191870952-6-23-2022-54-CC-RDEO-CFNUD9-20220623152911

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191870952
Report Date: 06/23/2022
Date Signed: 06/23/2022 03:29:18 PM

Document Has Been Signed on 06/23/2022 03:29 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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	STATE STREET EARLY EDUCATION CENTER		FACILITY NUMBER:	191870952
ADMINISTRATOR:	AVERY VALDEZ		FACILITY TYPE:	850
ADDRESS:	3210 BROADWAY		TELEPHONE:	(323) 589-3718
CITY:	HUNTINGTON PARK	STATE: CA	ZIP CODE:	90255
CAPACITY:	86	CENSUS: 30	DATE:	06/23/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Principal - Kandis Hamblet		TIME COMPLETED:	03:45 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 Analyst (LPA) Randy Derraco conducted an unannounced required one year inspection at the above facility on 06/23/22 at 01:15 PM. LPA met with Kandis Hamblet, Principal, who guided analyst on a tour of the facility. This is a preschool program that operates Monday-Friday from 7:00AM-5:30PM. There were 30 napping children and 13 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 A, B, C and E. 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 water bottles that facility provides to the children and water fountains. Per Principal, water cups are also allowed to be brought from the children's home and filled at the facility. LPA observed children's medication is stored in a cabinet located in a teachers only room. A separate refrigerator designated for medication was also observed in the room. LPA observed storage, expiration dates and documentation for medication. Children have cubbies to store personal belongings separate from each other. LPA observed children using cots to nap. All cots were observed to have required bedding. Bedding is provided by facility and washed weekly by laundry service. There is extra bedding on hand to change as needed. LPA toured the children’s restrooms. Restrooms were observed to be safe and sanitary with operable sinks and toilets. LPA toured outdoor play area. Outdoor area were 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 of 3)

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy Derraco	TELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:	DATE: 06/23/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2022

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 3

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: STATE STREET EARLY EDUCATION CENTER	FACILITY NUMBER: 191870952
	VISIT DATE: 06/23/2022

NARRATIVE

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structure to absorb fall. Shade was observed throughout the outdoor area. Water bottles are taken outdoors for children and water fountains are available.

LPA observed required posted documentation in the main office and on the outside parent board, 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 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 was on on 06/07/22. All items were observed.

LPA toured the kitchen on site. Facility provides breakfast, lunch and snack. Food is not cooked at the facility. Prepackaged food is brought from the neighboring, elementary school. Extra food is discarded into a trash can. Kitchen was observed to be clean, free of litter, insects and rodents. LPA reminded principal that trash cans for solid waste must have tight fitting lids. Cleaning supplies are stored separate from the food. External carbon monoxide detector are located in each of the classrooms and they were observed to be operable.

LPA reviewed Sign In/Out sheets located in each of the classrooms. All children present were signed in with date, time and full signature of the teacher who receives the child. Per Principal, effective 07/01/22, parents will be required to sign their children in and out of the facility. Due to COVID-19 precautions, parents are not entering the facility. Children are dropped off and picked up at the main entrance. A digital daily pass (approved child health assessment) is scanned for added precaution.

Children’s records were reviewed 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. 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 Teacher's Permit and current Mandated Reporter Training Certificate. Documents were discussed.
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SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy Derraco	TELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:	DATE: 06/23/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2022

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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: STATE STREET EARLY EDUCATION CENTER	FACILITY NUMBER: 191870952
	VISIT DATE: 06/23/2022

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. LPA observed that facility still is implementing COVID-19 precautions and procedures as required by Los Angeles Unified School District and the Department of Public Health.

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's observations and records review no deficiencies will be cited today 06/23/22.

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, appeal rights provided and report was reviewed with Principal Kandis Hamblet.

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SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy Derraco	TELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:	DATE: 06/23/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2022

LIC809 (FAS) - (06/04)

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