198015507-1-18-2022-54-CC-KCHE-CASTND-20220118135233

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198015507
Report Date: 01/18/2022
Date Signed: 01/18/2022 01:52:45 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 PRESCHOOL		FACILITY NUMBER:	198015507
ADMINISTRATOR:	ALEJANDRA FRUTOS		FACILITY TYPE:	850
ADDRESS:	8803 S. MAIN STREET		TELEPHONE:	(323) 750-3700
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90003
CAPACITY:	30	CENSUS: 7	DATE:	01/18/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Director, Griselda Villareal		TIME COMPLETED:	02:15 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	An unannounced Required – 1 Year Inspection was conducted on 01/18/22 at 12:00 PM by Licensing Program Analyst (LPA) Katrina Chicote. LPA conducted COVID-19 screening call prior to entering facility. Facility is currently licensed for a capacity of 30. Upon arrival, LPA met with Principal, Griselda Villareal. The program currently operates Monday thru Thursday from 7:30 AM to 2:45 PM, Fridays 7:30 AM to 11:45 PM. LPA was taken on a guided tour of the facility of both indoors and outdoors. Principal states facility just reopened on 01/11/22 after closing in March 2020 due to COVID-19 precautionary measures. Facility conducted COVID-19 screening questions and temperature check upon entering the building. LPA waited in lobby for Principal to escort LPA to preschool facility. At the initial start of the site visit, there is a total census of seven children that were down for nap time and a total census of one teacher (S1) present. The facility is made up of one bungalow classroom across the street from main building. Facility is located on church property that has an elementary thru middle school program. At 12:12 PM, LPA was walked over to preschool location. Furniture and equipment were inspected for age appropriateness and good repair. LPA observed child size tables and chairs with plexiglass barriers on desks, shelves with art, science, dramatic play toys and other toys free of lose and sharp parts available for children in care at time of inspection. Telephone service, heating, lighting and ventilation were evaluated. LPA observed cubbies as storage for children's belongings. Mats/cots were inspected, LPA observed standard blue cots that children were using for napping each labeled with child's names. Per Director, linens are washed weekly by S1. Availability of drinking water was reviewed. LPA observed water jug on table in classroom with small paper cups available for children at time of inspection. At 12:15 PM, LPA observed two bathrooms in preschool room that had age appropriate sinks and toilets and were inspected for availability, good repair, water temperature, toilet paper, area safety and sanitation. Report Continues - Page 1 of 4

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 01/18/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2022

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: 01/18/2022

NARRATIVE

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A first aid kit is kept in cabinet in classroom. Carbon monoxide detectors and smoke detectors are present in the facility. Fire extinguishers have been serviced in 05/19/2021. Hazardous items including poisonous cleaning compounds were stored inaccessible to children.

Snack/lunch menus were reviewed. Food and snacks were reviewed for availability, quantity and appropriateness to children in care. Per Director, due to low enrollment at this time, children are bringing their own lunches to school while facility provides AM/PM snack. LPA observed lunch boxes on a counter in the classroom that serves as classroom's makeshift kitchen that has microwave and large refrigerator.

Outdoor equipment was inspected for safety, cushioning material, good repair and age-appropriateness. Required shade and fencing were inspected. LPA observed large play structure with climbing wall, steps, and plastic slide to be free of hazards and good condition at time of inspection with cushioning material below. LPA observed shaded area where seating is available for children outside. LPA Chicote advised S1 that the children need to be within the direct care and supervision, including visual supervision of the teacher(s) at all times. Per S1, children have access to drinking water during outside play through water jugs that they bring outside with them. Play area was inspected for hazards and inaccessibility to bodies of water; no bodies of water or hazards observed.

Teacher-child ratios were 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. Personal Rights of children were observed by LPA.

Staff and Children’s Records were reviewed. Criminal Record Clearances were reviewed for adults. CPR card expires in 06/08/2023 for S1. Inspection of required forms made. At 12:50, LPA did not observe mandated reporter training certificate for S1 at time of inspection.

The following were discussed with the Director:
Rooms that are off-limits need to be made inaccessible during operating hours. Smoking is prohibited.

The Director was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care.

Report Continues - Page 2 of 4

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 01/18/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2022

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: 01/18/2022

NARRATIVE

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The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and Carbon Monoxide detectors should be checked and batteries replaced as needed. Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your location.

Mandatory Forms for the children’s files and staff files, requirements for fire drills, earthquake drills and documentation were discussed. Role and responsibilities of being a Mandated Reporter were reviewed. 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.

LPA advised Director that all adults 18 years of age and older providing Care & Supervision and/or have continuous presence in the facility shall adhere to a criminal background clearance with the Department of Justice, FBI and Child Abuse Index Check.

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. Director advised to visit www.shotsforschool.org for immunization information.

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

Per S1, sick policy is updated and isolation of sick children is at front office. S1 states she will call for assistance for child to be picked up from the classroom and taken to front office awaiting to be picke dup.

Report Continues - Page 3 of 4

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 01/18/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2022

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
	VISIT DATE: 01/18/2022

NARRATIVE

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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 inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted and report was reviewed with the Licensee (or facility representative), Griselda Villareal.

Report Continues - Page 4 of 4

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 01/18/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2022

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: 01/18/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

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
1 2 3 4	At 12:50 PM, based on record review and staff interview LPA did not observe proof of completion of Mandated Reporter Training in S1's file at time of inspection. S1 states she was unaware of requirement.
	POC Due Date: 01/31/2022
	Plan of Correction
1 2 3 4	Principal states she will email proof of completion to LPA by above POC date.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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 Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 01/18/2022

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2022

LIC809 (FAS) - (06/04)

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