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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198005460
Report Date: 06/08/2022
Date Signed: 06/08/2022 04:16:17 PM


Document Has Been Signed on 06/08/2022 04:16 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:AL HADI ELEMENTARY SCHOOLFACILITY NUMBER:
198005460
ADMINISTRATOR:ALI SLEIMANFACILITY TYPE:
850
ADDRESS:5150 E. GAGE AVETELEPHONE:
(323) 771-9135
CITY:BELLSTATE: CAZIP CODE:
90201
CAPACITY:60CENSUS: 25DATE:
06/08/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Ali Sleiman, DirectorTIME COMPLETED:
04:15 PM
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Licensing Program Analysts (LPAs) Alicia Mooberry and Austin Estrada conducted an Annual Inspection on this date. At 12:15pm LPAs met with Ali Sleiman, Director who provided a tour of the facility. The facility shared the building with a private school. The private school is located on one side of the building and not share the playground the common areas are not used at the same time by the preschool and private school. The preschool facility consists of 2 classrooms: Pre-K 1 and Pre-K 2, located at the entrance to the school. There were 12 children and 2 staff in Pre-K 2 and 13 children and 2 staff in Pre-K 2. Per Director, Hours of operation are 8:00am-2:20. All staff present has obtained background clearance. LPA reminded Director not to commingle the children form the private school and preschool.

The two classrooms were inspected for cleanliness and good repair. The carpets were clean and lighting was in operable condition. There were age appropriate toys and equipment. Children have individual cubbies where sheets and lunch boxes are stored. The facility does not provide meals. Snacks are available for children in care. LPA advised to keep snack stored properly to avoid contamination and pests.

Sign-in sheets were reviewed in the classroom and office. All children present were signed in. LPA reminded Director to ensure a parent's full and legible signature is obtained. There are first aid kits in each classroom and a first aid kit located in the office.

LPAs observed that there is no carbon monoxide detector missing from both classrooms, this poses a potential risk to the health and safety of children in care.

There drinking water is available from a water dispenser in each of the classrooms and drinking fountains outdoors.

Medication is not administered to children in care.

The restroom used by the pre-school is located in the hallway next to Pre-K 1, and observed to be clean and in operable condition. Outdoor area and equipment was inspected for safety, cushioning material, good repair and age appropriateness. Page 1

SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 06/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/08/2022
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: AL HADI ELEMENTARY SCHOOL
FACILITY NUMBER: 198005460
VISIT DATE: 06/08/2022
NARRATIVE
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At 12:52pm LPAs observed rotting wood beams on building connected to the children's play area with exposed nails. This poses an immediate risk to the health and safety of children in care. Per Director, the wood will be removed and repaired. Required shade and fencing were observed. Play area was inspected for hazards and inaccessibility to bodies of water. Teacher child ratios were observed and staff names recorded. Facility records were reviewed for LIC 9040- Facility Roster, 9148- Earthquake Preparedness form, Daily schedule and Disaster drill log, last drill conducted on May 10, 2022.

Children’s records were reviewed at for Emergency Card, Immunization Records, LIC 995 Notification of Parents’ Rights, LIC 701- Physician’s Report, LIC 613A- Personal Rights, and signed Admissions Agreement. The LIC 700 was missing for 6 out of 6 children's files reviewed, this poses a potential risk to the health and safety of children in care.

Staff records were reviewed for approved Pediatric First Aid and CPR certification, LIC-501: Personnel Record, LIC 503- Health Screening, LIC 508- Criminal Record Statement, LIC 9052- Employee Rights, Proof of immunization's against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse, Transcripts or Permit and current Mandated Reporter Training Certificate. LPA observed 4 out of 4 staff were missing the Mandated Reporter Training (AB1207) certificate, this poses a potential risk to the health and safety of children in care. Director was advised to complete the Mandated Reporter Certificate every 2 years https://mandatedreporterca.gov.

LPA discussed COVID-19 precautions and procedures. For the latest guidance on COVID-19 visit your local health department.

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

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SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 06/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2022
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: AL HADI ELEMENTARY SCHOOL
FACILITY NUMBER: 198005460
VISIT DATE: 06/08/2022
NARRATIVE
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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.

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

Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety

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, Ali Sleiman. Appeal right were discussed and a copy provided.

SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 06/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2022
LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 06/08/2022 04:16 PM - It Cannot Be Edited

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: AL HADI ELEMENTARY SCHOOL
FACILITY NUMBER: 198005460

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/08/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.954
Licensure Requirements
Every licensed child day care center shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above due to the required Carbon monixide detectors were not found in 2 out of the 2 classrooms which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/15/2022
Plan of Correction
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Per Director the carbon monoxide detectors will be placed inside the classroom and a photo of the correction will be sent to LPA by email by POC due date
Type B
Section Cited
CCR
101238(a)
Buildings and Grounds
(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in that a rotting wood beams on building connected to the children's play area accessible to children which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/22/2022
Plan of Correction
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Per Director, the wood beams will be removed and repaired, a photo of correction will be sent to LPA by POC due date.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 06/08/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/08/2022
LIC809 (FAS) - (06/04)
Page: 4 of 5


Document Has Been Signed on 06/08/2022 04:16 PM - It Cannot Be Edited

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: AL HADI ELEMENTARY SCHOOL
FACILITY NUMBER: 198005460

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/08/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238(g)
Buildings and Grounds
(g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in that a bottle Lysol spayer was observed to be on top of 5 ft cabinet in the PreK 1 classroom which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/08/2022
Plan of Correction
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The bottle was removed during inspection and placed in cabinet inaccessible to children in care.
Type B
Section Cited
CCR
101221(b)(8)(C)
Child's Records
(C) A signed consent form for emergency medical treatment unless the child's authorized
representative has signed the statement specified in Section 101220(f).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 6 out of 6 children's records reviewed did not have the required LIC700 Identifiacation and Emergency form which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/17/2022
Plan of Correction
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Per Director the LIC 700 wll be completed and a copy sent to LPA by POC due date

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 06/08/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/08/2022
LIC809 (FAS) - (06/04)
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