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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198006623
Report Date: 09/10/2019
Date Signed: 09/10/2019 12:36:53 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:CROSS, PRESCHOOL & KINDERGARTEN, THEFACILITY NUMBER:
198006623
ADMINISTRATOR:CARLA VELASCOFACILITY TYPE:
850
ADDRESS:20675 LA PUENTE ROADTELEPHONE:
(909) 468-9798
CITY:WALNUTSTATE: CAZIP CODE:
91789
CAPACITY:148CENSUS: 55DATE:
09/10/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Carla VelascoTIME COMPLETED:
12:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Crystal Green conducted an unannounced annual inspection. Upon arrival LPA met with Director, Carla Velasco, who provided LPA a tour of the facility both inside and outside. This is a preschool program licensed for 148 preschoolers which operates Monday – Friday from 06:30 AM to 06:30 PM.

This preschool consists of 7 classrooms (Rooms 1- 7). LPA observed there to be 9 children with 1 staff member in Room 3. In Room 4, LPA observed there to be 21 children with 3 staff members. In Room 5, LPA observed 8 children with 1 staff member. In Room 6, it was observed to have 12 children with 1 staff member. In Room 7, LPA observed 5 children with 1 staff member. Per Director, Rooms 1 and 2 are currently not in use. Teacher child ratios were observed, and staff names were recorded. All children were observed by licensing staff to be under visual supervision of a teacher at all times. 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.

Furniture and equipment were inspected to ensure that they are in good condition. Napping equipment was inspected for good condition, appropriate storage, and cleanliness. Bedding is stored separately in each child storage cubbies. Toilets and sinks were observed to be in safe and sanitary operating conditions. LPA observed each classroom to have drinking water available via water pitcher and each child also brings their own sippy cups. At this time, the office is used as an isolation area for ill children. Parents are contacted immediately when children are determined to be ill.

The facility provides AM snack, lunch and PM snack. Food preparation and storage areas are clean and free of litter. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children shall be made inaccessible.

Report Continues on Page 1 of 3.
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Crystal GreenTELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 4
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: CROSS, PRESCHOOL & KINDERGARTEN, THE
FACILITY NUMBER: 198006623
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/10/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/27/2019
Section Cited

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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
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This requirement was not met as evidence by during review of staff files, LPA observed the files reviewed to be missing the Mandated Child Abuse Training completion certificate. 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: Christina GabelmanTELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Crystal GreenTELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:
DATE: 09/10/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/10/2019
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: CROSS, PRESCHOOL & KINDERGARTEN, THE
FACILITY NUMBER: 198006623
VISIT DATE: 09/10/2019
NARRATIVE
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Outdoor playground equipment was observed to be in a safe condition. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. Climbing equipment observed is surrounded by wood chips to provide cushioning in a event of a fall. The facility also has adequate shade available outside. LPA observed there to be drinking water available outside via water fountains.

Staff Records was reviewed to ensure that each file contains a Personnel Record, Qualifications and verification of CPR/First Aid and health preventative practices documentation. Children’s Records was reviewed to ensure that each child has an Emergency and Identification form on file and Consent for Medical Treatment.

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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at http://www.ada.gov/childqanda.htm

Effective January 1, 2018: AB1207 Mandated Child Abuse Reporting- Existing licensees and employees must meet requirements by March 30, 2018. New facility employees must meet requirements within 90 days of employment. The required training must be completed every two years and documentation maintain on file. Website provided: http://mandatedreporterca.com. During review of staff files, LPA observed the files reviewed to be missing the Mandated Child Abuse Training completion certificate.

The deficiency listed on the following page was observed by the LPA and are being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809D for deficiency that are being cited and need to be cleared to protect the children’s health & safety.



Report Continues Page 2 of 3.
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Crystal GreenTELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: CROSS, PRESCHOOL & KINDERGARTEN, THE
FACILITY NUMBER: 198006623
VISIT DATE: 09/10/2019
NARRATIVE
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The exit interview was conducted with Director, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role. The Director was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these forms.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing reprehensive. Failure to maintain posting as required will result in a civil penalty of $100.00.



Report Ends Page 3 of 3.
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Crystal GreenTELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4