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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198004790
Report Date: 08/10/2021
Date Signed: 08/10/2021 10:55:16 AM

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-KFACILITY NUMBER:
198004790
ADMINISTRATOR:TRACIE GUTIERREZFACILITY TYPE:
850
ADDRESS:13817 PIONEER BLVD.TELEPHONE:
(562) 863-5721
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY:20CENSUS: 0DATE:
08/10/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Kristin Muniz, DirectorTIME COMPLETED:
11:10 AM
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Licensing Program Analyst (LPA) T. Tran arrived at the above facility to conduct an announced case management inspection. The preschool has been in inactive status and requested to be reopen by August 16, 2021. LPA met with Center Director, Kristin Muniz and Principal, Lina Vidal-Calderon and about 9:35 AM we toured around the facility. LPA did not observe any children present during today's inspection.
LPA obtained the Covid-1 Self-Assessment questionnaires for the record. The facility had planned and implemented with essential supplies and practices to protect all children, staff, and other.

The preschool is located on the premises of the Church and Elementary school. The facility hours of operation are 7:30 AM- 2:30 PM; Monday-Friday serving 20 preschool children in the preschool classroom. Per director, currently only 9 children enrolled. LPA observed all posting requirements for operation on the posting board LIC 203A-License, LIC-9213-Notice of site visit, 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, Activity Schedule, and consolidation Covid-19 posting.

The facility will be provided AM and PM snack. Children will bring their own lunch and staff will store in the refrigerator located in the classroom. Microwave is available to reheat the food if needed. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Storage for children's individual belongings, isolation area was inspected by the office and additional portable isolation area will be located outside by the preschool classroom with staff supervision. Children napping equipment were observed to be in good condition. Trash can with tight lids, First Aid supplies, smoke detectors; carbon monoxide/fire extinguishers were observed. Paper sign in and out sheet procedures were reviewed. The preschool children will be sharing the Elementary school playground and bathroom. Upon receiving the playground and bathroom waiver, the facility will post it on the licensing board. Play area and bathroom were inspected for hazards free and inaccessibility to bodies of water.
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 08/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2021
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: ST. JOHN OF GOD PRE-K
FACILITY NUMBER: 198004790
VISIT DATE: 08/10/2021
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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

LPA reminded that it is the facility responsibility to know the regulations as well as anyone who assists in providing care. Site supervisor was advised on how to access quarterly reports, forms, and regulations for Child Care online at www.cdss.ca.gov. LPA also 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. LPA informed the Child Care Advocate Program (CCAP) provide many other helpful resources to the licensees and the public. Facility may also register on CCAP website for the new quarterly report to be notified. CCAP’s direct contact information is as followed: Phone number: (916) 654-1541 Email Address: childcareadvocatesprogram@dss.ca.gov

Facility was found to be in substantial compliance at the time of the site inspection.



Exit interview was conducted and copy of report was discussed and given to the noted person.
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 08/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2021
LIC809 (FAS) - (06/04)
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