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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197402295
Report Date: 10/10/2019
Date Signed: 10/10/2019 01:02:56 PM

COMPREHENSIVE INSPECTION
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:SIERRA PARK ELEMENTARY SCHOOL CSPPFACILITY NUMBER:
197402295
ADMINISTRATOR:DE CARREON,LETICIA ESTRADAFACILITY TYPE:
850
ADDRESS:3170 BUDAU AVENUE ROOM DTELEPHONE:
(323) 223-1081
CITY:LOS ANGELESSTATE: CAZIP CODE:
90032
CAPACITY:21CENSUS: 10DATE:
10/10/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:53 AM
MET WITH:Eva N. Garcia, Interim PrincipalTIME COMPLETED:
01:15 PM
NARRATIVE
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Licensing Program Analyst (LPA) Mireya García conducted an unannounced random inspection visit. Interim Principal, Eva N. Garcia was not available upon LPAs arrival. LPA met with Quyen Ong, Coordinator who guided analyst on a tour of the facility. LPA arrived during AM session.

This is an LAUSD state preschool program CSPP located in RM D on the premises of Sierra Park Elementary School. There were 10 children present upon LPA arrival. This program runs an AM and PM session; (8:00AM – 11:00AM) and (11:30AM – 2:30PM). This program operates under California Code of Regulations Title 5, which states that contractors shall maintain at least the following minimum for preschool: Preschool (36 months to enrollment in kindergarten) - 1:8 adult-child ratio, 1:24 TEACHER-CHILD ratio.

All areas identified on this report were inspected. Upon arrival, the following staff were present during this inspection: Room D: Staff #1 and Staff #2 with 10 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 Staff, the isolation area is located in the nurse’s office. In the nurse’s office a bed is available 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. Children enrolled in this program do not nap. Therefore, there is no napping equipment to be inspected. LPA observed that the facility does not have a carbon monoxide detector. General sanitation was observed. Availability of indoor drinking water was observed inside classroom.

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SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019
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 5
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: SIERRA PARK ELEMENTARY SCHOOL CSPP
FACILITY NUMBER: 197402295
VISIT DATE: 10/10/2019
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 10/04/2019.

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. Lunch was reviewed for availability, quantity and appropriateness to children in care. Preschoolers are provided with breakfast and lunch by the Los Angeles Unified School District.

First Aid supplies were observed and kept in the classroom closet. According to the Staff, medication is only administered to a child when accompanied with a doctor's note. Medication is stored in the nurse’s office and the staff administers the medications which are stored in a locked cabinet. Per Staff, currently there is no child enrolled at this time that requires any medication.

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

The following deficiency is being cited in accordance to Title 22 of the California Code of Regulations and/or Health & Safety codes. Please refer to LIC809D for documentation of deficiency cited.



Exit interview was conducted with Interim Principal, Eva N. Garcia including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role. Interim Principal’ signature on this form acknowledges receipt of these rights.

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SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: SIERRA PARK ELEMENTARY SCHOOL CSPP
FACILITY NUMBER: 197402295
VISIT DATE: 10/10/2019
NARRATIVE
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A copy of this report must be provided to the authorized representatives of all currently enrolled children and must also be provided to newly enrolled children for the next 12 months. The report shall be provided no later than the next business day or the next day the child is in care.

The ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS (LIC9224) shall be signed and kept in each of the children’s records. Web site address to obtain forms, review quarterly updates, review Title 22 & Health & Safety Codes is: www.ccld.ca.gov.

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. Copies of this report must be posted for 30 days in a visible location for the authorized representatives of children.

Page 4 of 4 End of Report---------
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: SIERRA PARK ELEMENTARY SCHOOL CSPP
FACILITY NUMBER: 197402295
VISIT DATE: 10/10/2019
NARRATIVE
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Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children in all areas. Staff #1 states that there are no poisons stored at the facility.

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. There are no trash cans with tight fitting lids in the classrooms. However, Staff #1 states that trash is removed from the classroom right after breakfast and lunch.

Outdoor playground equipment is in safe condition, free of sharp, loose or pointed parts. There is no climbing equipment for this program. LPA García advised Staff 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. Availability of outdoor drinking water was observed.

FACILITY RECORDS

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

Children’s Records were reviewed for completeness; Inspection of required forms was made. LPA issued the Children’s Record Review (LIC 857) to the Interim Principal 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.

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.

LPA also issued the Confidential Names list (LIC 811) to the Interim Principal during this inspection.

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SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: SIERRA PARK ELEMENTARY SCHOOL CSPP
FACILITY NUMBER: 197402295
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/10/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/11/2019
Section Cited

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1596.954- Carbon monoxide detectors required; inspection: Every licensed child day care center shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections.
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This requirement is not met as evidenced by LPA observation and interview with Interim Principal, Teacher and Grounds worker who informed LPA that they did not have any carbon monoxide detector in the premises. This poses an immediate risk to the health and safety of children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 10/10/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/10/2019
LIC809 (FAS) - (06/04)
Page: 5 of 5