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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016683
Report Date: 03/08/2022
Date Signed: 03/08/2022 01:34:17 PM


Document Has Been Signed on 03/08/2022 01:34 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:DOVE DAY SCHOOLFACILITY NUMBER:
198016683
ADMINISTRATOR:JACQUELINE ALMEIDAFACILITY TYPE:
830
ADDRESS:908 W. ARROW HIGHWAYTELEPHONE:
(909) 599-2299
CITY:SAN DIMASSTATE: CAZIP CODE:
91773
CAPACITY:24CENSUS: 6DATE:
03/08/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Tracy MartinezTIME COMPLETED:
10:30 AM
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On 3/8/2022 at 8:45am, Licensing Program Analyst (LPA) Jennifer Hua conducted an unannounced Required - 1 year inspection. Upon arrival, LPA met with Director Tracy Martinez. A COVID-19 risk assessment was conducted prior to entry to the facility. LPA provided Director with a copy of the LIC 125 Entrance Checklist to facilitate the inspection. Director guided analyst on a tour of the facility. This is an infant program which consists of 2 classrooms: Otter Pups (younger infants) and Otters. Facility operation hours are Monday to Friday from 7:00 AM to 5:30 PM. This facility has two other components: Preschool facility #198016681 and School Age facility #198019661.
All areas identified on the sketch were inspected. LPA observed the following during the :inspection: Room Otter Pups, 1 staff with 3 infants, Room Otter, 1 staff with 3 infants. :

Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Per director, there are no poisons stored at the facility. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. All toilets and hand washing facilities are safe, sanitary and in good repair. All floors were observed to be clean and safe.

All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish and rodents and/or any other vermin. All storage containers for solid waste, including moveable bins have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids. Drinking water is readily available both indoors and outdoors. The facility was observed to be free of flies, other insects and rodents.



Outdoor playground 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 climbing equipment slides, and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard. LPAs observed that there is a swimming pool.---- Page 1 of 3 .
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jennifer HuaTELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:
DATE: 03/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/08/2022
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: DOVE DAY SCHOOL
FACILITY NUMBER: 198016683
VISIT DATE: 03/08/2022
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The swimming pool in on the premises of the facility. The pool is surrounded by 3 side brick walls and one side with a rod iron fence that is above 5 feet. The bottom part of the fencing is approximately one inch from a hard surface the vertical bars are approximately 2 and a half inches apart. Fence door swings away from pool and has padlocks on them in order for children to not have access to entering. Per director, the swimming pool is off-limits during hours of operation and it is only for lessons with parental permission and is ran by a different company.

Infant changing tables have a padded surface no less than one inch thick and are covered with washable vinyl or plastic and have raised sides at least three inches high. Toys were observed to be clean and safe. Infant napping equipment and cribs were observed. Sheets are washed daily at the facility. Indoor activity space for this infant program is physically separate from the other components at this facility.

The facility is in compliance with the staff-infant ratios. A fully qualified teacher is directly supervising no more than 4 infants. Individual Feeding Plans are on file for each infant. Infant Needs and Services Plan are on file for each infant. Teachers present have proof of the required infant units on file and meet the qualification requirements.

All individuals present have obtained a criminal record clearance or criminal record exemption. There is at least one person trained in CPR and Pediatric First Aid present during this inspection. The name of the child care center director is on file. Educational background, training, and/or experience for each staff present are on file and were reviewed.

In review of children’s records, files contain information including, but not limited to the following: Name, address and telephone number of the child's authorized representative and of relatives or others who can assume responsibility for the child if the authorized representative cannot be reached when necessary.

Children's roster is in place per director and is current. Children present were signed in. Children are signed in/out electronically by thumb print. Director stated that documents can be printed and on file for more than 30 days. Disaster drill log was available, last drill was conducted on 06/4/2021. Menus are posted one month in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request. -----------------Page 2 of 3

SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jennifer HuaTELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2022
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: DOVE DAY SCHOOL
FACILITY NUMBER: 198016683
VISIT DATE: 03/08/2022
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Snacks were reviewed for availability, quantity and appropriateness to children in care. Infants approximately 0-12 months bring their own food and formula. Infants approximately 12-24 months have an option to participate in a hot lunch program or they can bring their own lunch. The facility provides AM and PM snack.

The facility shall ensure that each infant is never left unattended, and is under the direct visual supervision of a staff person at all times.

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 director, IMS is not provided at this time

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

Deficiencies cited on attached 809D.

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. Exit interview was conducted with director, Tracy Martinez, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.

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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jennifer HuaTELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2022
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 03/08/2022 01:34 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754


FACILITY NAME: DOVE DAY SCHOOL
FACILITY NUMBER: 198016683

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/08/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101174(d)
Disaster and Mass Casualty Plan
(d) Disaster drills shall be conducted at least every six months.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/08/2022
Plan of Correction
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Per Directgor, will conduct drills tomorrow and submit copy to LPA by POC due date of 3/9/2022
Type B
Section Cited
CCR
101419.3(a)
Modifications to Infant Needs and Services Plan
(a) The written infant needs and services plan shall be updated at least quarterly, or as often as necessary to assure its accuracy.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. LPA observed child #2,3,4 plan has not been udpated since August 2021
POC Due Date: 03/14/2022
Plan of Correction
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Per director, will have teachers update plans and submit copies to LPA by POC due date of 3/14/2022

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: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jennifer HuaTELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:
DATE: 03/08/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/08/2022
LIC809 (FAS) - (06/04)
Page: 4 of 4