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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198015507
Report Date: 03/12/2020
Date Signed: 03/12/2020 12:17:51 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:MOTHER OF SORROWS PRESCHOOLFACILITY NUMBER:
198015507
ADMINISTRATOR:ALEJANDRA FRUTOSFACILITY TYPE:
850
ADDRESS:8803 S. MAIN STREETTELEPHONE:
(323) 750-3700
CITY:LOS ANGELESSTATE: CAZIP CODE:
90003
CAPACITY:30CENSUS: 19DATE:
03/12/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Griselda Villareal, DirectorTIME COMPLETED:
12:30 PM
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An unannounced Annual Required Inspection was conducted on 3/12/2020 at 8:35 AM by Licensing Program Analysts (LPAs) Katrina Chicote and Denise Gibbs. Facility is currently licensed for a capacity of 30. Upon arrival, Licensing staff met with Griselda Villareal, Director and announced purpose of the visit. The program currently operates Monday through Thursday from 7:45 AM to 2:45 PM and Fridays 7:45 AM to 12:45 PM. Facility runs on a school calendar and is closed during the Summer. Facility is located across the street from private elementary school.

LPAs were taken on a guided tour of the facility of both indoors and outdoors and the following were observed:

At the initial start of the site visit, there is a total census of 19 children and a total census of 2 teachers present. The facility is made up of 1 classroom and an outdoor yard. Furniture, toys and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. There were cubbies observed as storage for children's belongings. LPAs observed blue cots in classroom that are used for napping. Per Director, linens are provided by the facility and blankets taken home weekly. Availability of drinking water was reviewed, LPAs observed water fountains in the classroom. Age appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, area safety and sanitation.

LPAs observed First Aid kit in teacher cabinet. At 9:20 AM, LPAs did not observe a Carbon Monoxide detector in classroom. Per Director, they installed a Carbon Monoxide detector in the Transitional Kindergarten program, across the street, but they do not have one in the preschool program. Fire extinguishers have been serviced on April/2019, and last disaster drill log conducted on 1/22/2020. Hazardous items including poisonous cleaning compounds were stored inaccessible to children.

Report Continues - Page 1 of 3
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina ChicoteTELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2020
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 5
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: MOTHER OF SORROWS PRESCHOOL
FACILITY NUMBER: 198015507
VISIT DATE: 03/12/2020
NARRATIVE
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Snack/lunch menus were reviewed. LPAs observed refrigerator and cabinets in the classroom for food storage. Food and snacks were reviewed for availability, quantity and appropriateness to children in care. Food preparation areas were toured for safety, cleanliness and proper equipment. Per Director, food is provided by the food program.

Outdoor equipment was inspected for safety, cushioning material, good repair and age-appropriateness. Required shade and fencing were inspected. LPAs observed a large play structure with slide and rock climbing wall on the yard. Per Director, staff brings out water for children to drink when they are outside. Play area was inspected for hazards; no bodies of water or hazards observed.

Teacher-child ratios was observed and staff names recorded. Care and supervision was evaluated to determine if the basic needs of children are met and appropriate. Sign-in and out sheets and procedures were reviewed, and LPAs observed person who signs the child in and out uses their full legal signature and records the time of the day. Personal Rights of children were observed by LPA.

Ten out of 19 Children’s Records were reviewed. Child number one (C1) and Child Number two (C2) receive medications from facility. LPAs observed medications kept in teacher cabinet with directions. Two out of Two Staff records were reviewed. Criminal Record Clearances were reviewed for adults. At 10:15 AM, LPAs did not observe Mandated Reporter training two out of two staff files. Per Director, they do not have this training but will complete the training as soon as possible. At 10:20 AM, LPAs did not observe CPR/First AId available for review. Director states her staff have the training and provided dates, but will send certificates to Department.

Incidental Medical Services:
This facility provides Incidental Medical Services – IMS. LPA 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.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

Report Continues Page 2 of 3
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina ChicoteTELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2020
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: MOTHER OF SORROWS PRESCHOOL
FACILITY NUMBER: 198015507
VISIT DATE: 03/12/2020
NARRATIVE
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The following were discussed with the Director:
The Director was advised how to access forms and Regulations online at www.ccld.ca.gov.
Director was made aware that it is his/her responsibility to know the regulations as well as anyone who assists in providing care. The Director was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care.

AB 1207: Beginning on January 1, 2018, this law requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Website: http://www.mandatedreporterca.com/

Senate Bill 792: this bill, commencing September 1, 2016, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles. LPA discussed the influenza waiver during the visit.

The Director was also advised of the requirement to report Unusual Incidents and/or injuries to the parent/guardian and to CCL within the time frame specified by the regulation.

The Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. A hard copy of the Lead Handout and PIN 20-02-CCP “Coronavirus Information Guideline” was provided.



Based on this information, the following deficiencies 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.

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.

Exit interview was conducted with Griselda Villareal on 3/12/2020 at 12:15 PM. A copy of report and Appeal rights were given.
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina ChicoteTELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2020
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: MOTHER OF SORROWS PRESCHOOL
FACILITY NUMBER: 198015507
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/12/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/16/2020
Section Cited

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1597.543 Health and Safety Code
Every family day care home for children shall have one or more carbon monoxide detectors in the facility that meet the standards of department.

This regulation was not met as evidenced by:
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Based on observations and interviews the Director did not have Carbon Monoxide detectors in preschool program.

This poses a potential health, safety, or personal rights risk to children in care.
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Type B
04/10/2020
Section Cited

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1596.8662(d)(1) Health and Safety Codea person who is a licensed child care provider... of a licensed child care facility shall complete the mandated reporter training.. following the date on which he or she completed...
This regulation was not met as evidenced by:
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Based on observations, interviews, and record review the Director and staff have not completed mandated reporter training.
This poses a potential health, safety, or personal rights 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: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina ChicoteTELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:
DATE: 03/12/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/12/2020
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: MOTHER OF SORROWS PRESCHOOL
FACILITY NUMBER: 198015507
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/12/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/16/2020
Section Cited

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102416 (c) Personnel Records
The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid..
This regulation was not met as evidenced by:
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Based on observations, interviews, and record review, the Director did not have proof of Pediatric CPR/First Aid readily available. This 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: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina ChicoteTELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:
DATE: 03/12/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/12/2020
LIC809 (FAS) - (06/04)
Page: 5 of 5