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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198012292
Report Date: 01/17/2020
Date Signed: 01/17/2020 09:30:29 AM

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:KINDER PREP PRESCHOOL CENTERFACILITY NUMBER:
198012292
ADMINISTRATOR:EVELYN GOMEZFACILITY TYPE:
850
ADDRESS:3208 FLOWER STREETTELEPHONE:
(310) 569-9309
CITY:LYNWOODSTATE: CAZIP CODE:
90262
CAPACITY:26CENSUS: 9DATE:
01/17/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:31 AM
MET WITH:Angela Rivas Sandoval & Amber MooreTIME COMPLETED:
09:15 AM
NARRATIVE
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Licensing Program Analyst (LPA) Rita Ramos conducted an unannounced inspection to the above facility. LPA met with Angela Rivas Sandoval, who guided analyst on a tour of the facility. There were 9 children present upon arrival.

During the inspection LPA observed as Child #1 walked into the facility from a side door located in the side wall of the backyard. There is a Family Child Care Home directly next door with licensee #191513297. Kinder Prep Preschool Center and the Johnson Family Child Care are both licensed by the same Licensee, Marie Johnson.

LPA observed as Child #1 singularly walked into the preschool facility and sat at a table. LPA then asked where the sign-in and out sheets were since Child #1 was not being signed in. Per Director, Director signs Child #1 in and out on a daily basis. LPA asked in regards to Child #1 being next door and was informed that Child #1 is in care at the Family Child Care Home and then attends the preschool . LPA informed Director that if Child #1 is in care at the Family Child Care Home prior to entering the preschool facility then the person who is caring for Child #1 at the Family Child Care Home needs to physically walk the child into the preschool facility and sign-the child in and the person who picks up the child needs to sign the child out.

Due to the facility not having Child #1 appropriately signed-in and out, the following deficiency listed on the attached deficiencies page is being cited in accordance with California Code of Regulations Title 22.

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 $100.00. Exit interview was conducted with Amber Moore, Director, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Rita RamosTELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2020
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: KINDER PREP PRESCHOOL CENTER
FACILITY NUMBER: 198012292
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/17/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/31/2020
Section Cited

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Sign In and Sign Out

The person who brings the child to, and removes the child from, the center shall sign the child in/out.

This requirement is not met as evidenced by LPA observing that Child #1 entered the
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facility from a side door along the outdoor wall on their own and the person who was supervising the child prior to entering the preschool did not sign the child in. This poses a potential health and safety risk to 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: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Rita RamosTELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:
DATE: 01/17/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/17/2020
LIC809 (FAS) - (06/04)
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