198006261-9-28-2022-33-CC-MJAA-CJPNPP-20220928103841

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198006261
Report Date: 09/28/2022
Date Signed: 09/28/2022 10:38:50 AM

Document Has Been Signed on 09/28/2022 10:38 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	VAN WIG HEAD START/STATE PRESCHOOL		FACILITY NUMBER:	198006261
ADMINISTRATOR:	JOANNE MENDEZ		FACILITY TYPE:	850
ADDRESS:	1151 VAN WIG AVE.		TELEPHONE:	(626) 931-8000
CITY:	LA PUENTE	STATE: CA	ZIP CODE:	91746
CAPACITY:	72	CENSUS: 11	DATE:	09/28/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Socorro Ruiz, Lead Teacher		TIME COMPLETED:	11:02 AM

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On 09/28/2022 at 9:00AM, Licensing Program Analysts (LPAs) Monique Ayala and Veronica Martinez-Garz conducted an unannounced required 1-year inspection. A COVID-19 risk assessment was conducted prior to entering the facility. LPAs met with Lead Teacher, Socorro Ruiz who guided the LPAs on a tour of the facility. This is preschool age program that is licensed for 72 preschoolers which operates Monday through Friday from 8:00AM to 1:40PM, and is located on a Bassett Unified School District Site. Per the lead teacher there are 12 children enrolled.

The following classroom was inspected: Room I: 11 children with 3 teachers. Teacher-child ratios were observed to be in accordance with Title 22 Regulations. Staff names were recorded. All children were observed to be under supervision, including visual supervision. Licensed facility is within the conditions, limitations, and capacity specified on the license.

The classroom furniture and equipment was inspected for good repair, free of sharp, loose, or pointed parts. All indoor classrooms were inspected to ensure that the floors have a surface that is safe and clean. All toilets and washing facilities are in safe and sanitary operating conditions. All materials and surfaces accessible to children are toxic free.

The facility provides breakfast, lunch, snacks and water to children in care. The food is provided by the school district.

LPAs observed that there are functioning smoke and carbon detectors in the facility. LPAs observed a fully charged and serviced fire extinguisher. Emergency disaster drill was last conducted on 09/26/2022.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Monique Jessica Ayala	TELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2022

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: VAN WIG HEAD START/STATE PRESCHOOL	FACILITY NUMBER: 198006261
	VISIT DATE: 09/28/2022

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Outdoor playground equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard.

Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. LPAs were unable to review staff and children files, as the files are located in head start office. LPAs will conduct a visit to the head start office at a later date to review files. Per lead teacher, children's files are being converted to digital files.

LPA observed CPR and First Aid verification for staff, expiration date 06/19/2023.

SB792 (Immunization Requirements for Staff and Employees) was discussed with the Education Specialist.

AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018 any person who works in a child care facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers.

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: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Monique Jessica Ayala	TELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2022

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: VAN WIG HEAD START/STATE PRESCHOOL	FACILITY NUMBER: 198006261
	VISIT DATE: 09/28/2022

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LPAs advised the licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

Lead teacher 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.

The facility was found to be in compliance with Title 22 Regulations; no deficiencies given today 9/28/2022.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted, and a copy of the report was provided to lead teacher.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Monique Jessica Ayala	TELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2022

LIC809 (FAS) - (06/04)

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