<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198001757
Report Date: 09/09/2022
Date Signed: 09/09/2022 11:51:45 AM


Document Has Been Signed on 09/09/2022 11:51 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: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: 6DATE:
09/09/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:17 AM
MET WITH:Lisa ClintonTIME COMPLETED:
11:55 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 Analyst (LPA) Warren Birks conducted an unannounced Required 1 year inspection. LPA met with Director Lisa Clinton who guided analyst on tour of the facility. This is an infant program serving infants (zero to two years old). The program is physically separate from a preschool program housed on the premises. The facility operates Monday through Friday from 7:00 AM to 6:00 PM.

At approximately 9:25am all areas identified on the Facility Sketch were inspected. LPA observed the following teacher-child ratios during the inspection: Infant Room 1: (One teacher and three infants), Infants Room 6 (One teacher and three infants). Teacher-child ratios appeared to be in compliance and staff fingerprints have the required clearance at this time.

LPA observed all furniture and equipment was inspected for age appropriateness and good repair, telephone service, heating, lighting and ventilation were observed to be adequate. Storage for infants’ belongings and napping equipment/cribs were inspected and found to meet all regulatory requirements at this time. The facility uses a concave changing pad with 3 inch sides. LPA advised Director Clinton to use equipment that is separate from changing pad (facility has been operating like this for years). The padding at least one inch thick and sides at least three inches high. The changing area is also within arm’s reach of a hand washing sink. LPA observed toys to be clean and appear age appropriate. LPA observed first aid kits kept in each classroom. Carbon monoxide detectors and smoke detectors are present in the facility. 2A10BC Fire extinguishers are due for service in May 2023.

Hazardous items including including medicine and cleaning compounds are stored inaccessible areas such as high cabinets and/or storage rooms. At this time, the office is used as an isolation area. There are portable mats for rest and portable changing mats if needed. Parents provide snacks and lunch for the infants However, the facility always has food on hand (if necessary). Some parents provide breast milk for infants.

SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:
DATE: 09/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/09/2022
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 3


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: 09/09/2022
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
26
27
28
29
30
31
32
LPA observed drinking water in each classroom and children have their names labeled on their bottles and cups. Formula and breast milk have labels (along with child information listed) to distinguish one from the other. The parent provides sheets that are sent home to be laundered daily laundered daily (back up sheets are available at the facility). Food preparation areas (snack cabinets) were observed for safety, cleanliness and proper equipment. There is an adequate amount of snacks at the facility.

At approximately 9:45 the outdoor play equipment was inspected for safety, cushioning material, age appropriateness and good repair. LPA observed the outdoor play area to be physically separate from the preschool play area. LPA observed the infant playground to have adequate shade and adequate fencing. There were no bodies of waters and no appearance of immediate hazards on the playground. LPA Birks reminded Director that infants need to have direct care and supervision, including visual supervision of staff at all times.

LPA evaluated care and supervision and determined the basic needs of infants were met. LPA observed digital Sign in and Sign out records to be complete. At approximately 10:00am LPA observed sis of six files to be in compliance during a Children's Records Review. The review ensures children files are complete and have the proper forms (such as Identification and Emergency forms, Immunization records, Health History, Personal Rights, Parents Rights, Needs and service plans, Infant safe sleep forms etc. The children's roster is current).

At approximately 10:30am LPA reviewed Staff Records to ensure: All individuals present have the proper criminal record clearance (or criminal record exemption), education requirements, Criminal Record Clearance documents, CPR/First Aid and health preventative practices, proof of immunization against pertussis and measles and influenza (or flu declination available) etc. LPA observed at least one staff member to have current CPR (Expiration April 2023).

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated 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
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: 09/09/2022
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
26
27
28
29
30
31
32
The following was discussed with Director Clinton: Recently Approved Safe Sleep Regulations in Effect (PIN 20-24-CCP). LPA also informed Director to have staff sleep infants on their backs and check on them at a maximum at least every 15 minutes to check on signs on distress (and document their condition which includes but not limited to labored breathing, flushed skin color, increase in body temperature and restlessness). LPA already provided a copy of Safe Sleep PIN 20-24-CCP.

Rooms that are off-limits need to always be inaccessible during operating hours. Smoking is prohibited. No infant walkers, no infant bouncers, no Johnny Jumpers, no excer-saucers or any other item that falls into that category are allowed in facility. Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your location.


Mandatory Forms for the children’s files and staff files, requirements for fire drills, earthquake drills and documentation were discussed. Last drill conducted August 2022. Role and responsibilities of being a Mandated Reporter were reviewed. The Site Supervisor was advised how to access forms and Regulations online at www.ccld.ca.gov. Site Supervisor was made aware that it is his/her responsibility to know the regulations as well as anyone who assists in providing care.

LPA advised Site Supervisor that all adults 18 years of age and older providing Care & Supervision and/or have continuous presence in the facility shall adhere to a criminal background clearance with the Department of Justice, FBI and Child Abuse Index Check. Records for all children and staff must be maintained for three (3) years after separation from the facility. The Site Supervisor was also advised of the requirement to report Unusual Incidents and/or injuries to the parent/guardian and to CCL within the time frame specified by the regulation.

Exit interview was conducted with Director Lisa Clinton. The facility was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these forms.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2022
LIC809 (FAS) - (06/04)
Page: 3 of 3