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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198012158
Report Date: 03/03/2022
Date Signed: 03/03/2022 12:22:07 PM


Document Has Been Signed on 03/03/2022 12:22 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:CHILDREN'S ACADEMY OF SUCCESSFACILITY NUMBER:
198012158
ADMINISTRATOR:GOMEZ, LETICIAFACILITY TYPE:
850
ADDRESS:10839 LA REINA AVENUETELEPHONE:
(562) 231-4373
CITY:DOWNEYSTATE: CAZIP CODE:
90241
CAPACITY:48CENSUS: 40DATE:
03/03/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Leticia Gomez, DirectorTIME COMPLETED:
12:35 PM
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Licensing Program Analyst (LPA), Tran arrived at the Children's Academy of Success facility to conduct a Required visit. About 10:50 AM, LPA met with center director, Leticia Gomez and toured the facility inside and outside. LPA observed proper care and supervision. Staff and children observed with face masks covered during indoor. The facility hours are 7:30am - 5:00pm Monday - Friday. There is no extended care offered.
Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Napping equipment observe to be in good condition. Storage for children's belongings, bathrooms facilities, and isolation areas for ill children were inspected. Availability of drinking water was observed. First Aid supplies were inventoried. A review of medication policy. No children required food allergies or IMS at this visit. Documentation of current Fire & Earthquake drill was observed by analyst.
The facility provided snacks. Snack menus were posted. Parents provided their own lunch. Food preparation area was toured for safety, cleanliness and proper equipment. An inspection of cleaning and food supply storage areas was made. Outdoor equipment was inspected for safety, cushioning material, good repair and age appropriateness. Required shade, drinking water and fencing were inspected. Play area was inspected for hazards and inaccessibility to bodies of water. Children and staff files were reviewed for completeness. LPA observed current CPR and First Aid Certification for Center Staff.
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, Leticia Gomez.

SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 03/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/03/2022
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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