197411204-3-11-2022-30-CC-JLAO-CCESR2-20220311130536

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197411204
Report Date: 03/09/2022
Date Signed: 03/11/2022 01:06:14 PM

Document Has Been Signed on 03/11/2022 01:06 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	PACE - GREEN HEAD START		FACILITY NUMBER:	197411204
ADMINISTRATOR:	BEATRICE PREYER		FACILITY TYPE:	850
ADDRESS:	4540 W. 168TH STREET		TELEPHONE:	(213) 989-3244
CITY:	LAWNDALE	STATE: CA	ZIP CODE:	90260
CAPACITY:	18	CENSUS: 15	DATE:	03/09/2022
TYPE OF VISIT:	Case Management - COVID-19	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Nilda Santiago and Debbie Kahawji		TIME COMPLETED:	11:30 AM

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On 03/9/2022 at 10:00 am, Licensing Program Analyst (LPA) Judy Laureano conducted an unannounced Case Management – COVID-19 inspection for the purpose of following up on Unusual Incident Report (UIR) submitted on 02/15/2022. LPA Laureano met with Nilda Santiago, Site Lead who toured LPA through the inside and outside of the facility. LPA observed 15 children in care with 2 staff and Site Lead on site. At approximately 10:20 am, Regional Site Director, Debbie Kahwaji arrived to the classroom and met with LPA.

According to the UIR, on 02/15/2022- 3 children were reported as testing positive for COVID-19.

Site Lead stated all of the children and staff who were reported positive COVID have all isolated and have since all returned to the facility. Facility requires all who test positive to quarantine for 10 days and provide a PCR test. All children and staff are tested weekly at facility-Wednesday. Facility will no longer requiere PCR testing at this time. Staff will still be required to test weekly.

During inspection, LPA observed the classroom and outdoor area. Classroom maintains extra supplies such as additional masks, cleaning solutions, gloves, gowns and additional PPE in the classroom. LPA observed soap and paper towels to be available at the handwashing sink area as well as hand sanitizer available throughout the facility.

Site Lead confirmed facility has all visitors check in the main entrance to allow staff to take their temperature. Parents complete a wellness questionnaire before child is able to enter the classroom. LPA Laureano observed COVID-19 signage throughout the facility for mask wearing, washing hands, and stay safe 6 feet apart. All necessary posting for families are available throughout the facility. Regional site director confirmed the use of

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Judy Laureano	TELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2022

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: PACE - GREEN HEAD START	FACILITY NUMBER: 197411204
	VISIT DATE: 03/09/2022

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Class Dojo-online platform, ChildPlus, email and monthly parent meetings as methods to communicate with parents regarding any program updates, especially COVID-19 recommendation.

LPA Laureano observed facility supply of PPE COVID supplies as gloves, hand sanitizing wipes, liquid hand sanitizer, cleaning wipes, children mask, adult masks, thermometers and sanitizing equipment. Site Lead confirmed that custodial staff assists in cleaning nightly and when facility confirms a COVID 19 case, facility has a deep cleaning prior to reopening. Facility staff clean and disinfect every day after class. Facility has the Care and Supervision Team that follow up with Community Care Licensing and the local Department of Health to ensure all protocols are being followed.

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 Regional Director Debbie Kahwaji.

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Judy Laureano	TELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2022

LIC809 (FAS) - (06/04)

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