198009647-3-17-2022-54-CC-AMOY-CCLQG2-20220317120849

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198009647
Report Date: 03/17/2022
Date Signed: 03/17/2022 12:09:11 PM

Document Has Been Signed on 03/17/2022 12:09 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:	BELL GARDEN'S PRESCHOOL ACADEMY		FACILITY NUMBER:	198009647
ADMINISTRATOR:	MARIO MUNIZ		FACILITY TYPE:	850
ADDRESS:	6430 COLMAR ST.		TELEPHONE:	(323) 562-1800
CITY:	BELL GARDENS	STATE: CA	ZIP CODE:	90201
CAPACITY:	42	CENSUS: 24	DATE:	03/17/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Mayra Ramirez, Site Supervisor		TIME COMPLETED:	12:15 PM

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25

Licensing Program Analysts (LPA) Alicia Mooberry and Steven Tung conducted an unannounced annual inspection at the above facility on 3/17/22 at 9:00 AM. LPA met with Mayra Ramirez, Site Supervisor who guided analysts on a tour of the facility. LPA Mooberry provided Supervisor with the LIC 125 Inspection Entrance Checklist.

There were 24 children and 3 staff observed on the playground. All individuals present have obtained a criminal record clearance or criminal record exemption.

This is a preschool program that operates two sessions. The AM session is from 8:00 AM to 11:00AM and the PM session is from 12:30 to 3:30 PM. The preschool is located in Room #1 and Room #2. The bathrooms are located in the courtyard that separated the church and school.

Sign-in sheets were reviewed at the entrance of the courtyard. The two classrooms were inspected for cleanliness and good repair.

There are first aid kits in each classroom and a first aid kit located in the office. LPA observed required posted documentation located in the office, which included, Facility License, Publication (PUB) 393- Notification of Parent Rights, Licensing Form (LIC) 610- Facility Disaster Plan, PUB 269- Child Passenger Restraint System and LIC 613A- Notification of Parent’s Rights, and Snack menu.

LPA toured Classroom Room #1 and #2. LPA observed that furniture and equipment is maintained in good condition, free of loose, sharp and/or pointed parts. The floors of the classroom has surfaces that are safe and clean. Drinking water is made readily available for the children water dispenser and disposable cups provided by the center. Cleaning products are stored a cabinet with a child safety lock, inaccessible to children. LPA observed required Carbon Monoxide detector that is operable. Facility has smoke detectors and fire extinguishers that are routinely serviced.

---------Page 1

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia Mooberry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: BELL GARDEN'S PRESCHOOL ACADEMY	FACILITY NUMBER: 198009647
	VISIT DATE: 03/17/2022

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Per Supervisor, there are no children currently on medication. Medication is not administered in the facility.
The isilation area in in the office. A staff bathroom is avaialbe for emergencies.
LPA toured the children’s restroom. Restroom was observed to be sanitary and free of hazards.

LPA toured the outdoor play area. The outdoor space is free of hazards. There is cushioned material under climbing structure to absorb fall. Outdoor space has various areas of shade for children to play. Water is readily available to children via water dispenser and disposable cups. There are no pools, spas, or other bodies of water on school grounds. There are no firearms or weapons stored at the facility.

LPA reviewed Sign In/Out sheets located at the front entrance of the school. Due to COVID-19 precautions parents do not enter the facility unless requested. All children present were signed in and out with date, time and full signature of guardian.

Facility records were reviewed for LIC 9040- Facility Roster, 9148- Earthquake Preparedness form, Daily schedule and Disaster drill log, last drill conducted on 10/20/2021.

Children’s records were reviewed at 12:00 PM for Emergency Card, Immunization Records, LIC 995 Notification of Parents’ Rights, LIC 701- Physician’s Report, LIC 613A- Personal Rights, and signed Admissions Agreement. All children's records were complete.

Staff records were reviewed at 1:00 PM 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 that Staff #1 in the licensed preschool program does not have TB clearance available.

LPA toured the kitchen. All kitchen areas and food storage areas are kept clean and are free of litter, rubbish, rodents, and/or any other vermin. All storage containers for solid waste have tight-fitting covers that are kept on, and in good repair.

------------------------PAGE 2

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia Mooberry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: BELL GARDEN'S PRESCHOOL ACADEMY	FACILITY NUMBER: 198009647
	VISIT DATE: 03/17/2022

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

LPA observed that facility is implementing COVID-19 precautions and procedures. Supervisor was advised to be aware of the latest guidance on COVID-19 by visiting the LA Public Health website.

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.

Site Supervisor 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.

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

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 Mayra Ramirez, Site Supervisor.

Page 3 - End of Report

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia Mooberry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022

LIC809 (FAS) - (06/04)

Page: 3 of 4

Document Has Been Signed on 03/17/2022 12:09 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: BELL GARDEN'S PRESCHOOL ACADEMY	FACILITY NUMBER: 198009647
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/17/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101216(g)(1)

Personnel Requirements

(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 1 out of 4 staff did not have TB test results which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/25/2022
	Plan of Correction
1 2 3 4	Per Site Supervisor Staff #1 will submit proof of of TB clearance and send via email to LPA by POC due date.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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 Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia Mooberry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022

LIC809 (FAS) - (06/04)

Page: 4 of 4