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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197418048
Report Date: 11/04/2021
Date Signed: 11/04/2021 04:29:05 PM

Document Has Been Signed on 11/04/2021 04:29 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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:CII/WESTERN HEAD START STATE PRESCHOOLFACILITY NUMBER:
197418048
ADMINISTRATOR:MARGARITA PARRAFACILITY TYPE:
850
ADDRESS:4277 S. WESTERN AVENUETELEPHONE:
(213) 252-4380
CITY:LOS ANGELESSTATE: CAZIP CODE:
90062
CAPACITY: 40TOTAL ENROLLED CHILDREN: 23CENSUS: 12DATE:
11/04/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:10 PM
MET WITH:Janice White, Site SupervisorTIME COMPLETED:
04:45 PM
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Licensing Program Analyst (LPA) T. Tran arrived at the above facility to conduct an unannounced required inspection. Upon entering the facility, LPA observed the consolidated Covid-19 CHHS postings and health screening station. Staff conducted temperature check and logged. LPA met with Janice White, Site Supervisor about 3:30 PM we toured the facility inside and outside.
This is a preschool/toddler Head Start facility with the Infant program on the premises (198400300). The facility hours of operation are (8:00 AM – 4:30 PM; Monday-Friday). LPA observed staff and children were wearing mask indoor and outdoor. The facility obtained current pediatric CPR and First Aid for all facility staff members. All center staff that was present during today’s inspection had fingerprint cleared and associated to the designated license number.
LPA observed all posting requirements for operation on the posting board LIC 203A-License, LIC 610 A-Emergency Disaster Plan, LIC 9148-Earthquake Preparedness Check List, PUB 394-Notification of parent’s rights poster, LIC 613A- Personal Rights, PUB 269- Child Car Seat Law, Menus, and Activity Schedule.
LPA inspected the furniture and equipment for age appropriateness and good repair. Staff rotated learning materials based on children's interest. Telephone service, heating, lighting and ventilation were evaluated. Individual storage for children's belongings and learning materials was observed. Isolation area located in the site supervisor office. Children napping equipment observed to be in good condition. Age appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, paper towels, area safety and sanitation. All classrooms have trash can with tight lids, first aid supplies, smoke detectors; carbon monoxide/fire extinguishers were observed. Per staff, the facility frequently cleaned and disinfected all high-touch surfaces, including toys and learning materials.
The facility provided breakfast, lunch, and snack. All food items get delivered to the site daily by Chefables vendor individually wrapped. Sign in and out sheet procedures were reviewed. The facility roster was up to date and fire and emergency disaster drills were conducted monthly. Emergency disaster plan is updated and reflected to the current operation. Children and staff records were reviewed and in good order. No children required IMS at this time.
Outdoor play area was inspected for free of hazards and inaccessibility to bodies of water. Equipment was inspected for safety, cushioning material, good repair and age appropriateness. Water is accessible indoor and outdoor.
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Tiffanie Tran
LICENSING EVALUATOR SIGNATURE: DATE: 11/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/04/2021
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: CII/WESTERN HEAD START STATE PRESCHOOL
FACILITY NUMBER: 197418048
VISIT DATE: 11/04/2021
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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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
LPA recommended facility to stay updated with information related to Covid-19 from the California Department of Public Health (CDPH) guidelines, including Centers for Disease Control and Prevention (CDC) guidelines to help prevent and protect staff and children in care. LPA advised to read the Child Care quarterly updates every season as the come out to stay informed of any changes or updates to the regulations and PINs. LPA informed the Child Care Advocate Program (CCAP) provide many other helpful resources to the licensees and the public. Visit www.cdss.ca.gov to receive important updates.
LPA informed of released PIN 21-15 CCLD related to Kidde Trusense Smoke & combination Smoke/Carbon
LPA informed the effects of lead exposure for children between ages 1-6 years old are the most at risk for lead poisoning. A copy of lead exposure was provided.
Licensee was informed of responsibility to report suspected Child Abuse by calling the Child Abuse Hotline at 1-800-540-4000. Also call the Community Care Licensing office and follow up with a written Unusual Incident/Injury Report (LIC 624B). Licensee is reminded that smoking is prohibited on the premises.
To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.Facility representative was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated. LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an 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 https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

No deficiency was cited at this time. A notice of site visit was given and must remain posted for 30 days.Exit interview conducted and report was reviewed with the facility representatives, Janice White.

SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Tiffanie Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2021
LIC809 (FAS) - (06/04)
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