191870697-3-30-2023-54-CC-DGIS-CQEV2V-20230330160345

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191870697
Report Date: 03/30/2023
Date Signed: 03/30/2023 04:03:54 PM

Document Has Been Signed on 03/30/2023 04:03 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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	EASTMAN AVENUE EARLY EDUCATION CENTER		FACILITY NUMBER:	191870697
ADMINISTRATOR:	ELIZABETH MARES		FACILITY TYPE:	850
ADDRESS:	1266 S. GAGE		TELEPHONE:	(323) 268-7408
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90023
CAPACITY:	114	CENSUS: 55	DATE:	03/30/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:10 PM
MET WITH:	Elizabeth Mares, Facility Representative		TIME COMPLETED:	04:20 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) Denise Gibbs and Rosaura Valenzuela conducted an unannounced annual required inspection at the above facility on 3/30/23 at 2:10 PM. LPAs met with Elizabeth Mares, Facility Representative (FR) who guided analysts on a tour of the facility. There were 55 children and 12 staff present when LPAs arrived. Facility is in compliance with License capacity and Title Five ratio guidelines. All individuals present have obtained a criminal record clearance or criminal record exemption as a condition of employment with the Los Angeles Unified School District. LPAs toured Classrooms #1, #2A/B ,and #3 (General Education/PCC), All classrooms had furniture in good condition, free of loose, sharp and/or pointed parts. The floors and surfaces in the classrooms were clean and safe. LPAs discussed carpets in Room #3 with FR. LPAs did not observe any tripping hazards. Water is made readily available by via water bottles provided by the facility and brought from home. Each classroom also has operable water fountains that are available for children. Per FR, there is no children's medication at the facility currently. Children have cubbies to store personal belongings separate from each other. LPAs observed cots in the classroom for napping with required bedding. Bedding is washed weekly by laundry service. Facility has completed required water lead testing with no Action Level Exceedance (ALE) found. LPAs toured the children’s restrooms. Restroom for Rooms #1 and #2 are located outside the classroom off the hallway. Room#3 has a restroom inside the classroom. Restrooms were observed to be safe and sanitary with operable sinks and toilets. LPAs toured the outdoor play area. Outdoor area was observed to have age appropriate toys and material for children, free of loose, sharp, and/or pointed parts. LPA observed required cushioning under climbing ---------------------PAGE 1

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 03/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023

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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: EASTMAN AVENUE EARLY EDUCATION CENTER	FACILITY NUMBER: 191870697
	VISIT DATE: 03/30/2023

NARRATIVE

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structure to absorb fall. Shade was observed throughout the outdoor area. Water bottles are taken outside for children and water fountains and water fill station are readily available as an option.

LPAs observed required posted documentation which included, Facility License, Publication (PUB) 393- Notification of Parent Rights, Licensing Form (LIC) 610- Facility Disaster Plan, PUB 269- Child Passenger Restraint System, LIC 613A- Notification of Personal Rights and Lunch/Snack Menu. All documents were observed.

Facility records were reviewed for LIC 9040- Facility Roster, 9148- Earthquake Preparedness form, Daily schedule and Disaster drill log, last drill conducted on 3/28/23. All documents were observed.

LPAs reviewed Sign In/Out sheets located in each classroom. All children present were signed in with date, time and full signature children's representative.

LPAs toured the kitchen located off the hallway near Room #1. Facility provides AM snack, PM snack and lunch. Food is not cooked at the facility. Prepackaged food is brought from the neighboring, elementary school. Extra food is sent back to elementary and is not stored in the kitchen. Kitchen was observed to be clean, free of litter, insects and rodents. LPA observed trash cans for solid waste have tight fitting lids. Cleaning supplies are stored separate from the food. Carbon monoxide detector is located in the kitchen was observed and tested.

Children’s records were reviewed at 12:00 PM for Emergency Card, Immunization Records, Licensing Form (LIC) 627- Consent for Medical Treatment, LIC 995 Notification of Parents’ Rights, LIC 701- Physician’s Report, LIC 613A- Personal Rights, and signed Admissions Agreement.

Staff records were reviewed at 12:30PM for approved Pediatric First Aid and CPR certification for at least one staff member, LIC 9052- Employee Rights, Proof of immunization against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to report Child Abuse, Transcripts or Permit and current Mandated Reporter Training Certificate.

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. ----------------------PAGE 2

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 03/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023

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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: EASTMAN AVENUE EARLY EDUCATION CENTER	FACILITY NUMBER: 191870697
	VISIT DATE: 03/30/2023

NARRATIVE

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Incidental Medical Services (IMS):
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a plan for providing 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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm

Based on the LPA observations and record review no deficiencies will be cited today 3/30/23.

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/process.

Facility representative was reminded that all adults 18 and over living or working in the home, 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 Family Child Care Home. 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.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Facility Representative, Elizabeth Mares.

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 03/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023

LIC809 (FAS) - (06/04)

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