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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198015614
Report Date: 05/30/2023
Date Signed: 05/30/2023 03:21:38 PM


Document Has Been Signed on 05/30/2023 03:21 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:COVINA EDUCATIONAL CENTER STATE PRESCHOOLFACILITY NUMBER:
198015614
ADMINISTRATOR:VANESSA BURGUENOFACILITY TYPE:
850
ADDRESS:160 N. BARRANCATELEPHONE:
(626) 974-4204
CITY:COVINASTATE: CAZIP CODE:
91723
CAPACITY:72CENSUS: 52DATE:
05/30/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Director, Vanessa BerguenoTIME COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) Mireya García conducted an unannounced Annual Required Inspection. LPA met with Vanessa Bergueno, Director who guided LPA on a tour of the facility indoors and outdoors. This is a Preschool program. This program consists of three (3) classrooms; Rooms #1 #2 and #3. This preschool program is located inside of Tri-Community Adult School- Pioneer; serves adults. Facility operation hours are as follow Room #1 Monday through Friday from 7:00 AM to 6:00 PM. Rooms 2 & 3; AM Session: Monday through Friday from 8:30 AM to 11:30 AM. Per Director, currently there is only an AM session operating in Rooms 2 & 3 and the PM session at this time is not in operation due to low enrollment. This facility has a capacity of 72 children; serving children ages 3-5.

Upon arrival, the following staff were present during this inspection: Room #3: Staff #1, #2 and #3 with nineteen (19) preschoolers in the outdoor play area; Room #2: Staff #4, #5 and #6 with twelve (12) preschoolers and Room #1: Staff #7, #8 and #9 with twenty-one (21) preschoolers. Teacher-child ratio is met. All individuals present have obtained a criminal record clearance or criminal record exemption. All staff have received an active criminal record clearance as a condition of their employment with the Covina Unified School District. All children were observed to be under visual supervision of a teacher at all times.

LPA observed the facility to be clean, safe and sanitary. LPA observed the self-closing latch on the entrance gate in the outdoor play yard is in disrepair. During LPAs inspection the gate was secure by placing the chain with padlock on alternative secure hook that is on the gate pole. Director place work order and a copy of service order was email to LPA Garcia during this inspection. Furniture and equipment were inspected for good repair, free of sharp, loose, or pointed parts. Indoor classrooms were inspected to ensure that the floors have a surface that is safe and clean. The toilets and hand washing facilities are in safe and sanitary operating conditions. All materials and surfaces accessible to children are toxic free.



REPORT CONTINUES ON NEXT PAGE 1 OF 4.
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:
DATE: 05/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/30/2023
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 8


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: COVINA EDUCATIONAL CENTER STATE PRESCHOOL
FACILITY NUMBER: 198015614
VISIT DATE: 05/30/2023
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At this time, the main office is used as an isolation area. There is space for chairs and there is a bench and restroom available. Parents are contacted immediately when children are determined to be ill and staff are ensuring that children with obvious symptoms of illness are not being accepted.

Full day program Preschoolers are provided with Breakfast, Lunch and PM Snack, AM Session is provided Breakfast by the Covina Unified School District. A monthly meals menu is available and was observed posted outside classrooms bulletin boards. Meals are delivered directly from Nutrition Services. All food preparation, and storage areas are clean, free of litter, rubbish, and rodents/vermin. All food is protected from contamination, and LPA inspected that any contaminated food is discarded immediately.All storage containers for solid waste, including moveable bins, have tight fitting covers on and are in good repair.

Per Director, the facility provides water for children. Water bottles were observed readily available inside classrooms and children's water bottles was observed in the outdoor benches. Storage of water bottles was observed in the classrooms and two water filtered water fountains were observed outside classrooms/outdoor play area.

Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are stored in an area inaccessible to children. Director states that there are no poisons stored at the facility.

Facility has functioning smoke and carbon monoxide detector that meets statutory requirements. The carbon monoxide detector is located inside Room #1, which was tested at 10:58 a.m., and it is in operable condition.

Outdoor play equipment was observed to be in good condition, free of sharp, loose or pointed parts. The outdoor surface is maintained in a safe condition as is free of hazards. There is no shaded structure however, there are large tree's in the play yard that provide shade. The Director states that there are no bodies of water on the premises and LPA did not observe any bodies of water during this visit. Areas around and/or under climbing equipment and slides have soft wood chips/mat at the end of the slides as a cushioning to absorb a fall.



REPORT CONTINUES ON NEXT PAGE 2 OF 4.
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:

DATE: 05/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2023
LIC809 (FAS) - (06/04)
Page: 7 of 8
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: COVINA EDUCATIONAL CENTER STATE PRESCHOOL
FACILITY NUMBER: 198015614
VISIT DATE: 05/30/2023
NARRATIVE
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Sign in and out sheets were reviewed by LPA to ensure that children who are present where sign in. Staff Records were reviewed to ensure that personnel records are maintained on all staff. Children’s Records were reviewed to ensure that Identification and Emergency form and a medical assessment are on file. LPA issued the Children’s Record Review (LIC 857) and the Review of Staff records (LIC 859) to the Director during this inspection. There is at least one person trained in CPR and Pediatric First Aid present during this inspection.

SB792 (Immunization Requirements for Staff and Employees) was discussed with the facility representative. Staff #1, 2, 6 and #7 were missing immunization records on file.

AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018 any person who works in a child care facility shall complete the training and renew the training every 2 years. Staff #2, 6 and #7 no training certificates were available for review, therefore a technical violation was issued on this date.


Website provided:https://www.mandatedreporterca.com/training/child-care-providers

Incidental Medical Services (IMS) policy was discussed. This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. In review of medication bin LPA observed Child #1 Reagent Strips for urinalysis expired 02/28/23 and Level 3 Control Solution-One touch Verio expired 05/23 (pictures were taken). LPA Garcia provided technical assistance to District Registered Nurse, Nicole Salas & Director in the storage of medication and record keeping. 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

REPORT CONTINUES ON NEXT PAGE 3 OF 4.
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:

DATE: 05/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2023
LIC809 (FAS) - (06/04)
Page: 2 of 8
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: COVINA EDUCATIONAL CENTER STATE PRESCHOOL
FACILITY NUMBER: 198015614
VISIT DATE: 05/30/2023
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The following was discussed:
  • Reporting Requirements.
  • The facility shall ensure that each child is accorded the following personal rights: to be accorded safe, healthful and comfortable accommodations.
  • All personnel shall be in good health and shall be physically and mentally capable of performing assigned tasks; personnel that pose a threat to the health and safety of children shall be relieved of their duties.
  • All personnel shall be given on the job training in housekeeping, sanitation principles and universal health precautions.


LPA advised the facility representative to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

The following deficiencies are being cited in accordance to Title 22 of the California Code of Regulations. Please refer to LIC809D for documentation of deficiencies cited.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with facility representative, Vanessa Bergueno.

REPORT ENDS HERE PAGE 4 of 4.
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:

DATE: 05/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2023
LIC809 (FAS) - (06/04)
Page: 8 of 8
Document Has Been Signed on 05/30/2023 03:21 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754


FACILITY NAME: COVINA EDUCATIONAL CENTER STATE PRESCHOOL
FACILITY NUMBER: 198015614

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/30/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238(a)
Buildings and Grounds
(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPAs observation and Director disclosure the self-closing latch on entrance gate is not working properly. This poses a potential health and safety risk to children in care.
POC Due Date: 06/05/2023
Plan of Correction
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During LPAs inspection the gate was secure by placing the chain with padlock on alternative secure hook that is on the gate pole. Director place work order and a copy of service order was email to LPA Garcia during this inspection. Director, states the latch will be fixed by POC due date 06/05/23 and a picture will be taken and submitted to LPA Garcia via email.
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 records review of staff #1, 2, 6 and 7 files were missing Immunization records. This poses a potential health and safety risk to children in care.
POC Due Date: 06/13/2023
Plan of Correction
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Per Director, immunization records for staff wil be obtained and a scan copy will be sent to LPA Garcia via email by POC due date 06/13/23, and a copy will be placed in staff file for future CCLD review.
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: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:
DATE: 05/30/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/30/2023
LIC809 (FAS) - (06/04)
Page: 3 of 8


Document Has Been Signed on 05/30/2023 03:21 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754


FACILITY NAME: COVINA EDUCATIONAL CENTER STATE PRESCHOOL
FACILITY NUMBER: 198015614

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/30/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(g)(2)
Personnel Requirements
(2) Each person specified in (g) above shall have a health-screening report signed by the person performing the screening. This report shall indicate the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on records review of staff #1, 2, 3, 6, 7 and 8 files were missing Health Screening Report-Faciity Personnel LIC 503. This poses a potential health and safety risk to children in care.
POC Due Date: 06/13/2023
Plan of Correction
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Per Director, completed Health Screening Reports for staff wil be obtained and a scan copy will be sent to LPA Garcia via email by POC due date 06/13/23, and a copy will be placed in staff file for future CCLD review.
Type B
Section Cited
CCR
101217(d)
Personnel Records
(d) All personnel records shall be maintained at the child care center and shall be available to the licensing agency for review.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPAs inspection on this date and director disclosure staff files are not maintained at the child care center, and staff #7 file was not available for review. This poses a potential health and safety risk to children in care.
POC Due Date: 06/13/2023
Plan of Correction
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Per Director, a staff binder will be implemented with copies of required documentation will be maintained at the center for compliance and future CCLD review. Director will send LPA Garcia email verification that binder is complete and available for review by POC due date 06/13/23.
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: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:
DATE: 05/30/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/30/2023
LIC809 (FAS) - (06/04)
Page: 4 of 8


Document Has Been Signed on 05/30/2023 03:21 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754


FACILITY NAME: COVINA EDUCATIONAL CENTER STATE PRESCHOOL
FACILITY NUMBER: 198015614

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/30/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101226(e)(3)(A)
Health-Related Services
(3) Prescription medications may be administered if all of the following conditions are met: (A) Prescription medications shall be administered in accordance with the label directions as prescribed by the child's physician.

This requirement is not met as evidenced by:
Deficient Practice Statement
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In review of medication bin LPA observed Child #1 Reagent Strips for urinalysis expired 02/28/23 and Level 3 Control Solution-One touch Verio expired 05/23 (pictures were taken). This poses a potential health and safety risk to children in care.
POC Due Date: 05/31/2023
Plan of Correction
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Per Director, child's last day of school is 05/31/23, parent will be notified via telephone to bring the current unexpired medication to the center for child's last day of attendance. The Center Representative will give parent the expired medication. Per Director the assigned health clerk will conduct monthly medication inventory to ensure compliance with non experation medication. Compliance plan will be sent to LPA Garcia via email by POC due date 05/31/23.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:
DATE: 05/30/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/30/2023
LIC809 (FAS) - (06/04)
Page: 5 of 8