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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198013779
Report Date: 01/28/2020
Date Signed: 01/28/2020 12:32:22 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:EL MONTE CITY SCHOOL DISTRICT-GIDLEY (HEAD START)FACILITY NUMBER:
198013779
ADMINISTRATOR:LISA DUNBARFACILITY TYPE:
850
ADDRESS:10226 E. LOWER AZUSA AVENUETELEPHONE:
(626) 455-0962
CITY:EL MONTESTATE: CAZIP CODE:
91731
CAPACITY:25CENSUS: 15DATE:
01/28/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Carmelita Gonzalez, Lead TeacherTIME COMPLETED:
10:45 AM
NARRATIVE
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An unannounced Annual Random Inspection was conducted on this day by Licensing Program Analysts (LPAs) Lissete Gonzalez and Alanna Gontarek. Facility is currently licensed for a capacity of 25 children. LPAs met with Lead Teacher, Carmelita Gonzalez who guided analysts on a tour of the facility. This is a Head Start preschool program which is operated by El Monte Unified School District and is located on the premises of Gidley Elementary School. The program consists of two part-time day sessions. The AM Session operates from 8:00am to 11:30am and the PM Session operates from 12:00pm to 3:30pm, Monday through Friday.

All areas identified on the Indoors and Outdoors Facility Sketch were inspected. LPAs observed 15 children with two (2) Staff Members. Teacher child ratios were observed and staff names recorded.

Furniture and equipment was inspected for age appropriateness, good repair and free of sharp, loose, or pointed parts. Telephone service, heating, lighting and ventilation were evaluated. Storage for children's belongings and isolation area were inspected. Ill isolation area is in the "cozy" area of the room. Drinking water is readily available indoors for children to drink freely via a water fountain.

Age appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, area safety and sanitation. First Aid supplies were inventoried. A review of the medication policy, including administering, labeling, storage, and records was made. LPAs observed Child #5 to have Albuterol medication that expired on 12/2019.

Food is provided by the School District Cafeteria. The facility provides, breakfast and lunch to the AM Session and lunch and a PM snack to the PM Session. Proper storage of food, beverages and snacks was reviewed. Food menus were posted in a place that is visible by the child’s authorized representative. All storage containers for solid waste, including moveable bins had tight-fitting covers that are kept on, and in good repair. REPORT CONTINUES ON NEXT PAGE: 1 OF 3

SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Lissete GonzalezTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2020
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: EL MONTE CITY SCHOOL DISTRICT-GIDLEY (HEAD START)
FACILITY NUMBER: 198013779
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/28/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/14/2020
Section Cited

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Health-Related Services
All prescription and nonprescription medications shall be maintained with the child's name and shall be dated. This requirement was not met as evidenced by: LPAs observed Child #5 to have Albuterol medication that expired on 12/2019. This poses a potential risk to the health and
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safety of 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: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Lissete GonzalezTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 01/28/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/28/2020
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: EL MONTE CITY SCHOOL DISTRICT-GIDLEY (HEAD START)
FACILITY NUMBER: 198013779
VISIT DATE: 01/28/2020
NARRATIVE
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All floors were observed to be clean and safe. Disinfectants, cleaning solutions, medications and other items that are dangerous to children, were inaccessible.

This facility has a waiver for staggered outdoor play schedule. The Kindergarten and the Head Start classrooms do not go out at the same time to play. Outdoor play equipment was inspected for safety, free of sharp, loose pointed parts, good repair and age appropriateness. The surface of the outdoor activity area was observed to be maintained in a safe condition, and free of hazards. All areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with material that absorbs a fall. Required shade, drinking water and fencing were inspected. Drinking water was available outdoors for children to drink freely via a water fountain. Play area was inspected for hazards and inaccessibility to bodies of water; no bodies of water or hazards were observed.



Children's records were reviewed. Sampling of children’s emergency information was reviewed. Staff files were not reviewed as staff files are kept at the Main Office and will be reviewed at a later date. If there are any deficiencies during that review, this report may be amended. All staff is fingerprint cleared, as a condition of employment through the school district. Staff #1 and Staff #2 provided proof of current Pediatric First Aid and CPR certification.

Incidental Medical Services (IMS). The facility provides Incidental Medical Services-IMS. LPAs reviewed storage of medication and (equipment/supplies, and reviewed children’s, personnel, and administrative records). For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A 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.

Based on this information, the following deficiencies listed on the attached LIC 809d 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. An exit interview was conducted with Carmelita Gonzalez, Lead Teacher. A copy of this report and Notice of Site Visit was provided. REPORT CONTINUES ON NEXT PAGE: 2 OF 3

SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Lissete GonzalezTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2020
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: EL MONTE CITY SCHOOL DISTRICT-GIDLEY (HEAD START)
FACILITY NUMBER: 198013779
VISIT DATE: 01/28/2020
NARRATIVE
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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.
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Lissete GonzalezTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2020
LIC809 (FAS) - (06/04)
Page: 4 of 4