191870890-3-28-2023-54-CC-DGIS-CQD28S-20230328171050

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191870890
Report Date: 03/28/2023
Date Signed: 03/28/2023 05:10:56 PM

Document Has Been Signed on 03/28/2023 05:10 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:	NINETY SEVENTH STREET EARLY EDUCATION CENTER		FACILITY NUMBER:	191870890
ADMINISTRATOR:	ALTHEA SMITH-SIDNEY		FACILITY TYPE:	850
ADDRESS:	430 WEST COLDEN AVENUE		TELEPHONE:	(323) 777-1233
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90003
CAPACITY:	114	CENSUS: 13	DATE:	03/28/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Althea Smith-Sidney, Facility Representative		TIME COMPLETED:	05:15 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 (LPA) Denise Gibbs conducted an unannounced annual required inspection at the above facility on 3/28/23 at 3:00PM. LPA was initially met by Nancy Colocho , Facility Representative One (FR1) who granted access into the facility. LPA spoke with Facility Representative, Althea Smith-Sidney Two(FR2) on the phone who informed she would be arriving shortly. This is a preschool program that operates Monday - Friday from 7:00AM-5:30PM. There were 13 children and eight staff present when LPA 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. LPA toured Classrooms #1, 2A/B, and #3, General Education and Preschool Collaborative (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. Rugs were observed to be flat on the ground to avoid tripping hazards. Water is made readily available via operable water fountains in each classroom. LPA observed children's water bottles from brought from home and water bottles provided by facility. Children have cubbies to store their to store personal belongings separate from each other. Children have cots to nap. Bedding is provided by facility and washed weekly by laundry service. There is extra bedding on hand to change as needed. Per FR2, there are currently children with medication. Medication is stored in the main office, inaccessible to children. LPA reviewed medication expiration dates and required documentation. Facility has completed required water lead testing with no Action Level Exceedance Found (ALE). LPA toured the children’s restrooms. Restrooms were observed to be safe and sanitary with operable sinks and toilets. --------------------PAGE 1

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023

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: NINETY SEVENTH STREET EARLY EDUCATION CENTER	FACILITY NUMBER: 191870890
	VISIT DATE: 03/28/2023

NARRATIVE

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LPA toured outdoor play area. Outdoor play areas were observed to wrap around the facility. Outdoor areas were observed to have age appropriate equipment, toys and material for children. LPA observed required shade throughout the outdoor space. LPA observed operable water fountains and water bottle fill station available for children. LPA did not observed any hazards in the outdoor space.

LPA reviewed required posted documentation outside the main entrance and throughout the facility, which includes, 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 items were observed.

Facility records were reviewed for LIC 9040- Facility Roster, 9148- Earthquake Preparedness form, Daily schedules and Disaster drill log, last drill conducted on 3/6/23. All items were observed.

LPA toured the kitchen on site. Facility provides breakfast, PM snack and lunch. Food is not cooked at the facility. Prepackaged food is brought from the neighboring, elementary school. Extra food is taken back to elementary. Kitchen was observed to be clean, free of litter, insects and rodents. Trash cans for solid waste have tight fitting lids. Cleaning supplies are stored separate from the food. Carbon monoxide detector is wired with facility smoke and fire alarm.

LPA reviewed Sign In/Out sheets located in the front entrance. All children present were signed in with date, time and full signature of the child's representative.

Children’s records were reviewed for Emergency Card with consent for medical, Immunization Records, LIC 995 Notification of Parents’ Rights, LIC 701- Physician’s Report, LIC 613A- Personal Rights, and signed Admissions Agreement. All documents were complete.

Staff records were reviewed for approved Pediatric First Aid and CPR certification, 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. Staff files were complete.

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SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023

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

FACILITY NAME: NINETY SEVENTH STREET EARLY EDUCATION CENTER	FACILITY NUMBER: 191870890
	VISIT DATE: 03/28/2023

NARRATIVE

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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.

Lead Flyer and Earthquake Preparedness forms were provided.

Incidental Medical Services (IMS):
This facility provides Incidental Medical Services- IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personal, and administrative records. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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's observations and records review no deficiencies will be cited today 3/28/23.

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.

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 Althea Smith-Sidney

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SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023

LIC809 (FAS) - (06/04)

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