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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198001757
Report Date: 08/12/2019
Date Signed: 08/12/2019 04:15:32 PM

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:CHRIST LUTHERAN INFANT CENTERFACILITY NUMBER:
198001757
ADMINISTRATOR:CLINTON, LISAFACILITY TYPE:
830
ADDRESS:6500 STEARNS ST.TELEPHONE:
(562) 594-6117
CITY:LONG BEACHSTATE: CAZIP CODE:
90815
CAPACITY:9CENSUS: 4DATE:
08/12/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
03:06 PM
MET WITH:Lisa ClintonTIME COMPLETED:
04:30 PM
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An unannounced Increased inspection was conducted by Licensing Program Analyst, Timothy Fields and Dayna Chambers. Licensing staff met with Director Lisa Clinton who guided analyst on a complete tour of the facility. In the Infant Classroom, LPA observed one teacher supervising four infants. The playground equipment looked to be in good condition.

Rooms identified on facility sketch were inspected. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Cribs are being used for sleeping equipment. General sanitation was observed.

Outdoor area and equipment was inspected for safety, cushioning material, good repair and age appropriateness. Required shade and fencing were inspected. Play area was inspected for hazards and inaccessibility to bodies of water.

Feeding schedule was reviewed. Bottles were reviewed to ensure they were properly labeled. Director states infant food items are brought on a daily basis. First Aid supplies were inventoried. Teacher child ratios were observed and staff names recorded.



Staff and children records were reviewed for completeness including but not limited to Criminal Record Clearances for adults, teacher Qualifications and verification of CPR/First Aid. Review of required forms was made. Director was reminded staff member must be physically present in the napping and activity area.
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Timothy FieldsTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2019
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 2
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: CHRIST LUTHERAN INFANT CENTER
FACILITY NUMBER: 198001757
VISIT DATE: 08/12/2019
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After a complete inspection of the facility, there were no deficiencies observed according to California Code of Regulations Title 22 Division 12 during today's visit.

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


An exit interview was conducted and Appeal procedures explained. A copy of this report was provided.
INTERNET ADDRESS: http://www.ccld.ca.gov – To access licensing forms, updates and Title 22.
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Timothy FieldsTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2