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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191871356
Report Date: 06/29/2022
Date Signed: 06/29/2022 12:34:05 PM

Document Has Been Signed on 06/29/2022 12:34 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:LA SANTA CRUZ STATE PRESCHOOLFACILITY NUMBER:
191871356
ADMINISTRATOR:MARIA LABRADAFACILITY TYPE:
850
ADDRESS:2747 WHITTIER BLVD.TELEPHONE:
(213) 262-1123
CITY:LOS ANGELESSTATE: CAZIP CODE:
90023
CAPACITY: 40TOTAL ENROLLED CHILDREN: 22CENSUS: 14DATE:
06/29/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:43 AM
MET WITH:Site Supervisor Angelica Olvera TIME COMPLETED:
12:45 PM
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On 6/29/22 Licensing Program Analyst (LPA) Jeanette Estrada conducted an unannounced required 1 year inspection. LPA initially met with Facility Representative (teacher) Alexandra Ortiz and informed of the purpose of the visit. LPA provided Facility Entrance Checklist to Facility Representative. Site Supervisor Angelica Olvera arrived at approximately 9:30AM. LPA continued the visit with the Site Supervisor. This is a preschool program which consists of 1 classroom. There were a total of 15 children present with 5 staff including the site supervisor. The facility was observed to be within the license capacity and limitations. Criminal Record Clearances for staff present was verified. Operating hours are 6:30AM to 6:00 PM Monday to Friday. The facility provides services to children ages 2-5 years old.
All areas on the facility sketch were inspected. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. There is cental air/heating in the facility. Children have their own cubbies to store their belongings. Napping cots are available for rest time. Each child's bedding was observed to be stored separately from each other. Per facility representative the sleeping linens are sent home on a weekly basis. The Site Supervisor's work area is used as the isolation area for ill children waiting to be picked up. The isolation restroom is the staff restroom in the hall way. There is one restroom available for children in the facility. The restroom has 4 toilets and 3 sinks. General sanitation was observed in the children's restroom. The facility offers potty training. There is a changing table in the restroom.

Availability of indoor drinking water was observed in classrooms via water dispensers. Per Facility Representative, disposable cups are used and staff assist children if needed. Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Cleaning supplies are stored in the kitchen/food preparation room. Classroom has a medication box that is kept out of reach of children - behind the Site Supervisor's work area. Per Facility Representative there are no poisons stored at the facility. There is at least one operable carbon monoxide/ smoke detector in the facility. The facility has a central fire alarm installed. Classroom contains a first aid kit. First aid kit were inventoried.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE: DATE: 06/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/29/2022
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: LA SANTA CRUZ STATE PRESCHOOL
FACILITY NUMBER: 191871356
VISIT DATE: 06/29/2022
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The outdoor playground area was evaluated. The outdoor playground is fully fenced. Outdoor equipment is in a safe condition, free of sharp, loose or pointed parts. All areas around or under high climbing equipment and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard. There is a play structure in the play yard. There are several areas with different activities in the play yard. LPA observed an empty water table in the play yard. Availability of outdoor drinking water was observed via a water dispenser.
Per Facility Representative there are no firearms stored on the premises. There are no pools or bodies of water at the facility. There is a 2A10BC fire extinguisher in the classroom which was last serviced in 11/2021.

Children’s Records were reviewed for completeness.

LPA did not review staff files during the inspection due to the staff files being stored at the administrative office. LPA will review staff files at a later time and date. If staff files were to be incomplete during the time and date that LPA reviews files, a case management inspection will occur at the facility to reflect the incomplete files. 2 staff present had a current Teacher Permits.

Children's roster was reviewed and is current. Sign-In and Sign-Out sheets were reviewed. A disaster drill log was available. Last drill documented was held on 5/23/22


Menus are provided to parents/ authorized representatives one month in advance and the menus are also posted at the entrance to the facility. Menus for the past 30 days are available upon request. The facility provides breakfast, lunch and a PM snack.
Per Site Supervisor, food is prepared at the International Institute of Los Angeles Headquarters and is brought over to the site. Facility staff then set up and distribute the food to children. All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish, rodents, and/or any other vermin. All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids or solid waste bags shall be discarded immediately after each meal. There are no children currently enrolled with food allergies. Alternative food would be provided if any child had a food allergy.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2022
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: LA SANTA CRUZ STATE PRESCHOOL
FACILITY NUMBER: 191871356
VISIT DATE: 06/29/2022
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Incidental Medical Services (IMS) policy was discussed. There are no children currently enrolled who require 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

Facility Representative was reminded that all adults 18 and over, 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 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.


LPA advised the licensee/facility representative how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.
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/tion-process.

No deficiencies are being cited today.

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

Exit interview conducted and Appeal Rights and report were reviewed with the facility representative-Site Supervisor Angelica Olvera .

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2022
LIC809 (FAS) - (06/04)
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