197402309-3-4-2022-30-CC-LJCS-CC7QLM-20220304111610

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197402309
Report Date: 03/04/2022
Date Signed: 03/04/2022 11:16:16 AM

Document Has Been Signed on 03/04/2022 11:16 AM - 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	CCRC HEAD START - VALERIO		FACILITY NUMBER:	197402309
ADMINISTRATOR:	PHUNG PHAM		FACILITY TYPE:	850
ADDRESS:	15035 VALERIO STREET		TELEPHONE:	(818) 786-3427
CITY:	VAN NUYS	STATE: CA	ZIP CODE:	91405
CAPACITY:	41	CENSUS: 0	DATE:	03/04/2022
TYPE OF VISIT:	Case Management - COVID-19	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Phung Pham and Karen Perez		TIME COMPLETED:	11:30 AM

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	On 3/4/2022, Licensing Program Analyst (LPA) Lillian Casillas conducted an unannounced Case Management – COVID-19 inspection to follow up on reported positive cases of COVID-19. Upon arrival, LPA met with the Teacher Designee, Karen Perez, who toured LPA through the inside and outside of the facility. Director Phung Pham arrived at approximately 10:40AM. LPA observed 0 children and 5 staff. According to the Unusual Incident Reports LIC 624 submitted on 01/18/2022- 4 children and 1 staff tested positive for COVID-19. Licensee stated that all children and staff who tested positive for COVID-19 quarantined and were cleared to return to the facility on 2/7/2022 (see LIC 812 COVID-19 Follow Up for additional information about the positive COVID-19 cases). During this inspection, LPA observed COVID-19 related signs/posters throughout the facility. At the entrance, LPA observed a sanitation area with touchless thermometers, face masks, wipes, hand sanitizer, and gloves. LPA observed children's bathrooms fully stocked with soap and paper towels. Classroom materials, books and supplies are stored in cubbies assigned to each individual child. Cubbies feature name tags to differentiate each. Materials and equipment are not shared. The children are kept in small groups of 4. During the visit LPA, Teacher Designee, and Director discussed the following best practices: Arrival Procedures - Children and staff must complete temperature checks and wellness checks every morning before entering the facility. [CONTINUE ON PAGE 2]

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Lillian J Casillas	TELEPHONE: (424) 301-3097
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2022

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: CCRC HEAD START - VALERIO	FACILITY NUMBER: 197402309
	VISIT DATE: 03/04/2022

NARRATIVE

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Face Masks - All children and staff are required to wear a face mask indoors. Face masks will not be required indoors starting 3/12/2022, although the practice remains recommended. Face masks are no longer required outdoors.

Isolation area - Isolation area is located in a nook next to the staff bathroom. LPA observed a love seat in the isolation area. Director explained parents are notified immediately when a child is sick for pickup. A designated staff will stay with the child until the parent arrives.

Cleaning and Disinfecting - The outdoor play area and classrooms are sanitized daily. High-touch surface areas are sanitized throughout the day.

PPE - The facility orders PPE and cleaning supplies directly through CCRC.

Reporting Requirements – Facility is required to report all COVID-19 positives cases to Department of Public Health. In addition, report all positives cases and closure of facility or classrooms to Community Care Licensing (CCL). When reporting Unusual Incidents, call CCL within 24 hours and submit Unusual Incident Report LIC 624 within 7 days.

No deficiencies are cited, per Title 22, Division 12, Chapter 3, of the California Code of Regulations.

An exit interview was conducted and a copy of this report (LIC 809) and Notice of Site Visit were provided to Director.

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Lillian J Casillas	TELEPHONE: (424) 301-3097
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2022

LIC809 (FAS) - (06/04)

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