198004790-3-15-2023-54-CC-JESA-CPXR8F-20230315124752

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198004790
Report Date: 03/15/2023
Date Signed: 03/15/2023 12:48:01 PM

Document Has Been Signed on 03/15/2023 12:48 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:	ST. JOHN OF GOD PRE-K		FACILITY NUMBER:	198004790
ADMINISTRATOR:	TRACIE GUTIERREZ		FACILITY TYPE:	850
ADDRESS:	13817 PIONEER BLVD.		TELEPHONE:	(562) 863-5721
CITY:	NORWALK	STATE: CA	ZIP CODE:	90650
CAPACITY:	20	CENSUS: 13	DATE:	03/15/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Director Kristin Muniz		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	On 3/15/2023 Licensing Program Analyst (LPA) Jeanette Estrada conducted an unannounced required 1 year inspection. LPA met with Director Kristin Muniz who guided analyst on a tour of the facility. This is a preschool program which consists of one classroom. Facility operates from Monday through Thursday 7:30AM to 2:45PM and Fridays 7:30AM to 12:00PM. There were 13 children present with 2 staff when LPA arrived. All staff have approved criminal record clearances. The facility was within its capacity limitations. All areas identified on the facility sketch were inspected. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Children have their own cubby to store their belongings. Children are provided with cots for napping. Per Director, children bring their own bedding and it is taken home weekly to be cleaned. The isolation area used is in theoffice. Ill children use the staff restroom next to the office. The facility has a waiver on file which grants permission to use the same restroom as the elementary school on the premises. Staff accompany children during use of the restroom. Age appropriate sinks and toilets were inspected for availability and good repair. LPA observed 8 toilets and 8 sinks. At the time of the inspection, one toilet was under repair. General sanitation was observed. Availability of indoor drinking water was observed in classrooms via water bottles and a portable water dispenser with a separate water container. Per Director, Staff assist children with the drinking water if they need to re-fill their water bottles. Per Director, the preschool does not use any water source for drinking water or food preparation. Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Per Director, there are no poisons stored at the facility and medications are stored in a cabinet in the classroom, inaccessible to children in care. At this time, no children require medication. An operable combination carbon monoxide/ smoke detector was available in the classroom.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette Estrada	TELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2023

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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ST. JOHN OF GOD PRE-K	FACILITY NUMBER: 198004790
	VISIT DATE: 03/15/2023

NARRATIVE

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The outdoor playground area was evaluated. There is also a waiver for the outdoor play area. Outdoor play area is shared with the elementary school on site. Children are supervised while using the outdoor play area. Per Director, children do not use the large slide on the playground. LPA observed other equipment is in a safe condition, free of sharp, loose or pointed parts. There is adequate shade in the play yard. Children use water bottles during outdoor play time. Per Director there are no firearms stored on the premises. There are no pools or bodies of water at the facility. There is a 2A10BC fire extinguisher available in the classroom which indicates full and was last serviced in 8/2022.
Children’s Records were reviewed for completeness. (The name, address, and telephone number of child’s authorized representative and medical assessment are on file). Children's files reviewed contained the required documents.
LPA also reviewed staff records. Staff records contained all required documents. Director's mandated reporter training for child care providers expires 6/15/23. Staff 2's mandated reporter training for child care providers expires 6/6/24. Director and Staff 2 have pediatric first aid/ cpr issued by the American Red Cross. Director's certification expires 8/4/2024 and Staff 2's certification expires 8/4/2023.
Children's roster was reviewed and is current. Sign-In and Sign-Out sheets were reviewed. Disaster drill log was available, last drills were conducted on 1/30/2023
Food and snacks were reviewed for availability, quantity and appropriateness to children in care. Menus are posted online two weeks in advance for children's authorized representatives. Menus for the past 30 days are available upon request. The facility provides two snacks and children bring lunch from home.
Director 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.
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: Valarie Cook	TELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette Estrada	TELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2023

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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ST. JOHN OF GOD PRE-K	FACILITY NUMBER: 198004790
	VISIT DATE: 03/15/2023

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LPA advised the licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.
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/tion-process.
No deficiencies were cited during this visit.

A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and Appeal Rights and report were reviewed with the Director Kristin Muniz .

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette Estrada	TELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2023

LIC809 (FAS) - (06/04)

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