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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197405896
Report Date: 03/08/2024
Date Signed: 03/11/2024 08:54:48 AM


Document Has Been Signed on 03/11/2024 08:54 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
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:LAWNDALE SCHOOL DISTRICT-WILLIAM GREEN PRESCHOOLFACILITY NUMBER:
197405896
ADMINISTRATOR:MALDONADO, CLAUDIAFACILITY TYPE:
850
ADDRESS:4520 W. 168TH STREETTELEPHONE:
(310) 370-6345
CITY:LAWNDALESTATE: CAZIP CODE:
90260
CAPACITY:47CENSUS: 14DATE:
03/08/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Isabell Mondoza - Preachool Teacher/Site SupervisorTIME COMPLETED:
03:05 PM
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On 02/08/2024, Licensing Program Analyst (LPA) Cristina Castellanos conducted an unannounced Annual Required Inspection for the facility named above. LPA Castellanos was greeted by Preschool Teacher/Site Supervisor Isabel Mendoza and Instructional Assistant (IA) G. Pina. LPA toured the facility both indoors and outdoors and observed 14 children in care, being supervised and cared for appropriately by 2 fingerprint cleared staff members. Present during today’s inspection were Site Supervisor I. Mendoza and IA G. Pina.

The preschool program operates an AM and PM session. The AM session is from 8:00am to 11:00am and the PM session is from 12:15pm to 3:15pm. LPA observed only classroom P1 (Room 39) being utilized by the preschool program. LPA was informed by Site Supervisor Mendoza that classroom P2 (Room 40) is currently not being used and empty due to low enrollment. At approximatetly 12:45pm LPA Castellanos observed an individual and two children inside classroom P2 (Room 40). LPA knocked on the door an was greeted by Lawndale Elementary School District's Speech Therapist, C. Manchester. The speech therapist disclosed to LPA that room 40 is her office.

Capacity and limitations as specified on the license are not being maintained during todays’ inspection.

All children are under supervision, including visual supervision, of a teacher at all times. The preschool program is in compliance with Title 22 regulations regarding Staff to Student ratios. Parents sign their children in and out of the facility via the Care Connection online application. LPA Castellanos advised administrator to ensure that parents sign using their full legal name.

Currently the facility does not have any preschool children that require medication. Medication, if any is stored in the nurse’s office. LPA discussed with administrator all the necessary paperwork that needs to be included with the medication and reminded that all medication needs to be in its original content with current prescription. The allergy list was observed posted by the entrance door to the classroom.

There are no swimming pools, ponds, or other bodies of water on the premises. There are no firearms or ammunition allowed or stored on the premises. Disinfectants, cleaning solutions, medication and other hazardous items are made inaccessible. All poisons are kept out of the children’s reach, all inaccessible to the children in care.


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SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Cristina CastellanosTELEPHONE: 424-301-3097
LICENSING EVALUATOR SIGNATURE:
DATE: 03/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/08/2024
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
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: LAWNDALE SCHOOL DISTRICT-WILLIAM GREEN PRESCHOOL
FACILITY NUMBER: 197405896
VISIT DATE: 03/08/2024
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The facility has a designated district custodial staff that cleans and disinfects as needed and every day in the evening. Teachers do the day-to-day cleaning in the classroom.

LPA Castellanos observed two fully charged fire extinguishers, a smoke detector, and a working carbon monoxide detector in the classroom. Additionally, the classroom has a Pull Fire Alarm system. LPA observed First Aid Kit next to the parent board near the classroom’s main door. LPA reminded Site Supervisor Mendoza the importance of having the verification of the Disaster and Fire Drills Log available for review.

All toilets and hand washing facilities are in safe and sanitary operating condition. Floors in the facility are clean and safe. LPA Castellanos inspected the classroom and observed age-appropriate toys, books, and furnishings. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts.

Playground equipment is in safe condition, free of sharp, loose, or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. Areas around high climbing equipment, swings and slides have cushioning material to absorb all falls.

Facility provides meals for the AM & PM sessions through the Lawndale Elementary School District (LESD). The menu is posted on the classroom’s parent board. Parents can also review the menu via the Parent Square online application. All kitchen food preparation and storage areas are clean, free of litter/rubbish and free of rodents/vermin. LESD Cafeteria Staff members personally deliver meals to the classroom. Administration was reminded that copies of the menus as served should be dated and kept on file for at least 30 days. The preschool program coordinates with school cafeteria staff to ensure that all dietary restrictions are being adhered to. Solid waste storage containers have tight-fitting covers and are in good repair.

Drinking water is available to the children in care, inside the classroom there is a water fountain. Additionally, children bring in their own refillable water containers and if needed are provided paper cups by facility.

The facility communicates with families via the Parent Square an online application, Class-Dojo, flyers and/or verbal communication during pick-up time.

Prior to working or volunteering in a licensed childcare facility, all individuals subject to a criminal record review have received a criminal record clearance or exemption. Upon notification from the Department, the licensee will comply and


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SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Cristina CastellanosTELEPHONE: 424-301-3097
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024
LIC809 (FAS) - (06/04)
Page: 2 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: LAWNDALE SCHOOL DISTRICT-WILLIAM GREEN PRESCHOOL
FACILITY NUMBER: 197405896
VISIT DATE: 03/08/2024
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act immediately to terminate the employment of, remove from the facility or bar from entering the facility for any person it is deemed necessary while the Department considers granting or denying an exemption.

At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at offsite activities. A current CPR and Pediatric First Aid was observed for administrator Mendoza taken on 8/18/2023. Additionally, Ms. Mendoza holds a Child Development Site Supervisor Permit issued on 02/01/2023. LPA observed ASCIP E-Learning Mandated Reporter Training Certifications (AB1432-23) for both staff members present during today’s inspection. LPA discussed the importance of making sure that all training is from the approved vendor list. LPA discussed the importance of making sure that all Pediatric CPR and Pediatric First Aid training is EMSA approved. LPA Castellanos will set up an appointment with the district office to further review staff’s files.

LPA will follow up with Director Belt-Brown to see if form LIC9226 Request for Training Approval: Mandated Child Abuse Reporter Training provided via email on 01/12/2024 has been mailed out to our Department to see if it has been determined that ASCIP E-Learning training meets the minimum requirements of health and safety code section 1596.8662.

LPA Castellanos reviewed 6 children’s files and observed files to be in compliance including current contact information for authorized representatives and/or relatives who can assume responsibility for the child, immunization records, and authorization for medical treatment.

LPA provided Administrator Mendoza LIC125 and LIC311A forms for further review and reference.

Administrator was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.



Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.
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SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Cristina CastellanosTELEPHONE: 424-301-3097
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024
LIC809 (FAS) - (06/04)
Page: 3 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: LAWNDALE SCHOOL DISTRICT-WILLIAM GREEN PRESCHOOL
FACILITY NUMBER: 197405896
VISIT DATE: 03/08/2024
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For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

Facility provides Incidental Medical Services - IMS. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care­ centers/.

The Administrator was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

LPA Castellanos reminded administrator to access the Community Care Licensing website www.ccld.ca.gov for access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations. Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.



Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, there was one (1) deficiency cited at this time for violation of Title 22 Regulation: (see LIC809-D)

An exit interview was conducted and Plan of Correction was reviewed and developed with Administrator. A copy of this report and appeal rights were discussed and left with administrator Mendoza. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

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SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Cristina CastellanosTELEPHONE: 424-301-3097
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024
LIC809 (FAS) - (06/04)
Page: 4 of 6
Document Has Been Signed on 03/11/2024 08:54 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245


FACILITY NAME: LAWNDALE SCHOOL DISTRICT-WILLIAM GREEN PRESCHOOL

FACILITY NUMBER: 197405896

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 03/08/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101161(a)
Limitations on Capacity and Ambulatory Status
(a) A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview and record review, the licensee did not comply with the section cited above for classroom P2 (Room 40), currently it is being used for the purposes of Therapeutic Services not related to the conditions and limitations specified on the license, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/22/2024
Plan of Correction
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Licensee agrees to notified LPA with a written statement of moving forward with a capacity decrease or continue to use classroom P2 (Room 40) with the conditions and limitations specified on the license by due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Cristina CastellanosTELEPHONE: 424-301-3097
LICENSING EVALUATOR SIGNATURE:
DATE: 03/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/08/2024
LIC809 (FAS) - (06/04)
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