191890344-2-27-2020-33-CC-MGAA-BM7R62-20200227114402

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191890344
Report Date: 02/27/2020
Date Signed: 02/27/2020 11:44:11 AM

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	EVERGREEN EARLY EDUCATION CENTER		FACILITY NUMBER:	191890344
ADMINISTRATOR:	KARLA CORONA		FACILITY TYPE:	850
ADDRESS:	1027 N EVERGREEN AVE		TELEPHONE:	(323) 269-0406
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90033
CAPACITY:	162	CENSUS: 102	DATE:	02/27/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:39 AM
MET WITH:	Karla Corona, Principal & Leticia Espinoza, Contact Teacher		TIME COMPLETED:	11:50 AM

NARRATIVE

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Licensing Program Analysts (LPAs) Mireya García and Monique Ayala conducted an unannounced annual required inspection. LPA met with Karla Corona, Principal, who guided analyst on a tour of the facility. This is a preschool program which consists of 5 classrooms; RM 1, RM 2, RM 3, RM 4, and RM 5. Facility operation hours are Monday through Friday from 7:00 AM to 5:30 PM.

All areas identified on the Facility Sketch were inspected. Upon arrival, the following staff were present during this inspection: RM 1: Staff #1, #2, #3 and #4, with 26 preschoolers; RM 2: Staff #5, #6 and #7 with 18 preschoolers, RM 3: Staff # 8, #9, and #10 with 19 preschoolers, RM 4: Staff # 11, #12, #13 and #14 with 21 preschoolers and RM 5: Staff #15, #16, #17 and #18 with 18 preschoolers. The following was observed during the tour of the facility:

PHYSICAL PLANT

Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Children have their own cubby to store their belongings. Per Principal, the isolation area is located in the staff lounge. In the staff lounge mat can be placed on the floor for an ill child and the staff restroom is readily available if an ill child requires it. Age appropriate sinks and toilets were inspected for availability and good repair in all restrooms. LPA observed that the facility has one carbon monoxide detector which was tested and is in operable condition. General sanitation was observed. Availability of indoor drinking water was observed inside classrooms.

Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children in all areas. Principal Karla Corona states that there are no poisons stored at the facility.

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SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Mireya Garcia	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2020

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: EVERGREEN EARLY EDUCATION CENTER	FACILITY NUMBER: 191890344
	VISIT DATE: 02/27/2020

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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. There are no trash cans with tight fitting lids in the classrooms. However, Principal states that trash is removed from the classroom right after meal times.

Outdoor playground equipment is in safe condition, free of sharp, loose or pointed parts. LPA Garcia advised Principal that the children need to be within the direct care and supervision, including visual supervision, of the teacher(s) and supervising staff at all times. All areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard. Availability of outdoor drinking water was observed.

FACILITY RECORDS

All individuals present have obtained a criminal record clearance or criminal record exemption. All staff have received an active criminal record clearance as a condition of their employment with the Los Angeles Unified School District. There is at least one person trained in CPR and Pediatric First Aid present during this inspection.

Children’s Records were reviewed for completeness; Inspection of required forms was made. LPA issued the Children’s Record Review (LIC 857) to the Contact Teacher during this inspection. In review of children’s records, files contain information including, but not limited to the following: Name, address and telephone number of the child's authorized representative and of relatives or others who can assume responsibility for the child if the authorized representative cannot be reached when necessary.

Staff Records were reviewed for completeness; Per Principal required forms are available to view at District office however, LPA was able to review Staff binder which includes; Teacher qualifications, CPR, Mandated reporter AB1207 Certificate and immunization records. LPA Garcia will review staff files at the administrative office on 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.

LPA also issued the Confidential Names List (LIC 811) to the Contact Teacher during this inspection. The LIC 857 and the LIC 811 documents the staff names and children’s files that were reviewed during this inspection.

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SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Mireya Garcia	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2020

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: EVERGREEN EARLY EDUCATION CENTER	FACILITY NUMBER: 191890344
	VISIT DATE: 02/27/2020

NARRATIVE

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Children's roster was reviewed and is current. Sign-In and Sign-Out sheets were reviewed. Children present were signed in. Disaster drill log was available, last drill was conducted on 01/30/20.

Food Menus are posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request. Breakfast was reviewed for availability, quantity and appropriateness to children in care. Preschoolers are provided with breakfast, lunch, and p.m., snack by the Los Angeles Unified School District.

First Aid supplies were observed in each classroom in the closets. According to the Principal, medication is only administered to a child when accompanied with a doctor's note and is stored in the locked cabinet in the staff lounge.

Medication: This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

LPA advised the Principal and Contact Teacher to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

At this time, there were no deficiencies cited during today’s inspection.

Notice of Site Visit has been posted (LIC9213). The notice shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.

Exit interview was conducted with Contact Teacher Leticia Espinoza, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.

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SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Mireya Garcia	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2020

LIC809 (FAS) - (06/04)

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