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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198005675
Report Date: 11/21/2019
Date Signed: 11/21/2019 05:09:48 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:WALNUT VALLEY PRESCHOOL AND EARLY LEARNING CENTERFACILITY NUMBER:
198005675
ADMINISTRATOR:DR. JOSEPHINE KISAFACILITY TYPE:
850
ADDRESS:841 S. GLENWICK AVE.TELEPHONE:
(909) 595-3107
CITY:WALNUTSTATE: CAZIP CODE:
91789
CAPACITY:124CENSUS: 44DATE:
11/21/2019
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Francis Gomez Lead TeacherTIME COMPLETED:
05:30 PM
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An unannounced Random Required Site Inspection was conducted on this date, by Licensing Program Analyst (LPAs) Alanna Gontarek and Cynthia Reyes. All areas identified on the Facility Sketch were inspected and checked the following: Fingerprint clearances, staff/child ratio, children and staff records, and food preparation area storage and refrigeration. LPAs observed some unlabeled food in storage cabinet. During inspection, LPAs consulted staff to label dates on food items that were opened and removed from their original containers. Also, LPAs consulted staff to separate, and label, staff food and children's food in the refrigerator. The following were inspected as well: restrooms, equipment, outside play area and over all conditions of facility. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Napping equipment and bedding were inspected for good condition, appropriate storage, and cleanliness. LPAs consulted staff to store children's bedding into each child's individual cubbies. High Chairs, feeding tables, trays, changing tables, cribs & bedding identification were inspected. Storage for children's belongings were inspected. Availability of drinking water was reviewed. Age appropriate sinks and toilets were inspected for availability, good repair, water temperatures, toilet paper, paper towels, area safety and sanitation. First Aid supplies were inventoried. LPAs observed insufficient amount of First Aid Supplies in each of the classrooms. However, the school's office has a Master List with children's information, along with a box of sufficient First Aid Supplies. LPAs consulted staff to update information and supplies for each classroom. A review of medication policy, including administering, labeling, storage, and records were made. (Please contact your analyst for regulations if considering using Nebulizer or administering Blood-Glucose testing.) Incidental Medical Services was discussed.
An isolation area, for an ill child is located in Director's office, with a mat/cot. A sink and toilet, for the ill child, is in the Staff restroom located in the kitchen, across from DIrector's office.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2019
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: WALNUT VALLEY PRESCHOOL AND EARLY LEARNING CENTER
FACILITY NUMBER: 198005675
VISIT DATE: 11/21/2019
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Facility provides AM and PM Snack, children can bring own lunch, or have the option of choosing lunch from the DIstrict's food program. Food and snacks were reviewed for availability, quantity and appropriateness to children in care. Food preparation areas were toured for safety, cleanliness and proper equipment. A review of cleaning and food supply storage areas was made. Outdoor equipment was inspected for safety, cushioning material, good repair and age appropriateness. Required shade, drinking water and fencing were inspected. Play area was inspected for hazards and inaccessibility to bodies of water. Teacher child ratios were observed and staff names recorded. Care and supervision was evaluated to determine if the basic needs of children are met appropriately. Staff was questioned to establish their familiarity of emergency reporting requirements, emergency disaster plans and other site operations. Sign in and out sheets and procedures were reviewed with staff, policy of checking children for illnesses/Wellness Check. Personal Rights of children were discussed and observed by LPA. No transportation policy or procedures. Staff and children records were reviewed for completeness including but not limited to Criminal Record Clearances for adults, Director Qualifications and verification of Pediatric CPR/First Aid and health preventive practices documentation.
Inspection of required forms was made. Children and Staff confidential name report (LIC 811) was given and documented on this date. No weapons or bodies of water on premises. The smoke detectors, carbon monoxide & fire extinguishers were in operable condition.

The following deficiencies were observed in accordance to Title 22 of the California Code of Regulations. See 809D page and consultation was conducted on this date.

Upon receipt, Licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.

****Licensee advised that signing the report does not imply agreement with the findings but is acknowledging receipt of the licensing report.****
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2019
LIC809 (FAS) - (06/04)
Page: 2 of 7
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: WALNUT VALLEY PRESCHOOL AND EARLY LEARNING CENTER
FACILITY NUMBER: 198005675
VISIT DATE: 11/21/2019
NARRATIVE
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Recent regulatory changes were discussed (including SB 933). Exit interview was conducted including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.

Health & Safety Code 1597.622(a1) Employees or volunteers at Child Care Center; immunization requirements; records; exemptions Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

HSC 1596.8662(B)(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.


AB1207 Mandated Child Abuse Reporting – Implementation was discussed with Licensee. Website provided: http://mandatedreporterca.com/

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
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2019
LIC809 (FAS) - (06/04)
Page: 3 of 7
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: WALNUT VALLEY PRESCHOOL AND EARLY LEARNING CENTER
FACILITY NUMBER: 198005675
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/21/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/02/2019
Section Cited

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Employees or volunteers at day care center; immunization requirements; records; exemptions. Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and
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volunteer shall receive an influenza
vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by staff file review of several staff missing MMR/TDAP/FLU. This poses a potential health and safety risk to the children in care.
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Send a List of staff with verification that they all have ALL immunization's by the POC date
Type B
12/02/2019
Section Cited

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Health-Related Services- In centers where the licensee chooses to handle medications: All prescription and nonprescription medications shall be maintained with the child's name and shall be dated. This requirement was not met as evidenced by: child # having expired medication.
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This poses a potential risk to the health and safety of children in care
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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: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:
DATE: 11/21/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/21/2019
LIC809 (FAS) - (06/04)
Page: 5 of 7
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: WALNUT VALLEY PRESCHOOL AND EARLY LEARNING CENTER
FACILITY NUMBER: 198005675
VISIT DATE: 11/21/2019
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Licensing Program Analysts, (LPAs) also conducted an Incident report Inspection. There was one (1) Incident report that came into the office on 08/02/19.

LPAs interviewed, reviewed and received records. LPAs went over Incident report with Director Ms. Kathy Mooney and Francis Gomez Lead Teacher.

Based on information obtained on this date, no follow up is necessary regarding the incident report listed above. The facility followed all proper procedures per the parent hand book/admission agreement, incident reports were sent and called in properly and timely, all medical needs were met if needed and parents notified.

Per Interviews it was determined that the child was alone for less than a minute because he walked away from the group that was lined up to transition to another class room and stated he needed to use the rest room. It was the child's last day of school and parent was notified on that same date that the child did not ask permission to use the restroom.

Exit interview conducted and a copy of this report was left with Director Ms. Kathy Mooney
No Citation given.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2019
LIC809 (FAS) - (06/04)
Page: 7 of 7
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: WALNUT VALLEY PRESCHOOL AND EARLY LEARNING CENTER
FACILITY NUMBER: 198005675
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/21/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/02/2019
Section Cited

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Criminal Record Clearance. Prior to working or volunteering in a licensed child care facility, all individuals subject to a criminal record review shall request a transfer of a criminal record clearance from another facility or Trustline. This requirement has not been met as evidenced by: LPA determined through LIS
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(Licensing Information System) Staff #4 is not associated to the licensed facility. This poses a potential risk to the health and safety of children in care.
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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: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:
DATE: 11/21/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/21/2019
LIC809 (FAS) - (06/04)
Page: 4 of 7
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: WALNUT VALLEY PRESCHOOL AND EARLY LEARNING CENTER
FACILITY NUMBER: 198005675
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/21/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/02/2019
Section Cited

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Plan of Operation: Each licensee shall have and keep on file a current written, definitive plan of operation. A copy of the plan shall be submitted to the Department. The requirement is not met as evidenced by the facility does not have a IMS plan on file. This poses a potential risk to the health and safety of children in care.

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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: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:
DATE: 11/21/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/21/2019
LIC809 (FAS) - (06/04)
Page: 6 of 7