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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016106
Report Date: 06/10/2019
Date Signed: 06/10/2019 03:07:05 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:ANGELA PRESCHOOL & KINDERGARTENFACILITY NUMBER:
198016106
ADMINISTRATOR:BAO JUAN XUFACILITY TYPE:
850
ADDRESS:1930 NOGALES STREETTELEPHONE:
(626) 964-3281
CITY:ROWLAND HEIGHTSSTATE: CAZIP CODE:
91748
CAPACITY:230CENSUS: 172DATE:
06/10/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:17 PM
MET WITH:Hou (Selena) HongTIME COMPLETED:
03:15 PM
NARRATIVE
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An unannounced random site inspection was conducted by Licensing Program Analyst Jennifer Hua, met with director (Selena) Hong Hou, who led LPA to a tour of facility indoors and outdoors. There are a total of 9 classrooms. There is a also a multipurpose room next to office.

Room identified on facility sketch were inspected. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Storage for children's belongings and an isolation area with a sink, toilet, and mats/cots was inspected. Age appropriate sinks and toilets were inspected for availability and good repair. General sanitation was observed. Availability of indoor drinking water was observed.

Outdoor equipment was inspected for safety, cushioning material, good repair and age appropriateness. Required shade, drinking water and fencing were inspected. Play area was inspected for hazards and inaccessibility to bodies of water.

Snack/lunch menus were reviewed. Food and snacks were reviewed for availability, quantity and appropriateness to children in care. Food preparation areas were toured for safety, cleanliness. A review of cleaning and food supply storage areas was made.

Teacher child ratios were observed and staff names recorded. Care and supervision was evaluated to determine if the basic needs of children are met. Sign in and Sign Out reviewed.
SUPERVISOR'S NAME: Katherine HarewoodTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Jennifer HuaTELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2019
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: ANGELA PRESCHOOL & KINDERGARTEN
FACILITY NUMBER: 198016106
VISIT DATE: 06/10/2019
NARRATIVE
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Staff and children records were reviewed for completeness including but not limited to Criminal Record Clearances for adults, Director Qualifications and verification of CPR/First Aid and health preventive practices documentation. Review of required forms was made. LPA observed certificate for mandated reporter in staff files. Licensee was informed that certificate needs to be renewed every 2 years. Mandated Reporter Training on department website at http://www.mandatedreporterca.com/

A review of all facility staff or other individuals who require caregiver background checks was conducted on this date to determine if they have received criminal record and child abuse index clearances or exemptions and/or have provided proof of submission of finger prints to DOJ, FBI and CAIC. MOST RECENT EXEMPTION REGULATIONS DISCUSSED.

Incidental Medical Services - (IMS) was discussed. For IMS information see Evaluator Manual - Regulation and 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

INTERNET ADDRESS: http://www.ccld.ca.gov – To access licensing forms, updates and Title 22.

Deficiencies cited on attached 809D.

An exit interview conducted with director, copy of report given. Appeals rights provided and explained.

Notice of Site Visit Form was provided and explained. The notice shall be posted for 30 days or a civil penalty of $100 will be assessed.
SUPERVISOR'S NAME: Katherine HarewoodTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Jennifer HuaTELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2019
LIC809 (FAS) - (06/04)
Page: 2 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: ANGELA PRESCHOOL & KINDERGARTEN
FACILITY NUMBER: 198016106
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/10/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/11/2019
Section Cited
CCR
101229.1(b)
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Sign In and Sign Out. The person who brings the child to, and removes the child from, the center shall sign the child in/out. The requirement is not met as evidenced by: LPA counted 172 in care and 158 were signed in. This is a potenital risk to the health and safety of children in care.
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Per licensee, will remind parents and also send notice to ensure compliance.
Type B
06/24/2019
Section Cited
HSC
1596.7995(c)
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Required Immunizations. Effective 9/1/16, all staff and volunteers that provide care and supervision are required to maintain proof of influenza, Pertussis and Measles immuniations on file. The requirement is not met as evidenced by: 1 staff files lack record.
This is a potential risk to the health and safety of children in care.
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Per licensee, will maintain copy in file and submit copy to LPA by the POC due date of 6/24/19.
Type B
06/10/2019
Section Cited
CCR
101216.1(g)
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Teacher Qualifications and Duties. A photocopy of the teacher's child development permit or transcripts as specified shall be maintained at the child care center. The requirement is not met as evidenced by: LPA observed 1 teacher file lack 3 semester units in Child, Family & the Community. This poses a potential risk to the health & safety of children in care..
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Per licensee, will have staff enroll in course, maintain copy and submit copy to LPA by the POC due date of 6/24/19. Director will adjust staffing in classrooms to ensure ratio is met until staff is enrolled.
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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: Katherine HarewoodTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Jennifer HuaTELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2019
LIC809 (FAS) - (06/04)
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