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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198013666
Report Date: 03/13/2023
Date Signed: 03/13/2023 04:22:09 PM


Document Has Been Signed on 03/13/2023 04:22 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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754



FACILITY NAME:ST. BERNARD SCHOOLFACILITY NUMBER:
198013666
ADMINISTRATOR:LORENA MURGUIAFACILITY TYPE:
850
ADDRESS:9626 PARK STREETTELEPHONE:
(562) 867-9410
CITY:BELLFLOWERSTATE: CAZIP CODE:
90706
CAPACITY:24CENSUS: 11DATE:
03/13/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:51 PM
MET WITH:Director Lorena MurguiaTIME COMPLETED:
04:35 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Austin Estrada and Jeanette Estrada conducted an unannounced annual required inspection at the above facility. LPAs met with Director Lorena Murguia, who guided analysts on a tour of the facility. Per Director operation days/hours are Monday Thru Friday 7:00 AM- 3:30 PM. The preschool program (indoors and outdoors) is separate from the school age program that operates on the same premises. There is no commingling with other programs. Per Director there are 15 children enrolled.
The facility has one classroom where care is provided. LPA observed 11 children supervised by the Director and one additional staff (S2) in the Preschool Classroom. Teacher child ratios were observed, and staff names recorded. The following was observed during the tour of the facility: LPA toured the preschool classroom which was observed to be clean and in good repair. The floors were clean and lighting was in operable condition. There were age appropriate toys and equipment. LPA observed water readily available via a water dispenser in the classroom. Children bring water bottles from home and use the water dispenser in the classroom. LPA observed cubbies/storage area for children to store their personal belongings. LPA observed a smoke detector and carbon monoxide detector to be in operable condition. LPA observed Fire extinguisher indicated fully charged last serviced August 2022. First Aid kit was observed and inventoried. Appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, paper towels, and general sanitation. Disinfectants and cleaning solutions were observed to be inaccessible to children in care. Per Director there are no poisons stored at the facility. Napping equipment and bedding were inspected and found to be clean and in operable condition. Per Director, bedding sheets are taken home by the children and washed weekly. The isolation area is located in the main office. Per Director, no children require medication and is stored in the office inaccessible to children in care. LPA toured the outdoor play area. Outdoor area was observed to have age-appropriate toys and material available for children, free of loose, sharp, and/or pointed parts. LPA observed required cushioned padding to absorb a fall. Per Director, water is provided to children via water containers while outdoors. LPA observed required shade in the outdoor area and there are no bodies of water on the premises.

SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 9813362
LICENSING EVALUATOR NAME: Austin EstradaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 03/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/13/2023
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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Document Has Been Signed on 03/13/2023 04:22 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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754


FACILITY NAME: ST. BERNARD SCHOOL
FACILITY NUMBER: 198013666

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/13/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
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
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Based on record review, the licensee did not comply with the section cited above: S2 did not have immunization records available at the time of inspection which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/10/2023
Plan of Correction
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Director will provided proof of immunization's for S2 to LPA via email by POC due date.
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
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Based on record review, the licensee did not comply with the section cited above: S2 did not have proof of completed mandated reporter training certificate which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/10/2023
Plan of Correction
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Director will provided proof of mandated reporter training certificate for S2 to LPA via email by POC due date.
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 CookTELEPHONE: (323) 9813362
LICENSING EVALUATOR NAME: Austin EstradaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 03/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/13/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/13/2023 04:22 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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754


FACILITY NAME: ST. BERNARD SCHOOL
FACILITY NUMBER: 198013666

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/13/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101170(e)(1)
Criminal Record Clearance
(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department or

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above: S2 was not associated to the facility at the time of inspection. S2 was associated to the school but not the facility which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/20/2023
Plan of Correction
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Director will provided proof of fingerprint clearance for S2 to LPA via email by POC due date.
Type B
Section Cited
CCR
101217(a)
Personnel Records
(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above: S2 did not have LIC 503, LIC 508, LIC 9108, LIC 9052, and Staff Qualifications available for review during the inspection. which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/10/2023
Plan of Correction
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Director will provided proof of the above requested personnel records for S2 to LPA via email by POC due date.
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 CookTELEPHONE: (323) 9813362
LICENSING EVALUATOR NAME: Austin EstradaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 03/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/13/2023
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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: ST. BERNARD SCHOOL
FACILITY NUMBER: 198013666
VISIT DATE: 03/13/2023
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LPA observed the kitchen area, food preparation area, and food storage area to be clean and free of litter, rubbish, rodents, and/or any other vermin. LPA observed refrigerator to be clean and in operable condition. LPA observed items in the refrigerator not to be expired. Food that was not in the original packaging were sealed and labeled with an expiration date. Children bring their own snacks and lunch. If a child doesn't bring snacks, the school provides one snack for children. Lunch menus are provided a month in advance. LPA observed a current children's roster. During the inspection, children present was observed to be treated with dignity and respect, observed to be receiving safe, healthful, and comfortable accommodations, furnishings, and equipment, and free from corporal and/or unusual punishment. LPA observed required posted documentation which included, Facility License, LIC610- Emergency Disaster Plan, Publication (PUB) 393- Notification of Parent Rights, PUB 269- Child Passenger Restraint System, LIC 613A- Notification of Personal Rights and Lunch/Snack Menus. All documents were observed to be in a prominent, publicly accessible area in the preschool classroom. LPA observed Sign in/out sheets, LIC 9148 Earthquake Preparedness, Daily Activity Schedule, and Verification of Disaster and Fire Drills (last conducted on 2/10/23). LPA observed 1 out of 15 enrolled children were not to be signed in. Director was advised to have all children signed in and out daily. Children’s records were reviewed for LIC 613A- Personal Rights, Admission Agreement, Immunization Records, LIC 700- Identification and Emergency Information, LIC 701- Physician’s Report, LIC 627- Consent for Medical Treatment, and LIC 995A Notification of Parents’ Rights. All records were observed to be complete. Staff records were reviewed for approved Pediatric First Aid and CPR certification, staff qualifications, LIC 508-Criminal Record Statement, LIC 503- Health Screening Report, LIC 9052- Employee Rights, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, and LIC 9108- Statement of Child and Mandated Reporter Training Certificate. There was at least one person trained in CPR and Pediatric First Aid present during this inspection. S2 did not have LIC 503, LIC 508, LIC 9108, Mandated Reporter Training Certificate, LIC 9052, Staff Qualifications, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment available for review during the inspection. As part of the plan of correction, Director was advised that S2 shall be associated to the facility. Lead Poisoning Facts Flyer (PUB 515) – All licensees (Child Care Centers) must provide the following flyer to parents and families upon enrolling or re-enrolling any child. PIN 21-21-CCP: Release of the Written Directives for Lead Testing of Water in Licensed Child Care Centers Per AB 2370
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 9813362
LICENSING EVALUATOR NAME: Austin EstradaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2023
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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: ST. BERNARD SCHOOL
FACILITY NUMBER: 198013666
VISIT DATE: 03/13/2023
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6. PIN 22-06-CCP: Lead Testing in Child Care Center – Frequently Asked Questions
7. Lead Testing in Child Care Centers Frequently Asked Questions (regarding your questions, please refer to Q23, Q24, Q29, Q34, and PIN 21-21-CCP). Please visit the Lead Toxicity Prevention and Water Testing Information website for additional information and resources regarding lead testing in licensed childcare centers by visiting the following weblink: https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information. For any additional questions, please email: CCCWaterTesting@dss.ca.gov. Per Director, the facility has been tested for lead exceedance. LPA advised Director to provide documentation to LPA of lead testing as soon as possible.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication. 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.

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.

SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 9813362
LICENSING EVALUATOR NAME: Austin EstradaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2023
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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: ST. BERNARD SCHOOL
FACILITY NUMBER: 198013666
VISIT DATE: 03/13/2023
NARRATIVE
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Based on the LPA’s observations, interviews and records review, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety. Deficiencies include four type B violations.

The following deficiencies are as follows:
1) S2 not having required personnel records available for review
2) S2 not having immunization records available for review
3) S2 not having mandated reporter training certificate available for review
4) S2 not being associated to the facility

A notice of site visit was given and must remain posted for 30 days. Failure to maintain posting as required will result in a $100.00 civil penalty. Exit interview was conducted and report was reviewed with the Director. Appeal rights were discussed and provided to Director.
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 9813362
LICENSING EVALUATOR NAME: Austin EstradaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2023
LIC809 (FAS) - (06/04)
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