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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197414773
Report Date: 08/06/2019
Date Signed: 08/06/2019 11:27:53 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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:CORONA ELEMENTARY SCHOOL PKFLPFACILITY NUMBER:
197414773
ADMINISTRATOR:RACHEL SALDANAFACILITY TYPE:
850
ADDRESS:3825 BELL AVENUE RM. 13TELEPHONE:
(323) 560-1323
CITY:BELLSTATE: CAZIP CODE:
90201
CAPACITY:22CENSUS: 0DATE:
08/06/2019
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Rachel Saldana, PrincipalTIME COMPLETED:
11:40 AM
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Licensing Program Analysts (LPAs) Rita Ramos and Alicia Mooberry conducted an announced case management inspection to inspect and measure a classroom due to a temporary room relocation. LPAs met with Rachel Saldana, Elementary School Principal, who guided analysts on a tour of the facility. The Elementary School Principal is designated to oversee this program.

This is a proposed state pre-school program which is operated by LAUSD, and is located on the premises of Corona Elementary School. The state pre-school program will operate in Room 61. Licensee is seeking to continue to provide care for 22 preschool children in Room 61. The facility is currently licensed to operate in Room 13, however, due to the elementary school having construction in several areas which includes Room 13, the Licensee is requesting the temporary room relocation until construction is over. The expected time for construction to complete is January of 2020. The proposed program in Room 61 will operate two sessions. The AM and session will operate from 7:40 AM – 11:40 AM and the PM session will operate from 11:45 AM – 2:45 PM. This program will serve children ages 3 to 4. Per Principal, children will enter from Gate G which can be accessed on Corona street and there will be sign-in and out sheets for parents upon entering Gate G.

All areas identified on the facility sketch were toured both indoors and outdoors; measurements were taken indoors for Room 61. The Licensee has requested that the facility continue to use the same outdoor area that it is currently licensed for. Upon inspecting the facility, LPAs observed that the location of Room 61 is farther from the outdoor yard than what Room 13's distance is. LPAs measured the distance from Room 61 to the outdoor yard and it is 469 feet. LPAs advised the Principal to submit an updated waiver request for the continued use of the outdoor yard to reflect the room change and distance. LPAs did observe, however, that the outdoor playground equipment is in a 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. All areas around or under high climbing equipment, 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 via a water faucet. --Pg 1 of 4
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3439
LICENSING EVALUATOR NAME: Rita RamosTELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2019
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 4
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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: CORONA ELEMENTARY SCHOOL PKFLP
FACILITY NUMBER: 197414773
VISIT DATE: 08/06/2019
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The following corrections must be made and/or submitted prior to granting a new license:
1. The water faucet in Room 61 needs to be functioning.
2. All required forms to be posted need to be posted which includes a menu.
3. First-Aid kit needs to be observed in the classroom.
4. Room 61 needs to be set-up
5. An updated outdoor yard waiver needs to be submitted to reflect the new distance and Room change
6. A facility sketch that reflects the building and location of the restrooms along with the amount of sinks, toilets, and urinals. A sketch to reflect where Room 61 is located and the distance and buildings that children need to walk by to get to the outdoor yard.
7. The restroom signs need to be updated to reflect its use by the preschool children.
8. An updated LIC 200A: Application for a Child Care Center to indicate the correct classroom number, the total capacity amount requested, and the correct county indicated.
9. Updated LIC 501 Personnel Summary
10. A Copy of the the Step 2 Orientation for Rachel Saldana
11. LIC 508 Criminal Record Statement for Principal
12. LIC 9108 Statement Acknowledging the Requirement to Report Child Abuse
13. Pediatric CPR/First Aid card
14. LIC 500 Personnel Report
15. LIC 610 Emergency Disaster Plan
16. Daily Schedule

The above corrections are due on or before 09/06/19.


Exit interview conducted with Rachel Saldana, Principal.
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3439
LICENSING EVALUATOR NAME: Rita RamosTELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4
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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: CORONA ELEMENTARY SCHOOL PKFLP
FACILITY NUMBER: 197414773
VISIT DATE: 08/06/2019
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LPAs provided the Principal with the following documents:
· LIC 311 – Record to be Maintained at the Facility: Child Care Centers, LIC 613A – Personal Rights Form
· PUB 269 – Child Passenger Restraint System Poster, PUB 393 – Parent’s Rights Poster; with Complaint Hotline information and LIC 9040 – Child Care Facility Roster.

Also discussed during this visit:
I. ZERO TOLERANCE includes the following: Refused Entry to a Facility or Any Part of a Facility is a violation of Section 1596.852, 1596.853 or 1597.09. Regulations 101238 (g) (2), The Presence of an Excluded Individual, Fire Clearance Violations, Accessible Bodies of Water, Accessible Firearms, Ammunition or Both.
II. Breakfast/Lunch Menus: Menus are required to be posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days must also be available upon request.
III. Current Children’s Roster: Each child day care facility shall maintain a current roster of children who are provided care in the facility. The roster shall include the name, address, and daytime telephone number of the child's parent or guardian, and the name and telephone number of the child's physician. This roster shall be available to the licensing agency upon request.
IV. Pediatric First Aid and CPR: At least one person trained in Pediatric First Aid and CPR must be present. Per applicant, Teacher’s will have a copy of their teacher permit available.
V. Designated Staff: The name of the child care center director or fully qualified teacher(s) designated to act in the director's absence must be on file.
VI. Qualifications: Educational background, training, and/or experience for each staff present must be available for review. Per applicant, Teacher’s will have a copy of their teacher permit available.
VII. Teacher-Child Ratio: The facility was observed to be meeting the required teacher-child ratio. This program operates under California Code of Regulations, Title 5 which states that contractors shall maintain at least the following minimum teacher-child ratio for preschool programs: 1:8 adult-child ratios, 1:24 teacher-child ratio.
VIII. Children’s Records: must be available for review; 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.

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SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3439
LICENSING EVALUATOR NAME: Rita RamosTELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4
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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: CORONA ELEMENTARY SCHOOL PKFLP
FACILITY NUMBER: 197414773
VISIT DATE: 08/06/2019
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During the inspection LPAs were not able to inspect all equipment and furniture due to Room 61 not being set-up for inspection. LPAs did not observe any of the required forms to be posted on the walls and LPAs observed that the drinking faucet was not functioning. LPAs advised the Principal in regards to having the room ready for inspection and informed the Principal that a 2nd inspection will need to occur.

This facility is proposing that the children enrolled in this program share the restroom with the 1st and 2nd grade elementary school children. LPAs observed that there is a sign on the restroom door that indicates the exclusive use for 1st and 2nd grade children, LPAs advised the Principal to update the sign to reflect the use of the preschool children as well. There are 6 sinks and 9 toilets in the Girls restroom and there is 4 sinks, 5 toilets, and 5 urinals in the boys restroom. While inspecting the Girls restroom, LPAs observed that one of the sinks in not functioning. LPAs advised the Principal to have the sink repaired. A waiver for the shared use of the restrooms has been requested. All floors were observed to be clean and safe.

LPAs did not inspect the kitchen area/food preparation area during this inspection, but informed the Principal that the inspection will be made during the 2nd visit.

There are no bodies of water on the premises.



Applicants state that medication will be stored in the Nurse's office in a locked cabinet. LPAs did not observe a First aid kit in the classroom.

The Nurse's Office will be used as an ill/isolation area. Ill children will use the restroom in the nurse's office if ill. There is a cot/bed available for children to rest if needed. This room was observed to be conducive for children's use at this time.

Incidental Medical Services (IMS): This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A Plan of Operation that includes IMS must be submitted to the Department. 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.
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SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3439
LICENSING EVALUATOR NAME: Rita RamosTELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2019
LIC809 (FAS) - (06/04)
Page: 2 of 4