198012652-8-23-2022-54-CC-MAYA-CHKU74-20220823151918

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198012652
Report Date: 08/23/2022
Date Signed: 08/23/2022 03:19:35 PM

Document Has Been Signed on 08/23/2022 03:19 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:	CONNECTING KIDS		FACILITY NUMBER:	198012652
ADMINISTRATOR:	TINA TRIBOLET		FACILITY TYPE:	840
ADDRESS:	18800 NORWALK BLVD		TELEPHONE:	(562) 924-4466
CITY:	ARTESIA	STATE: CA	ZIP CODE:	90701
CAPACITY:	150	CENSUS: 2	DATE:	08/23/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Director, Tina Tribolet		TIME COMPLETED:	03:40 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On August 23, 2022 at 11:30 am, Licensing Program Analyst (LPA) Monique Ayala conducted an unannounced inspection at the facility noted above and met with Director, Tina Tribolet. The purpose of the inspection was to conduct the Required 1 Year inspection at the facility. Entrance Checklist – Child Care Centers (LIC 125) was provided to the Director upon arrival. The facility is currently licensed for 150 children, ages 6 to 12. The facility is located on New Life Community Church premises. There is also a licensed preschool program on site (License Number: 191505107). Per Director, the school-age program operates Monday through Friday from 6:30 am to 9:00 am and 12:00 pm to 6:30 pm. The Director guided LPA on a tour of the inside and outside of the facility. All areas on the facility sketch were inspected. The facility has six (6) classrooms where care is provided. The facility also has a large gym and multiple multipurpose rooms that are used for additional indoor activity space. Upon arrival, there were 5 other staff and 2 children present. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Children have space to store their personal belongings. The school-age program does not offer nap time since care is only provided before and after school. Per Director, the isolation area is in the main office. In the office, a mat can be placed on the floor for an ill child and the restroom located next to the office is readily available if an ill child requires it. Sinks, toilets, and urinals were inspected for availability and good repair. General sanitation was observed. Availability of indoor drinking water was observed in each classroom. The facility does not have a carbon monoxide detector. Smoke detectors were not tested during this visit due to the detectors being wired to the emergency pull down fire alarm. The fire extinguishers are fully charged and were last serviced on May 3, 2022.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Monique Ayala	TELEPHONE: (323) 246-2016
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022

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: CONNECTING KIDS	FACILITY NUMBER: 198012652
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/23/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101230(a)

Activities/Napping

(a) Each center shall provide a variety of daily activities designed to meet the needs of children in care, including but not limited to: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above as the facility did not have a Daily Activity Schedule available for review which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/23/2022
	Plan of Correction
1 2 3 4	The Director will e-mail a copy of the Daily Activity Schedule to LPA Ayala by September 23rd.

Type B

Section Cited

HSC

1596.7995(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 6 out of 6 personnel records (Director, S1, S2, S3, S4, and S5) which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/23/2022
	Plan of Correction
1 2 3 4	The Director will obtain a copy of the immunization records for staff, including pertussis, measles, and influenza (or documentation of exemption). The Director will submit proof to LPA Ayala via e-mail by September 23rd.

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: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Monique Ayala	TELEPHONE: (323) 246-2016
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2022

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022

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: CONNECTING KIDS	FACILITY NUMBER: 198012652
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/23/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 3 personnel records (S1, S2, and S3) which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/23/2022
	Plan of Correction
1 2 3 4	Staff will renew their mandated reporter (AB 1207) training and the Director will submit the certificates of completion to LPA Ayala via e-mail by September 23rd.

Type B

Section Cited

CCR

101215.1(m)

Child Care Center Director Qualifications and Duties

(m) A child care center director shall complete 16 hours of health and safety training if necessary pursuant to Health and Safety Code Section 1596.866. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above as the Director did not have the Preventative Health and Safety Practices (EMSA-approved) certificate of completion on record which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/23/2022
	Plan of Correction
1 2 3 4	The Director will complete the Preventative Health and Safety Practices (EMSA-approved) course and submit the certificate of completion to LPA Ayala via e-mail by September 23rd.

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: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Monique Ayala	TELEPHONE: (323) 246-2016
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2022

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022

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: CONNECTING KIDS	FACILITY NUMBER: 198012652
	VISIT DATE: 08/23/2022

NARRATIVE

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Disinfectants, cleaning solutions, medication and other items that are hazardous to children, were made inaccessible to children in all areas. Director confirmed that there are no poisons stored at the facility. All kitchen, food preparation and food storage areas are kept clean and are free of litter, rubbish, rodents, and/or any other vermin. All storage containers for solid waste have tight-fitting covers that are kept on and in good repair.

Outdoor playground equipment is in a safe condition, free of sharp, lose 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, slides, and similar equipment are cushioned with sand that could absorb a fall. Per Director, the sand is inspected daily by staff prior to use. The facility also utilizes a grass area between the classroom building and the gym for outdoor activity space. There is adequate shade in the outdoor play areas. Availability of outdoor drinking water was observed. There is a reflecting pool with a rock waterfall on the church grounds. It is located on the side of the Worship Center in the vicinity of the A Building. The school-age program operates in the B Building.

All individuals present have obtained a criminal record clearance or criminal record exemption. There is at least one person present with a valid Pediatric First Aid and CPR certification (EMSA-approved) during this inspection.

LPA conducted a record review of 2 children’s records and 6 personnel records for completeness. Based on the record reviews, children's records were complete per Title 22 regulations. Based on the record review, the Director did not have their immunization record for pertussis, measles, and influenza, and the Preventative Health and Safety Practices (EMSA-approved) certificate of completion on record. Based on the record review, 5 personnel records (S1, S2, S3, S4, and S5) did not have the immunization record for pertussis, measles, and influenza. Based on record review, 3 personnel records (S1, S2, and S3) did not have a current mandated reporter (AB 1207) training certificate on record. Based on record review, 1 personnel record (S5) did not have the Health Screening Report (LIC 503) and TB clearance or risk assessment on record. The names of children and staff whose records were reviewed were documented.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Monique Ayala	TELEPHONE: (323) 246-2016
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022

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: CONNECTING KIDS	FACILITY NUMBER: 198012652
	VISIT DATE: 08/23/2022

NARRATIVE

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Children's roster was reviewed and is current. Sign-in and sign-out sheets were reviewed. The facility did not have verification of disaster and fire drills available for review. Director was advised that disaster and fire drills shall be conducted at least every six months and shall be documented, including the date and time of each drill. Per Director, the facility transports children to and from local schools. The facility currently has six vehicles available for transportation.

The facility provides the children with morning and afternoon snacks. Food menus are posted one week in advance where it is visible by the child’s parent or authorized representative. Menus for the past 30 days are available upon request. During the inspection, snacks were reviewed for availability and quantity.

First Aid supplies were observed and kept in the children's restroom. According to the Director, medication is only administered to a child when accompanied with a doctor's note and medication is stored in a cabinet located in one of the multipurpose rooms.

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.

Director 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.

LPA advised the Director on how to access forms, regulations, quarterly updates, and Provider Information Notices (PINs) on the Department website at: www.ccld.ca.gov.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Monique Ayala	TELEPHONE: (323) 246-2016
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022

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: CONNECTING KIDS	FACILITY NUMBER: 198012652
	VISIT DATE: 08/23/2022

NARRATIVE

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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.

Deficiencies were cited in accordance with Title 22 regulations (refer to deficiency pages).

A Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days.

Exit interview was conducted and report was reviewed with Director, Tina Tribolet. Appeal Rights were discussed, and a copy was provided to the facility representative.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Monique Ayala	TELEPHONE: (323) 246-2016
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 08/23/2022 03:19 PM - It Cannot Be Edited

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: CONNECTING KIDS	FACILITY NUMBER: 198012652
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/23/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101216(g)(1)

(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 1 out of 6 personnel records (S5) which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/23/2022
	Plan of Correction
1 2 3 4	The Director will submit the completed Health Screening Report (LIC 503) and TB clearance or risk assessment for S5 to LPA Ayala via e-mail by September 23rd.

Type B

Section Cited

HSC

1596.954

Every licensed child day care center shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and interview, the licensee did not comply with the section cited above as the facility does not have a carbon monoxide detector which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/23/2022
	Plan of Correction
1 2 3 4	The Director will submit photographs of the purchased carbon monoxide detector(s) and a copy of the receipt to LPA Ayala via e-mail by September 23rd.

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: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Monique Ayala	TELEPHONE: (323) 246-2016
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2022

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 08/23/2022 03:19 PM - It Cannot Be Edited

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: CONNECTING KIDS	FACILITY NUMBER: 198012652
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/23/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101174(d)(2)

(2) The drills shall be documented. This documentation shall be kept in the child care center for at least one year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above as the facility did not have verification of fire and disaster drills available for review which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/23/2022
	Plan of Correction
1 2 3 4	The facility will conduct a fire and disaster drill, and the Director will submit a copy of the drill log to LPA Ayala via e-mail by September 23rd.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Monique Ayala	TELEPHONE: (323) 246-2016
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2022

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022

LIC809 (FAS) - (06/04)

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