<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198013539
Report Date: 07/20/2022
Date Signed: 07/20/2022 12:06:04 PM


Document Has Been Signed on 07/20/2022 12:06 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:HSA BELL GARDENS LAUPFACILITY NUMBER:
198013539
ADMINISTRATOR:LETICIA RICO-NUNEZFACILITY TYPE:
850
ADDRESS:6800 FLORENCE AVE.TELEPHONE:
(562) 806-5400
CITY:BELL GARDENSSTATE: CAZIP CODE:
90201
CAPACITY:24CENSUS: 8DATE:
07/20/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Mariana Toribio, Teacher/ Leticia Martinez, Site SupervisorTIME COMPLETED:
12:15 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
Licensing Program Analysts (LPAs) Alicia Mooberry conducted an unannounced annual required inspection at the above facility on this date. LPAs met with Mariana Toribio, Teacher and Leticia Martinez, Facility Representative (FR) who guided analysts on a tour of the facility. This is a preschool program consisting of one (1) classroom. Hours of operation are Monday-Friday, 8:00am - 2:30pm. The preschool is completely gated and physically separate from other programs operating on site. There are community services for families and seniors.

There were eight (8) children and three staff present when LPA arrived. Staff #3 were sent from Child Care Careers, a substitute agency. Facility is in compliance with License capacity and Title 22 ratio guidelines. All individuals present have obtained a criminal record clearance.

LPAs toured classroom and observed. Classroom had furniture in good condition, free of loose, sharp and/or pointed parts. The floors and surfaces in the classrooms were clean and safe. LPA did not observe any tripping hazards. Water is made readily available by via water dispenser and disposable cups Per FR, there are currently no children taking medication and there is no medication stored at the facility. Children have cubbies to store personal belongings separate from each other. LPA observed napping cots stored in separate storage area. Bedding is brought by parents and washed weekly.

LPA toured the children’s restroom. Restroom was observed to be safe and sanitary with operable sinks and toilets.

LPA verified that at least one staff is current with Pediatric CPR and 1st aid. LPA observed first aid kit accessible in classroom and in the playground, items were inventoried to ensure there is a thermometer, scissors, tweezers and current 1st aid manual. At this time there are no children requiring medications.

Facility records were reviewed for LIC 9148- Earthquake Preparedness form, Daily schedule and Disaster drill log. All documents were observed.


-------------------------PAGE 1
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 07/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/20/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 3 of 7


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: HSA BELL GARDENS LAUP
FACILITY NUMBER: 198013539
VISIT DATE: 07/20/2022
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
26
27
28
29
30
31
32
LPA observed outdoor spaces. Outdoor area was observed to have age appropriate toys and material for children, free of loose, sharp, and/or pointed parts. There are no bodies of water observed. LPA observed a water table with lid and drained. LPA reminded FR to ensure proper supervision when conducting water activities. Shade was observed throughout the outdoor area. Water is easily accessible via dispensers and disposable cups.

LPA observed required posted documentation which included, Facility License, Publication (PUB) 393- Notification of Parent Rights, Licensing Form (LIC) 610- Facility Disaster Plan, PUB 269- Child Passenger Restraint System, LIC 613A- Notification of Personal Rights and Lunch/Snack Menu. LPA reminded FR to ensure the documents are updated with current Regional Office information.

LPA reviewed Sign In/Out sheets located at the front entrance. All children present were signed in with date, time and full signature of the child's representative.

LPA toured the kitchen located adjacent to the classroom. Facility provides Breakfast, PM snack and lunch. Food delivered daily from a vendor. Kitchen was observed to be clean, free of litter, insects and rodents. All storage for solid waste have tight fitting covers. Cleaning supplies are stored separate from the food.

Carbon monoxide/smoke detector was observed in the classroom and operable. Per FR smoking is prohibited on the the facility premises and there are no firearms or weapons stored at the facility. LPA did not observe smoking or firearms/weapons.

Children’s records were reviewed for Licensing Form (LIC) 700 Emergency Card, Immunization Records, LIC 627- Consent for Medical Treatment, LIC 995 Notification of Parents’ Rights, LIC 613A- Personal Rights, and signed Admissions Agreement. All documents complete.

Staff records were reviewed for approved Pediatric First Aid and CPR certification for at least one staff member on site, LIC 9052- Employee Rights, LIC 501- Personnel Record, LIC 503- Health Screening Report, LIC 508- Criminal Record Statement, Proof of immunization against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse, Transcripts and current Mandated Reporter Training Certificate. Records complete.

During inspection all children were observed to be treated with dignity and respect, they were observed to be receiving safe, healthful and comfortable accommodations, furnishings and equipment, and free from corporal and/or unusual punishment. --------------------PAGE 2

SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2022
LIC809 (FAS) - (06/04)
Page: 6 of 7
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: HSA BELL GARDENS LAUP
FACILITY NUMBER: 198013539
VISIT DATE: 07/20/2022
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
26
27
28
29
30
31
32
Facility representative was reminded that all adults 18 and over working in the facility, 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 licensed 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 observed that facility is implementing COVID-19 precautions and procedures as recommended by the Los Angeles Department of Public Health. LPA reminded FR to stay informed on the latest guidance regarding COVID or other diseases.

Incidental Medical Services (IMS):


Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a plan for providing 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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm

Based on the LPA’s observations and record reviews no deficiencies are cited as a result of this inspection in accordance with Title 22 Regulations.

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.

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 Martinez.

SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2022
LIC809 (FAS) - (06/04)
Page: 7 of 7