatric First Aid and CPR certification. This is a potential risk to the health and safety of children in care. LPA observed that there is no thermometer in any first aid kit at the facility. This is a potential risk to the health and safety of children in care.



SB792 Immunization Requirements for Staff and Employees was discussed. All staff have current required immunization's on file.

AB1207 Mandated Child Abuse Reporting – Implementation was discussed. Website provided: https://www.mandatedreporterca.com/training/child-care-providers. All staff have current certificates of completion on file.

Incidental Medical Services (IMS) policy was discussed. Per Lead Teacher, there are no children on medication. 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

*REPORT CONTINUES ON NEXT PAGE

SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Judy MoraTELEPHONE: (323) 981-3371
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2019
LIC809 (FAS) - (06/04)
Page: 2 of 4