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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198015694
Report Date: 01/21/2022
Date Signed: 01/21/2022 04:26:58 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:CHERRY BLOSSOM CHILD CARE & PRESCHOOLFACILITY NUMBER:
198015694
ADMINISTRATOR:LYNN MARROQUINFACILITY TYPE:
850
ADDRESS:906 S. GRAND AVENUETELEPHONE:
(626) 335-5500
CITY:GLENDORASTATE: CAZIP CODE:
91740
CAPACITY:55CENSUS: 30DATE:
01/21/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Martha AlvarezTIME COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Cynthia Reyes, conducted an unannounced 1 year annual inspection on this date. LPA met with Assistant Director, Martha Alvarez and a copy of the Entrance Checklist for Child Care Centers form (LIC 125) was provided. A risk assessment was conducted prior to entering the facility. Due to COVID- 19 precautionary measures were taken during the entire inspection and all individuals present during this inspection wore appropriate personal protective equipment. This is a preschool program which consists of four (04) classrooms. The facility operating hours are from 6:30AM to 6:30PM, Monday through Friday.

1 PM The tour began at the front lobby area where LPA observed where parents will sign the child in/out at a table located at the entrance door. Temperatures and health checks will be conducted. Use of hand sanitizer will also be available. Parents will not enter the class rooms, unless they request to enter the class room, which at that time all precautionary measures will be taken for that individual entering. Facility staff will walk the child inside the class room and bring the child out at pick up time. LPA observed by the sign in/out area, all licensing forms and Covid-19 posters. Facility was observed to be adhering to local public health guidelines. (According to CDC guidelines, children under the age of (2) are not required to wear masks.)

Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were observed to be inaccessible to children. Martha states there are no poisons located at the facility. Carbon monoxide and smoke detectors were observed and are operable. Martha stated there are no weapons or firearms on the premises.

All areas identified on the Facility Sketch were inspected. The following was observed during the tour of the preschool class rooms. 6 children were napping in the 2 year old class room with staff #3 and in the 3 year old class room, were 24 children with staff #2 and #3 and the 4 year old class room was empty. Staff #4 & 5 are floaters today. PAGE 1 OF 4
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2022
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 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: CHERRY BLOSSOM CHILD CARE & PRESCHOOL
FACILITY NUMBER: 198015694
VISIT DATE: 01/21/2022
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Teacher-child ratios were observed to be in accordance with Title 22 Regulations. Staff names were recorded. All children were observed to be under supervision and observation, including visual supervision, of a teacher at all times. The licensed facility is within the conditions, limitations, and capacity specified on the license.

Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Preschool children have their own cubby to store their personal belongings. LPA observed napping equipment/bedding and was inspected to be in good condition, appropriate storage and cleanliness. Linens are washed weekly. The ill isolation area is located in the back office area of the lobby. Staff rest room is located in the first door of the hallway off the lobby area.

Menus were reviewed to ensure that they are being posted at least one week in advance and visible to an authorized representative. The facility provides breakfast, lunch and AM and PM snack. All kitchen, 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. There is drinking water available indoors and outdoors by use of pitcher/jugs and disposable cups. All storage containers for solid waste, including moveable bins, have tight fitting covers on and are in good repair. The licensee takes measures to keep the facility free of flies, other insects and rodents.

2 PM The outdoor playground was inspected and the play equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under high climbing equipment, slides, and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard. LPA did not observe any bodies of water on the premises. The Preschool play yard is separated by a gate to ensure no commingling with the other components.



Martha was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

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SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2022
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: CHERRY BLOSSOM CHILD CARE & PRESCHOOL
FACILITY NUMBER: 198015694
VISIT DATE: 01/21/2022
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Children’s Records were reviewed for completeness; Inspection of required forms was made and documented on the LIC 857. LPA also reviewed Staff record, which were documented on the LIC 859. Staff present had proof against TB, measles, pertussis, and influenza, as well as current Mandated reporter.

2:30PM There is at least one person trained in CPR and Pediatric First Aid present during this inspection. Pediatric CPR & First Aid is documented for staff who have it and is current for the Director & Assistant Director, both Exp. 10/21/2022

Medication: 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

Children's roster was reviewed and is current and number of total enrolled at this time was documented. Sign-In and Sign-Out sheets were reviewed. Children present were signed in correctly and accounted for on this date. Disaster drill log was available and posted visibly for all to see. The last drill was conducted on 12/20/2021.

Menus for the past 30 days are available upon request. Snacks and food were reviewed for availability, quantity and appropriateness to children in care.

First Aid supplies were observed in the classroom in a cabinet. According to Staff, medication is only administered to a child when accompanied with a doctor's note and is stored in the classroom.

Update: Effects of Lead Exposure and the following Provider Information Notices (PINs) Required Lead Testing: PIN 20-01 CCP Effects of Lead Exposure, and Guardian User Account Access - PIN 20-20-CCLD. were discussed.

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SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2022
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: CHERRY BLOSSOM CHILD CARE & PRESCHOOL
FACILITY NUMBER: 198015694
VISIT DATE: 01/21/2022
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Helpful Resources:

Access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov. Reporting Unusual Incidents: MPROIncidentReports@dss.ca.gov. CCL Resources for Parents & Providers: https://ccld.childcarevideos.org/ Provider Information Notices (PINs): https://www.cdss.ca.gov/inforesources/community-care-licensing/policy/provider-information-notices/child-care

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



To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

There were no deficiencies cited during today’s inspection.

3 PM Exit interview conducted and report was reviewed with Assistant Director, Martha Alvarez

A notice of site visit was given and must remain posted for 30 days. Consultation was conducted on this date.

END OF REPORT: PAGE 4 OF 4

SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2022
LIC809 (FAS) - (06/04)
Page: 4 of 4