198015619-5-7-2019-54-CC-JMAZ-BBXPNJ-20190507112801

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198015619
Report Date: 05/07/2019
Date Signed: 05/07/2019 11:28:13 AM

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:	NORWALK-LA MIRADA USD HEAD START/STATE PS-CHAVEZ		FACILITY NUMBER:	198015619
ADMINISTRATOR:	JACQUELINE FLIETES		FACILITY TYPE:	850
ADDRESS:	12110 E. WALNUT AVENUE		TELEPHONE:	(562) 210-4533
CITY:	NORWALK	STATE: CA	ZIP CODE:	90650
CAPACITY:	48	CENSUS: 34	DATE:	05/07/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Cyndie Allen, Assistant Director		TIME COMPLETED:	11:30 AM

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 Annual Random Inspection was conducted on this day by Licensing Program Analyst (LPA) Jacqueline Martinez. Facility is currently licensed for a capacity of 48 children. LPA met with Teacher, Kimberly Montalvo, who guided analyst on a tour of the facility. Twenty minutes into the inspection Cyndie Allen, Assistant Director arrived to complete the inspection. This is a Head Start preschool program which is operated by Norwalk La Mirada Unified School District and is located on the premises of Chavez Elementary School. The program consists of a full day program in Room 43 from 8:30am to 3:00pm and a part-time day program in Room 42 from 8:00am to 11:30am and 1:00pm to 3:30pm, Monday through Friday. The indoors and outdoors of the facility were inspected. LPA observed 18 children with 2 Staff Members in Room 42 and 16 children with 2 Staff Members from Room 43 in the outdoor play yard. 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. Napping equipment (cots) and bedding were inspected for good condition, appropriate storage and cleanliness. Children take their blankets and sheets home to wash weekly. Storage for children's belongings and isolation area were inspected. Ill isolation area is in the quiet area of each room. Drinking water is readily available indoors for children to drink freely via a water fountain. Facility has a waiver to share elementary restrooms with preschool children. Age appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, area safety and sanitation. First Aid supplies were reviewed and inventoried. PAGE 1 OF 3

SUPERVISOR'S NAME: Katherine Harewood	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Jacqueline Martinez	TELEPHONE: 323 981-3384
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2019

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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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: NORWALK-LA MIRADA USD HEAD START/STATE PS-CHAVEZ	FACILITY NUMBER: 198015619
	VISIT DATE: 05/07/2019

NARRATIVE

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AB1207: This is a reminder that As of January 1, 2018, Health & Safety Code 1596.8662 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. New employees shall have 90 days from date of employment to complete training as required. The training may be met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules at: http://www.mandatedreporterca.com/.

No deficiencies were cited during this inspection. An exit interview was conducted with Cyndie Allen, Assistant Director. A copy of this report and Notice of Site Visit was provided.

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.

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SUPERVISOR'S NAME: Katherine Harewood	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Jacqueline Martinez	TELEPHONE: 323 981-3384
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2019

LIC809 (FAS) - (06/04)

Page: 3 of 3

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: NORWALK-LA MIRADA USD HEAD START/STATE PS-CHAVEZ	FACILITY NUMBER: 198015619
	VISIT DATE: 05/07/2019

NARRATIVE

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Food menus were reviewed. Food is provided by the school district cafeteria. The facility provides, breakfast, lunch and an a PM snack to the full day program; breakfast and lunch to the AM Session and lunch and a PM snack to the PM Session. All storage containers for solid waste, including moveable bins had tight-fitting covers that are kept on, and in good repair. The facility was observed to be free of flies, other insects and rodents. Disinfectants, cleaning solutions, medications and other items that are dangerous to children, were inaccessible to children

The play yard is fully fenced and exclusively used by the preschool program. 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 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 as well as a sampling of children’s emergency information. All staff is fingerprint cleared, as a condition of employment through the school district. Four (4) Staff members provided proof of current Pediatric First Aid and CPR certification. The name of the child care center director or fully qualified teacher(s) designated to act in the director's absence has been reported to the department.

Incidental Medical Services (IMS). The facility is providing IMS Services and an IMS Plan is on file for this facility. A review of the medication policy, including administering, labeling, storage, and records was made. 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.

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SUPERVISOR'S NAME: Katherine Harewood	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Jacqueline Martinez	TELEPHONE: 323 981-3384
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2019

LIC809 (FAS) - (06/04)

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