197419324-6-14-2022-54-CC-DGIS-CFDNM7-20220614103439

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197419324
Report Date: 06/14/2022
Date Signed: 06/14/2022 10:34:55 AM

Document Has Been Signed on 06/14/2022 10:34 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	CHILDREN'S COLLECTIVE,INC/CONCORD CDC, THE		FACILITY NUMBER:	197419324
ADMINISTRATOR:	COTO, DILCIA		FACILITY TYPE:	850
ADDRESS:	2828 WEST JEFFERSON BOULEVARD		TELEPHONE:	(310) 733-4388
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90018
CAPACITY:	30	CENSUS: 7	DATE:	06/14/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Dilcia Coto, Facility Representative		TIME COMPLETED:	10:45 AM

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 (LPA) Denise Gibbs conducted an unannounced annual required inspection at the above facility on 6/14/22 at 8:30 AM. LPA met with Dilcia Coto, Facility Representative (FR) who guided analysts on a tour of the facility. There were seven children and three staff present when LPA arrived. Satff One (S1) and S2 were sent from from Child Care Careers, a substitute agency. Facility is in compliance with License capacity and Title 22 ratio guidelines. All individuals present have obtained a criminal record clearance. This is a preschool program. Facility currently has one classroom. Hours of operation are Monday-Friday, 7:30AM-5PM. LPA toured classroom. Classroom had furniture in good condition, free of loose, sharp and/or pointed parts. The floors and surfaces in the classrooms were clean and safe. LPA did not observe any tripping hazards. Water is made readily available by via water bottles provided by parents, water to refill bottles is readily available via a water tank. Per FR, there are currently no children taking medication and there is no medication stored at the facility. Children have cubbies to store personal belongings separate from each other. LPA observed napping cots stored in separate storage area. Bedding is brought by parents and washed weekly. LPA toured the children’s restroom. Restroom was observed to be safe and sanitary with operable sinks and toilets. LPA observed outdoor spaces. Outdoor area was observed to have age appropriate toys and material for children, free of loose, sharp, and/or pointed parts. Shade was observed throughout the outdoor area. Water bottles are taken outside during play time. -------------------------PAGE 1

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2022

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

FACILITY NAME: CHILDREN'S COLLECTIVE,INC/CONCORD CDC, THE	FACILITY NUMBER: 197419324
	VISIT DATE: 06/14/2022

NARRATIVE

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LPA observed required posted documentation 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. All documents were observed.

Facility records were reviewed for LIC 9148- Earthquake Preparedness form, Daily schedule and Disaster drill log, last drill conducted on 6/12/22. All documents were observed.

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

LPA toured the kitchen located adjacent to the classroom. Facility provides Breakfast, PM snack and lunch. Food delivered daily from main facility location. Kitchen was observed to be clean, free of litter, insects and rodents. All storage for solid waste have tight fitting covers. Cleaning supplies are stored separate from the food. Carbon monoxide detector was observed in the classroom and operable. Per FR smoking is prohibited on the the facility premises and there are no firearms or weapons stored at the facility. LPA did not observe smoking or firearms/weapons.

Children’s records were reviewed for Licensing Form (LIC) 700 Emergency Card, Immunization Records, LIC 627- Consent for Medical Treatment, LIC 995 Notification of Parents’ Rights, LIC 701- Physician’s Report, LIC 613A- Personal Rights, and signed Admissions Agreement. All documents complete.

Staff records were reviewed for approved Pediatric First Aid and CPR certification for at least one staff member on site, LIC 9052- Employee Rights, LIC 501- Personnel Record, LIC 503- Health Screening Report, LIC 508- Criminal Record Statement, 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 and current Mandated Reporter Training Certificate. Records complete.

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. --------------------PAGE 2

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2022

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: CHILDREN'S COLLECTIVE,INC/CONCORD CDC, THE	FACILITY NUMBER: 197419324
	VISIT DATE: 06/14/2022

NARRATIVE

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LPA observed that facility is implementing COVID-19 precautions and procedures as recommended by the Department of Public Health.

Incidental Medical Services (IMS):
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a plan for providing 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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm

Based on the LPA’s observations no deficiencies will be cited today 6/14/22.

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 living or working in the home, 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 licensed Family Child Care Home. 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.

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 Dilcia Coto,.------PAGE 3

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2022

LIC809 (FAS) - (06/04)

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