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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198013666
Report Date: 02/13/2020
Date Signed: 02/13/2020 12:34:19 PM

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:ST. BERNARD SCHOOLFACILITY NUMBER:
198013666
ADMINISTRATOR:JACQUELINE REYESFACILITY TYPE:
850
ADDRESS:9626 PARK STREETTELEPHONE:
(562) 867-9410
CITY:BELLFLOWERSTATE: CAZIP CODE:
90706
CAPACITY:24CENSUS: 22DATE:
02/13/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Lorena MurgiaTIME COMPLETED:
12:50 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Elka Chavez and Raul Navarro conducted an unannounced random inspection. LPAs met with designated facility Interim Director, Lorena Mungia, who guided LPAs on a tour of the facility. This is a preschool age program licensed for 24 children which operates Monday – Friday from 7:00 AM – 3:00 PM. Per the Director there are 24 children enrolled.

All areas identified on the facility sketch were inspected. Upon arrival, LPA's observed 22 children with 3 staff. Teacher-child ratios were observed to be in accordance with Title 22 regulations. The Licensee is within the conditions, limitations, and capacity specified on the license. Staff names were recorded. All children were observed to be under visual supervision of a teacher at all times.

Furniture and equipment was inspected for good repair, free of sharp, loose, or pointed parts. All indoor classrooms were inspected to ensure that the floors have a surface that is safe and clean. All toilets and hand washing facilities are in safe and sanitary operating conditions. All materials and surfaces accessible to children are toxic free. At this time, the main office is used as an isolation area. There are chairs in the office. Parents are contacted immediately when children are determined to be ill.

Children bring their own snacks and lunch. If a child doesn't bring snacks, the school has snacks available for children. Lunch menus are provided a month in advance. All kitchen, food preparation, and storage areas are clean, free of litter, rubbish, and rodents/vermin. All food is protected from contamination, and LPAs inspected that any contaminated food is discarded immediately. There is drinking water available in all indoor classrooms and drinking containers are taken outdoors.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Elka ChavezTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 4
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: ST. BERNARD SCHOOL
FACILITY NUMBER: 198013666
VISIT DATE: 02/13/2020
NARRATIVE
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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

All storage containers for solid waste, including moveable bins, have tight fitting covers on and are in good repair. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are stored in a top shelf in an area inaccessible to children. Facility has one functioning carbon monoxide detector that meets statutory requirements. The facility takes measures to keep the facility free of flies, other insects and rodents.

Outdoor play equipment was observed to be in good condition, free of sharp, loose or pointed parts. Outdoor activity space surface is maintained in a safe condition as is free of hazards. The Interim Director states that there are no bodies of water on the premises and LPAs did not observe any bodies of water during this visit. Interim Director states there are no weapons or firearms on the premises.

Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. Children’s Records were reviewed to ensure that Identification and Emergency form and a medical assessment are on file.



Criminal Records Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed. Staff Records were reviewed to ensure that a health screening report is on file. SB792 Immunization Requirements for Staff and Employees was discussed with the Interim Director. The Interim Director and their assistants currently have proof of immunization against influenza. LPA did not observe proof pertussis for Interim Director and measles and pertussis for Staff #2. This is a potential risk to the health and safety of children in care.

AB1207 Mandated Child Abuse Reporting Implementation was discussed with Director. Staff present have taken the required Mandated Reporter Training.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Elka ChavezTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2020
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: ST. BERNARD SCHOOL
FACILITY NUMBER: 198013666
VISIT DATE: 02/13/2020
NARRATIVE
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LPAs advised the Director how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

The deficiency listed on the following page were observed by the LPAs and is being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809D for the deficiency that is being cited and needs to be cleared to protect the children’s health & safety.

Exit interview was conducted with Interim Director Lorena Mungia. The Director was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these forms.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Elka ChavezTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2020
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: ST. BERNARD SCHOOL
FACILITY NUMBER: 198013666
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/13/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/18/2020
Section Cited

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1596.7995
Employees or volunteers at day care center; immunization requirements; records; exemptions ..

This requirment is not met as evidenced by file review.
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Based on LPA's review of staff files, the Interim Director and Staff #2 are missing proof of vaccines which 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: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Elka ChavezTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 02/13/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/13/2020
LIC809 (FAS) - (06/04)
Page: 4 of 4