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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198011557
Report Date: 05/24/2022
Date Signed: 05/24/2022 01:09:19 PM


Document Has Been Signed on 05/24/2022 01:09 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:KIRKWOOD CHRISTIAN SCHOOLSFACILITY NUMBER:
198011557
ADMINISTRATOR:ROSA SERRANOFACILITY TYPE:
850
ADDRESS:10822 BROOKSHIRE AVENUETELEPHONE:
(562) 862-4251
CITY:DOWNEYSTATE: CAZIP CODE:
90241
CAPACITY:100CENSUS: 49DATE:
05/24/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:LuAnn Irvine, Office ManagerTIME COMPLETED:
01:30 PM
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About 11:00 AM, Licensing Program Analyst (LPA) T, Tran arrived at the above facility to conduct an unannounced a required inspection and met with LuAnn Irvine, office manager. About 11:25 AM, we toured the facility inside and outside.
LPA observed all posting requirements for operation on the posting board LIC 203A-License, LIC 610 A-Emergency Disaster Plan, LIC 9148-Earthquake Preparedness Check List, LIC 613A- Personal Rights, PUB 269- Child Car Seat Law, Menus, and Activity Schedule. LPA observed the consolidated Covid-19 CHHS postings by the classroom door. The facility had sufficient cleaning supplies to continue operation. All center staff that was present during today’s visit had fingerprint cleared and associated to the designated license number.
The facility services five full day classes. (6:30 AM – 6:00 PM; Monday-Friday). LPA inspected the furniture and equipment for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Storage for children's belongings, isolation area was inspected. Children napping equipment observed to be in good condition. Age appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, paper towels, area safety and sanitation. Isolation bathroom for children is available if needed. All classrooms have trash can with tight lids, first aid supplies, smoke detectors; carbon monoxide/fire extinguishers were observed. Sign in and out sheet procedures were reviewed. The facility roster was up to date and fire and emergency disaster drills were conducted monthly. Emergency disaster plan is updated and reflected to the current operation. Children and staff records were reviewed and in good order. No children with IMS or food allergies at this time.
The facility offered breakfast, lunch, and snacks. All food items and snacks were inspected. Parents had options to provide their own lunch and snack. Water is accessible indoor and outdoor. Separated outdoor play area was all fenced. Equipment was inspected for safety, cushioning material, good repair and age appropriateness. LPA observed shade as well as drinking water was provided. Play area was inspected for hazards and inaccessibility to bodies of water.
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 05/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/24/2022
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: KIRKWOOD CHRISTIAN SCHOOLS
FACILITY NUMBER: 198011557
VISIT DATE: 05/24/2022
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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
LPA recommended facility to stay updated with information related to Covid-19 from the California Department of Public Health (CDPH) guidelines, including Centers for Disease Control and Prevention (CDC) guidelines to help prevent and protect staff and children in care. LPA advised to read the Child Care quarterly updates every season as the come out to stay informed of any changes or updates to the regulations and PINs. LPA informed the Child Care Advocate Program (CCAP) provide many other helpful resources to the licensees and the public. Visit www.cdss.ca.gov to receive important updates.
LPA informed of released PIN 21-15 CCLD related to Kidde Trusense Smoke & combination Smoke/Carbon
LPA informed the effects of lead exposure for children between ages 1-6 years old are the most at risk for lead poisoning. A copy of lead exposure was provided.
Facility was informed of responsibility to report suspected Child Abuse by calling the Child Abuse Hotline at 1-800-540-4000. Also call the Community Care Licensing office and follow up with a written Unusual Incident/Injury Report (LIC 624B). Licensee is reminded that smoking is prohibited on the premises.
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.Facility representative 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.

No deficiency was cited at this time. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the facility representative, LuAnn Irvine.

SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2022
LIC809 (FAS) - (06/04)
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