197417000-3-24-2023-54-CC-DGIS-CQ8UNN-20230324154413

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197417000
Report Date: 03/24/2023
Date Signed: 03/24/2023 03:44:33 PM

Document Has Been Signed on 03/24/2023 03:44 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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	LOCKE EARLY EDUCATION CTR EARLY HEADSTART		FACILITY NUMBER:	197417000
ADMINISTRATOR:	CHARLETHA ROBINSON		FACILITY TYPE:	830
ADDRESS:	320 E. 111TH STREET		TELEPHONE:	(323) 755-0721
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90061
CAPACITY:	18	CENSUS: 6	DATE:	03/24/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Charletha Robinson, Facility Represeatative		TIME COMPLETED:	01:00 PM

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	Licensing Program Analysts (LPAs) Denise Gibbs and Rosaura Valenzuela conducted an unannounced annual required inspection at the above facility on 3/24/23 at 10:00 AM. LPAs met with Charletha Robinson, Facility Representative (FR) who guided analysts on a tour of the facility. There were six children and three staff present when LPAs arrived. Facility is in compliance with license capacity and Title Five ratio guidelines. All individuals present have obtained a criminal record clearance or criminal record exemption as a condition of employment with the Los Angeles Unified School District. This is an Infant program which also houses a Preschool program, facility #191870871. Facility has two classrooms and a nap room. One classroom is currently in use. Entrance to the infant program is separate from the preschool program. LPAs toured the classroom, which is physically separate from preschool. Classroom furniture is in good condition, free of loose, sharp and/or pointed parts. The floors and surfaces in the classrooms were clean and safe free of toxins. Rugs were observed to be flat on the ground to avoid tripping hazards. Toys and material were observed to be age appropriate free of small parts which could be a choking hazard. Water is made readily available by via water bottles that facility provides to the children. Staff transfer water from water bottles to Sippy cups for each child if needed. Children have cubbies to store personal belongings separate from each other. LPA observed cots for nap stored in a separate room. All cots were observed to have required bedding. Bedding is provided by facility and washed weekly by laundry service. There is extra bedding on hand to change as needed. Per FR, children's medication is stored in the main office. LPA observed storage, expiration dates and documentation for medication. Facility has completes required water lead testing with no Action Level Exceedance(ALE) found. Lead results are posted where parent can view them. LPA toured the children’s restroom. Restroom was observed to be safe and sanitary with operable sinks and toilets. There is a changing table in the classroom with raised sides. changing pad material is vinyl and sanitized after each use. Changing table is within arms distance to a sink. ---------------------PAGE 1

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023

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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LOCKE EARLY EDUCATION CTR EARLY HEADSTART	FACILITY NUMBER: 197417000
	VISIT DATE: 03/24/2023

NARRATIVE

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Facility does have a separate crib room that is not currently being used due the age of children in care. All current children sleep on cots in the classroom. LPAs did observe six cribs that were free of hazards. Cribs were observed to have firm mattresses with tightly fitted sheets. Facility has extra bedding on hand to change as needed. Cribs do not block entrances exits. LPAs did not observe toys, bumpers, hanging objects, pillows or blankets in the cribs. Safe Sleep poster observed in nap room.

Infant yards are physically separate from Preschool. Facility has two outdoor areas for infants. One area has a cushioned surface for younger infants and the other yard has both cushioned and concrete surface for older infants. Outdoor areas were observed to have age appropriate toys and material for children, free of loose, sharp, and/or pointed parts. LPA observed required cushioning under climbing objects. Shade was observed throughout the outdoor area. Water is taken outside for children.

LPA observed required posted documentation in infant main entrance, which included, Facility License, Publication (PUB) 393- Notification of Parent Rights, Licensing Form (LIC) 610- Facility Disaster Plan, PUB 269- Child Passenger Restraint System, LIC 613A- Notification of Personal Rights and Lunch/Snack Menu.

Facility records were reviewed for LIC 9040- Facility Roster, 9148- Earthquake Preparedness form, Daily schedule and Disaster drill log, last drill conducted on 2/24/23. All items were observed.

LPA toured the kitchen on site. Facility provides AM snack, PM snack and lunch. Food is not cooked at the facility. Prepackaged food is brought from the neighboring, elementary school. Extra food is stored in the kitchen. Expiration dates were reviewed for stored food and beverages. Kitchen was observed to be clean, free of litter, insects and rodents. LPA observed trash cans for solid waste have tight fitting lids. Cleaning supplies are stored separate from the food. Per FR, carbon monoxide detector is wired to smoke detector main system. Facility provides pureed food, formula, and infant cereal for younger infants. LPAs observed age appropriate dishes and utensils and sippy cups were labeled with the child's name.

LPA reviewed Sign In/Out sheets located in the main entrance. All children present were signed in with date, time and full signature of the child's parent or guardian.

Children’s records were reviewed for Emergency Card, Immunization Records, Licensing Form (LIC) 627- -----PAGE 2

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023

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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LOCKE EARLY EDUCATION CTR EARLY HEADSTART	FACILITY NUMBER: 197417000
	VISIT DATE: 03/24/2023

NARRATIVE

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Consent for Medical Treatment, LIC 995 Notification of Parents’ Rights, LIC 701- Physician’s Report, LIC 613A- Personal Rights, LIC 9227 Individual Sleep Plan (0-12 months), 15 minute sleep check, Needs and Service Plan and signed Admissions Agreement. Documents were discussed and noted. LPAs did not observe documentation for 15-minute sleep check. Per FR, they will be implementing the sleep check on Monday 3/27/23. Infant needs and Service Plan and LIC 9227 was discussed with FR.

Staff records were reviewed for approved Pediatric First Aid and CPR certification, LIC 9052- Employee Rights, Proof of immunization against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse, Transcripts or Permit and current Mandated Reporter Training Certificate. Staff files are complete

LPA's observed children just turned two years old in the infant classroom. Per FR, in order to move to the preschool program children have to be fully potty trained. Parents are informed of this after the child turns one year and resources are given to parents to help the partnership between school and home. The children that are still in the infant program due to developmental delays, but should be transitioning soon. LPA advised that the FR request an exception for children with medical needs.

During inspection all children were observed to be treated with dignity and respect, they were observed to be receiving safe, healthful and comfortable accommodations, furnishings and equipment, and free from corporal and/or unusual punishment.

Incidental Medical Services (IMS):
This facility provides Incidental Medical Services- IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personal, and administrative records. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm

Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. --------------------PAGE 3

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023

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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LOCKE EARLY EDUCATION CTR EARLY HEADSTART	FACILITY NUMBER: 197417000
	VISIT DATE: 03/24/2023

NARRATIVE

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Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Facility Representative Charletha Robinson.

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/24/2023 03:44 PM - 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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LOCKE EARLY EDUCATION CTR EARLY HEADSTART	FACILITY NUMBER: 197417000
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/24/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101419.2(a)

Infant Needs and Services Plan

(a) Prior to the infant's first day at the center, the infant care center director or assistant director shall complete a needs and services plan for the infant. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 5 out of 5 children's files which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/24/2023
	Plan of Correction
1 2 3 4	Per FR, she will tailor a document to the facility and begin implementing assessment on Monday 3/27/23. FR will email a completed needs assessment to LPA by POC date 4/24/23.

Type B

Section Cited

CCR

101429(a)(2)(C)(3)

Responsibility for Providing Care and Supervision for Infants

(C) Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: (3) Time of each 15-minute check This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 5 out 5 children's files, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/31/2023
	Plan of Correction
1 2 3 4	FR corrected during inspection. Document was created during inspection and given to staff to start implementation.

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: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023

LIC809 (FAS) - (06/04)

Page: 5 of 6

Document Has Been Signed on 03/24/2023 03:44 PM - 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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LOCKE EARLY EDUCATION CTR EARLY HEADSTART	FACILITY NUMBER: 197417000
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/24/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101226(e)(3)(A)

Health-Related Services

(e) In centers where the licensee chooses to handle medications: (3) Prescription medications may be administered if all of the following conditions are met: (A) Prescription medications shall be administered in accordance with the label directions as prescribed by the child's physician. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above. C5 had expired medication. C5 was not present at facility during inspection, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/31/2023
	Plan of Correction
1 2 3 4	FR called parent during inspection and email a her a new request for medication. Parents stated that she will contact the doctor. FR will send updated documentation and picture of new medication by POC date 3/31/23. Chid will not return until medication is updated.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023

LIC809 (FAS) - (06/04)

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