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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198010840
Report Date: 09/03/2021
Date Signed: 09/03/2021 12:47:43 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: 29DATE:
09/03/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Belinda Xu - LicenseeTIME COMPLETED:
12:50 PM
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Licensing Program Analyst (LPA) Nolan Tcheng conducted an unannounced random inspection. Upon arrival, at 10:10am, LPA met with Licensee Belinda Xu. At 10:15am, licensee led LPA on a tour of the facility. This is a preschool program which consists of 4 classrooms. Per licensee, there are currently 38 enrolled in the program. Hours of operation for this facility are 7:30am-6:30pm.

Licensing staff observed all required forms/publications to be posted in the front office by entrance. Snack menus were reviewed to ensure that they are being posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request.

PHYSICAL PLANT: At 10:16am, LPA entered and inspected Room 1: 7 children with 2 staff members, Room 2: 7 children and 1 staff member, and Room 3: 15 children and 2 staff members. Per licensee, Room 3 is not currently being used. Teacher-child ratios were observed to be in accordance with Title 22 regulations. Staff names were recorded. All children were observed to be under visual supervision of a teacher during tour. The Licensee is within the conditions, limitations, and capacity specified on the license. All areas were identified on the Facility Sketch were inspected. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. All floors are clean and safe. At 10:18am, LPA reviewed the storage of napping equipment. Napping equipment was observed to be cots stacked in the corner of each classroom. Restrooms for children's use were next to the front office and one next to Room 1. All toilets, hand washing, and bathing facilities are safe, sanitary and are operating properly. Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. At 10:20am, the kitchen was inspected. All food preparation areas and food storage areas are kept clean and are free of litter, rubbish and rodents and/or any other vermin. Snacks were reviewed for availability, quantity and appropriateness to children in care. This facility provides breakfast, lunch, and pm snack.


REPORT CONTINUES PAGE 1 of 3
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Nolan TchengTELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2021
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: ANGELA PRESCHOOL & KINDERGARTEN
FACILITY NUMBER: 198010840
VISIT DATE: 09/03/2021
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All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids. The facility was observed to be free of flies, other insects and rodents. Sufficient individual storage space for children was observed and each child has a cubby. Drinking water was readily available indoors. At this time, the library is used as an isolation area. A cot is available for an ill child to rest on. First Aid supplies are available and complete. Facility has a functioning carbon monoxide detector that meets statutory requirements. Director states there are no weapons, firearms, or bodies of water on the premises. At 10:25am, A fire extinguisher was observed. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 11/23/2020, as indicated on service tag. Per State Fire Marshall standards, fire extinguishers shall be serviced annually.

At 10:30am, LPA reviewed the outdoor play area. 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 are three outdoor areas with play structures in each area. Per Licensee, each classroom uses one play area each. Water pitchers are brought outside during outdoor play time.

FACILITY RECORDS: 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. Staff files were reviewed for a health screening report and immunizations that meet regulatory requirements. Criminal Record Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed. During file review, LPA observed that 3 of 7 staff members did not have an up to date Mandated Reporter Training certificate. LPA explained to license that it is a requirement for all staff to maintain up to date Mandated Reporter Training for Child Care Providers every two years. The name of the child care center director or fully qualified teacher(s) designated to act in the director's absence is on file. Educational background, training, and/or experience for each staff present are on file and were reviewed. A random sample of Children’s Records were reviewed to ensure that they are complete. L



LPA observed that a COVID-19 Health and safety guidelines were put into place at the facility.

REPORT CONTINUES PAGE 2 of 3
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Nolan TchengTELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2021
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: ANGELA PRESCHOOL & KINDERGARTEN
FACILITY NUMBER: 198010840
VISIT DATE: 09/03/2021
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INCIDENTAL MEDICAL SERVICES:
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

LPA advised the licensee how to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov. AB1207 Mandated Child Abuse Reporting – Implementation was discussed with Licensee. Website provided: http://mandatedreporterca.com/

The Notice of Site Visit (LIC 9213) – must remain posted for 30 day during the hours of operation after each site visit by a licensing representative.


Exit interview was conducted with Belinda Xu, at 12:35pm, and Plan of Corrections were reviewed and developed. A copy of the report was provided.

END OF REPORT PAGE 3 of 3
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Nolan TchengTELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2021
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: ANGELA PRESCHOOL & KINDERGARTEN
FACILITY NUMBER: 198010840
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/03/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/10/2021
Section Cited

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1596.8662(d)(1) Health and Safety Codea person who is a licensed child care provider... of a licensed child day care facility shall complete the mandated reporter training, complete renewal... every two years following the date on which he or she completed...
This regulation was not met as evidenced by:
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Based on file review, Licensee did not ensure that 3 of 7 staff members had a current mandated reporter training certificate in their file. This poses a potential risk to the health, safety, and personal rights 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) 981-3380
LICENSING EVALUATOR NAME: Nolan TchengTELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:
DATE: 09/03/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/03/2021
LIC809 (FAS) - (06/04)
Page: 4 of 4