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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198009647
Report Date: 03/30/2023
Date Signed: 03/30/2023 01:02:46 PM


Document Has Been Signed on 03/30/2023 01:02 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 ACADEMYFACILITY NUMBER:
198009647
ADMINISTRATOR:MARIO MUNIZFACILITY TYPE:
850
ADDRESS:6430 COLMAR ST.TELEPHONE:
(323) 562-1800
CITY:BELL GARDENSSTATE: CAZIP CODE:
90201
CAPACITY:42CENSUS: 18DATE:
03/30/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Mayra Ramirez, Site SupervisorTIME COMPLETED:
01:15 PM
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Licensing Program Analyst (LPA) Alicia Mooberry conducted an unannounced Annual Inspection at the above facility on this date 3/30/23. LPA arrived at the facility at 10:00am and met with Mayra Ramirez, Site Supervisor, who guided analysts on a tour of the facility. LPA explained teh purpose of the inspection and provided Site Supervisor with the LIC 125 Inspection Entrance Checklist.

There were eighteen (18) children and two (2) staff present in Room #2. All individuals present have obtained a criminal record clearance and are associated to the facility.

This is a preschool program that operates two part-time sessions using Room #1 and Room #2. The morning session is from 8:00 AM to 11:00AM and the afternoon session is from 12:45 to 3:45 PM. The facility (indoor and outdoors) operates on the grounds of a Church building, however the facility has completely separate operations. 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 by water dispenser and disposable cups provided by the center. Cleaning products are stored a cabinet with a child safety lock, inaccessible to children. The facility has completed the Lead testing.

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SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 03/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/30/2023
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: BELL GARDEN'S PRESCHOOL ACADEMY
FACILITY NUMBER: 198009647
VISIT DATE: 03/30/2023
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LPA observed wall heaters that have been made inaccessible by barrier. LPA observed required Carbon Monoxide detectors in in Room #1 and #2 that are operable. Facility has smoke detectors and fire extinguishers that are routinely serviced.

Per Supervisor, medications are not administered by the facility and there are no children that require IMS services. The isolation area is located in the office. A staff bathroom is available for emergencies.
LPA toured the children’s restroom and observed that the bottom areas of bathroom stall doors (close to toilet) have possible water damage, bubbled paint and some brown spots that appear to be mildew have appeared. This poses a potential risk to the health and safety of persons on care.

LPA toured the outdoor play area. The outdoor space is adjacent to a parking area. Per Site Supervisor, the gate is maintained closed during playtime. There is cushioned material under climbing structure to absorb fall. Outdoor space has shaded 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.

LPA reviewed Sign In/Out sheets located at the front entrance of the school. 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 10/2023. Facility representative was reminded that drill are to be conducted every six months.

Children’s records were reviewed 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 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 staff records to be complete. At least one person has completed the EMSA approved Pediatric CPR/1st Aid.

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. ------------------------PAGE 2

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

DATE: 03/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023
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: BELL GARDEN'S PRESCHOOL ACADEMY
FACILITY NUMBER: 198009647
VISIT DATE: 03/30/2023
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LPA reminded facility representative the storage containers for solid waste should have tight-fitting covers, to be kept on, and in good repair.

LPA discussed the latest guidance on COVID-19 including reporting requirements, and advised facility representative to visit the LA Public Health website for the latest guidance on communicable diseases.

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

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.

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 Mayra Ramirez, Site Supervisor. Appeal Rights 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: 03/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 03/30/2023 01:02 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: 03/30/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
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 LPA observation, the licensee did not comply with the section cited above due to the bottom areas of bathroom stall doors (close to toilet) have visible water damage (photo taken), bubbled paint and some brown spots that appear to be mildew, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/30/2023
Plan of Correction
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Per Site Supervisor, photo proof of correction will be emailed to LPA by POC due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 03/30/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/30/2023
LIC809 (FAS) - (06/04)
Page: 4 of 4