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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198010840
Report Date: 08/08/2019
Date Signed: 08/08/2019 02:10:29 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:ANGELA PRESCHOOL & KINDERGARTENFACILITY NUMBER:
198010840
ADMINISTRATOR:XU, BAOJUANFACILITY TYPE:
850
ADDRESS:100 E. LIVE OAK AVENUETELEPHONE:
(626) 445-9288
CITY:ARCADIASTATE: CAZIP CODE:
91006
CAPACITY:91CENSUS: 74DATE:
08/08/2019
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Jenny NgTIME COMPLETED:
02:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Ariel Cazares conducted an unannounced annual/required inspection on this date. LPA met with Director Jenny Ng. LPA toured the facility and observed a total of 74 children and 8 staff. The facility operates from Monday through Friday, 7am-6:30pm. LPA toured the facility which consists of 4 classrooms (#1-4). The preschool playground consists of 3 separately gated spaces. There is a kitchen that is used to provide food for the facility.

LPA inspected the preschool classrooms and observed age appropriate equipment, toys, and furniture. Telephone service, heating, lighting and ventilation were evaluated. Children have their own cubby to store their belongings. Napping equipment in form of cots were observed in each classrooms. Linens are taken home each week to be washed. There is drinking water available in form of water jug and personal bottles. There are 2 restrooms in the facility: Restroom 1 is near the entrance of the facility, Restroom 2 is located near Classroom #1. Children's restrooms were observed to be clean with adequate supplies. The facility did not have a carbon monoxide detector present. LPA informed director that one needed to be installed.

The outdoor space was inspected for age appropriate equipment and toys, cushioning, and to be hazard free. Drinking water is available outdoors via the children's personal water bottles. LPA observed no hazards or violations. There is appropriate shaded areas for children to rest.

The kitchen was inspected by LPA. The facility offers two snacks and lunch, which are prepared and cooked on site. All preparation areas were observed to be clean and in order. There is sufficient storage and cabinet space for supplies. A facility menu was observed to be posted at the entrance of the facility. LPA observed cereal stored in a container for animal crackers. Per director it was taken out of the box and placed in a different container for easy access. LPA observed the expiration date on the box was not passed. LPA informed director that if items are taken out of original container, the date removed and expiration shall be noted on the new container. LPA suggested cutting the label from the box and taping to the new container.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Ariel AlmazanTELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2019
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 3
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: ANGELA PRESCHOOL & KINDERGARTEN
FACILITY NUMBER: 198010840
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/08/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/12/2019
Section Cited
CCR
101226(e)(1)(b)
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(e) In centers where the licensee chooses to handle medications: (1)All prescription and nonprescription medications shall be centrally stored in accordance with the requirements specified below: (B) Each container shall have an unaltered label.
This requirement has not been met as evidenced by LPA's inspection of medication
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Director was unaware the parent brought an altered bottle. Per director a new bottle was brought today when child ran out. LPA verified with parent who arrived after being contacted by director. Parent took bottle and confirmed she altered the bottle saying it belong to sibling and brought it to facility when child #1 ran out of his medication.
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on site. LPA observed that medication designated to Child #1 had an altered label on the bottle. This poses a potential risk to the health and safety of children in care.
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Director will submit a written statement explaining how she will ensure compliance with medication services. This will be submitted to LPA by 8/12/19
Type B
08/09/2019
Section Cited
HSC
1596.954
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Every licensed child day care center shall have one or more carbon monoxide detectors in the facility.
This requirement has not been met as evidenced by LPA's inspection, in which LPA did not observe a carbon monoxide detector. This poses a potential risk to the health and safety of children in care.
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Per director, she was not aware of the need for the detector and will purchase one and install in the facility. A photo of receipt and detector will be sent to LPA by POC due date of 8/9/19.
Type B
09/09/2019
Section Cited
HSC
1596.7995(c)
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The day care center shall maintain documentation of the required immunizations or exemptions from immunization.
This requirement has not been met as evidenced of file review for director who is missing proof of measles vaccine. This poses a potential risk to the health and safety of children in care.
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Per director, she will make appointment with doctor to obtain the record or exemption she needs. This will be submitted to LPA by POC due date of 9/9/19.
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: Ariel AlmazanTELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3
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: ANGELA PRESCHOOL & KINDERGARTEN
FACILITY NUMBER: 198010840
VISIT DATE: 08/08/2019
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Per Director, the isolation area is located in the office and a staff restroom available for ill children. There is a mat available when needed. Medication is stored in a box on top of a shelf that is inaccessible to children, located near the entrance of the facility. LPA inspected the medication currently on site and observed that the medication brought in for Child #1 had a label that was altered. The name on the bottle did not match the name of Child #1 and the dosage was crossed out and edited. LPA reviewed the medication log and observed signed authorization was provided by the parent. LPA spoke with parent who confirmed they altered label and brought in a new bottle today belonging to a sibling when Child #1's bottle became empty. LPA verified on the medication log that the child was not administered the medication from the altered bottle on this date. LPA informed director that the medication with altered labels should not be accepted nor administered to children. This poses a potential health and safety risk to the child in care.

Staff and children's records were reviewed. The facility maintains their children's roster. Sign in and out sheets were reviewed. Director is missing proof of measles vaccine or exemption.

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

Exit interview conducted with Director Jenny Ng. A copy of this report and appeal rights were provided and explained.



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 representative. Failure to maintain posting as required will result in a civil penalty of $100.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Ariel AlmazanTELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3