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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191870556
Report Date: 07/08/2022
Date Signed: 07/15/2022 01:48:54 PM


Document Has Been Signed on 07/15/2022 01:48 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:CABRILLO AVENUE EARLY EDUCATION CENTERFACILITY NUMBER:
191870556
ADMINISTRATOR:JACKSON, JOSEMIEFACILITY TYPE:
850
ADDRESS:741 W. 8TH ST.TELEPHONE:
(310) 832-2809
CITY:SAN PEDROSTATE: CAZIP CODE:
90731
CAPACITY:116CENSUS: 31DATE:
07/08/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Lizette Torres, Principal TIME COMPLETED:
04:45 PM
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On 7/8/2022 Licensing Program Analyst Dalicia Adkins conducted an unannounced visit to conduct an annual inspection. LPA met with lead teacher who guided LPA on a tour throughout the facility. Principal Torres joined and facilitated the inspection.

This a Preschool Day Care Center with 3 operating classroom with outside play yard. Operation hours are 7:30am-5:30pm. There were children 31 present and 8 teachers.

LPA observed Required posting requirements; Facility license (LIC203) earthquake preparedness checklist (LIC 9148) notification of parents right (PUB 394), Parents Rights Poster (PUB 393), Personal Rights (LIC 613A), Child Care Seat Law (PUB 269), Center Menu, Activity Schedule,

LPA Observed facility safety device requirements; fully charged fire extinguisher (2A:10BC), Carbon Monoxide Detector, Smoke Detectors and Working Landline.


LPA observed facility to be well ventilated with adequate lighting. LPA did not observe any bodies of water on premises. Sing in and Out sheets are located outside near the back gate.

SUPERVISOR'S NAME: Karren StarksTELEPHONE: (424) -30-3038
LICENSING EVALUATOR NAME: Dalicia AdkinsTELEPHONE: (424) 301-3064
LICENSING EVALUATOR SIGNATURE:
DATE: 07/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/08/2022
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CABRILLO AVENUE EARLY EDUCATION CENTER
FACILITY NUMBER: 191870556
VISIT DATE: 07/08/2022
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No poisons were observed during the inspection. detergents, cleaning compounds, and other hazardous items are made inaccessible. Off limits rooms/areas were made inaccessible by locked doors and locked gates.

LAUSD provides breakfast, lunch and snack for children. LPA observed clean food preparation area and refrigerator. Food stored in a safe manner, free from contamination, pets, toxins and cleaners.

LPA observed 3 Classrooms. Restrooms were clean with operable toilets and sinks. LPA observed cots and individual storage for children’s belonging. Furniture and toys observed to be age appropriate and in good repair. Drinking water readily available inside of classrooms.

Outdoor play area is free from defects or dangerous conditions. Play equipment is securely anchored. Playground is enclosed with at least four feet around perimeter. Drinking water is readily available and shaded rest area.

LPA discussed safe sleep regulations; licensee must check infant every fifteen minutes and documents any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants can be visually observed through an open door if sleeping in a separate room. (Individual Infant Sleeping Plan is completed and in file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping. No children under 12 months present during visit, LPA confirmed with licensee that one child is enrolled who is under 12 months. Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. Who provide bottles and pampers. No infants are enrolled in the Preschool Program.


SUPERVISOR'S NAME: Karren StarksTELEPHONE: (424) -30-3038
LICENSING EVALUATOR NAME: Dalicia AdkinsTELEPHONE: (424) 301-3064
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2022
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CABRILLO AVENUE EARLY EDUCATION CENTER
FACILITY NUMBER: 191870556
VISIT DATE: 07/08/2022
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LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. LPA reviewed staff files, mandated reporting completed.

Principal was reminded that all adults 18 and over living or working in at the facility, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption to initial presence in a licensed Child Care Center. 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.

Assembly Bill (AB) 2370 Chapter 676, Statutes of 2018 requires all licensed Child Care Centers constructed before January 1,2010 to test their drinking water for lead contamination between January 1, 2020 and January 1, 2023, and then every five years after the date of the first test.

Instructions for required lead testing are outlined in PIN 21-21. This PIN contain Written Directors, have the same force and effects as the regulations contained in the Title 22 of the California Code of Regulations.

Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.
SUPERVISOR'S NAME: Karren StarksTELEPHONE: (424) -30-3038
LICENSING EVALUATOR NAME: Dalicia AdkinsTELEPHONE: (424) 301-3064
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2022
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CABRILLO AVENUE EARLY EDUCATION CENTER
FACILITY NUMBER: 191870556
VISIT DATE: 07/08/2022
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LPA discussed safe sleep regulations and provided licensee with copy of individual sleeping plan, infant sleep check form - 15 minuet checklist and PIN 20-24-CCP. For additional safe sleep information and resources visit link: http://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep
LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at http://www.cpsc.gov/ and recommended they register all infants’ devices with the CPSC to be notified of any recalls on their purchased equipment
LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Mandated reporting must stay current and renew every two years, www.mandatedreportereporterca.com

IMS/ Americans with Disability Act (ADA): Disability rights laws prohibit child care providers from excluding children solely because they have a disability related need for medication. As a child care provider, you must have an individualized plan included in plan of operation submitted to the department.


Child Care Advocate Program: promotes the delivery of quality child care, link childcareadvocatesprogram@dss.ca.gov

No citations issued during today's 7/8/22 facility inspection.

Exit interview conducted, this report reviewed with principal and copy given.
SUPERVISOR'S NAME: Karren StarksTELEPHONE: (424) -30-3038
LICENSING EVALUATOR NAME: Dalicia AdkinsTELEPHONE: (424) 301-3064
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2022
LIC809 (FAS) - (06/04)
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