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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017126
Report Date: 05/31/2019
Date Signed: 05/31/2019 02:03:00 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:SUNDANCE CHILDCARE CENTERFACILITY NUMBER:
198017126
ADMINISTRATOR:JI HEE SUHFACILITY TYPE:
850
ADDRESS:700 S. ROSEMEAD BLVD.TELEPHONE:
(626) 304-9713
CITY:PASADENASTATE: CAZIP CODE:
91107
CAPACITY:40CENSUS: 22DATE:
05/31/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Ji Hee Suh, Director TIME COMPLETED:
02:15 PM
NARRATIVE
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Licensing Program Analyst (LPA) Carlos Gonzalez, conducted an Annual/Random inspection on this date. LPA met with Ji Hee Suh, Director, who guided Analyst on a tour of the facility. This is a preschool program consisting of three (3) classrooms and operates Monday thru Friday, from 8:00 AM to 6:00 PM.

All areas identified on the Facility Sketch were inspected. 4 - Year Old's Classroom, Staff #2 was observed with nine (9) children in care. 2 - Year Old's Classroom, Staff #3 was observed with eleven (11) kids in care. 3 - Year Old's Classroom, Staff #4, was observed with twelve (12) children in care.

Furniture and equipment was inspected for age appropriateness and good repair. Adequate lighting was observed in each classroom. Each classroom was also observed to having individual Air Conditioning units, which are mounted in the wall. Napping equipment and bedding was inspected for good condition, appropriate storage and cleanliness. LPA observed blankets, within the stacked cots, to be touching one another, in the 2 - Year Old's classroom. Each child has a bag for linens, which are taken home at the end of the week to washed. Storage for children's belongings was inspected. Age appropriate sinks and toilets were inspected for availability, good repair, toilet paper, area safety and sanitation.

Facility provides a morning, and an afternoon snack, and lunch is also provided. Snacks were reviewed for availability, quantity and appropriateness to children in care. Children provide their own water, and LPA observed children's individual water bottles. Per Director, children's water bottles, are also taken outdoors, in a crate, by their assigned teacher during play time. Cleaning compounds are inaccessible and were observed in a locked closet, adjacent to the kitchen. There is a full size kitchen on the premises, which consists of two refrigerators, a sink, stove, and microwave. The kitchen appeared to be clean and free of rodents.
Report continues on next page 1 of 3
SUPERVISOR'S NAME: Katherine HarewoodTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Carlos GonzalezTELEPHONE: (323) 981-3381
LICENSING EVALUATOR SIGNATURE:

DATE: 05/31/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2019
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 5
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: SUNDANCE CHILDCARE CENTER
FACILITY NUMBER: 198017126
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/31/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/14/2019
Section Cited
HSC
1596.7995(a)(1)
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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
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Per Director, Staff #4 will obtain the Pertussis vaccination by the POC due date. Director will submit proof to LPA.
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requirement is not being met as evidenced by: Staff #4 did not have proof of "Pertussis" vaccination. This is a potential risk to the health and safety of children in care.
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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: Carlos GonzalezTELEPHONE: (323) 981-3381
LICENSING EVALUATOR SIGNATURE:

DATE: 05/31/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2019
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: SUNDANCE CHILDCARE CENTER
FACILITY NUMBER: 198017126
VISIT DATE: 05/31/2019
NARRATIVE
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Beginning January 1, 2018, Health and 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. Volunteers are encouraged but not required to take the training. Effective January 1, 2018: Existing licensees must meet requirements by March 30, 2018. Preventive (OCAP) online training modules are free of cost and available at http://www.mandatedreporterca.com/.

LPA determined that Director and Staff's primary language is Korean, and therefore, are not subject to the required Mandated Reporting training at this time.

Based on LPA’s observations and records review, the following deficiencies listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit made by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Ji Hee Suh, Director, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.
Report ends page 3 of 3
SUPERVISOR'S NAME: Katherine HarewoodTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Carlos GonzalezTELEPHONE: (323) 981-3381
LICENSING EVALUATOR SIGNATURE:

DATE: 05/31/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2019
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: SUNDANCE CHILDCARE CENTER
FACILITY NUMBER: 198017126
VISIT DATE: 05/31/2019
NARRATIVE
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Areas around and/or under climbing equipment has grass, to absorb a fall. The outdoor play yard is enclosed with a black metal fence, however the metal gate (with latch), was only secured with a with a rubber bike lock cable. LPA determined at the time of inspection, that the cable was not wrapped tightly enough around both the fence and gate, therefore making it accessible to children to exit the playground. There is an additional playground, located on the opposite side of the facility (east side) for children to ride their bikes. There is outside shade, on both playground's for resting.

Teacher child ratios were observed and staff names recorded. Sign in/out sheets and procedures were reviewed with Director.

Staff and children records were reviewed for completeness and an inspection of required forms was made. A copy of the Confidential Name List (LIC 811) was provided to the licensee. No bodies of water were observed on the premises.

UPDATE: H&S 1597.622: Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home 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.

Incidental Medical Services (IMS): Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing 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.

LPA advised the licensee how to access forms and regulations on line at: www.ccld.ca.gov.

LPA also advised Licensee on how to obtain the Department's Quarterly Updates via the following website address: www.childcareadvocatesprogram@dss.ca.gov


Report continues on next page 2 of 3
SUPERVISOR'S NAME: Katherine HarewoodTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Carlos GonzalezTELEPHONE: (323) 981-3381
LICENSING EVALUATOR SIGNATURE:

DATE: 05/31/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2019
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: SUNDANCE CHILDCARE CENTER
FACILITY NUMBER: 198017126
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/31/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/31/2019
Section Cited
CCR
101238(a)
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Buildings and Grounds - 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 being met as evidenced by: LPA observed that the metal gate in the outdoor play yard (west side) was not latched
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At the time of inspection, LPA observed the Director tightly wrapping the rubber bike lock cable around the metal fence and gate, to prevent children from exiting the outdoor play yard.
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on to the metal fence. The gate was observed to be only secured with a rubber bike lock cable, which was loosely tied around the metal fence. This is a potential risk to the health and safety of children in care.
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Type B
05/31/2019
Section Cited
CCR
101239.1(c)(2)
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Napping Equipment - Bedding shall be individually stored so that each child's bedding is identifiable and no child's used bedding comes into contact with other bedding. This requirement is not being met as evidenced by: LPA observed children's bedding coming into contact with other bedding, which was observed
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At the time of inspection, the Director tucked away the bedding (blankets) in between the cots, so that they were no longer touching one another.
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on the cots in the 2-Year Old's classroom. This is a potential risk to the health and safety of children in care.
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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: Carlos GonzalezTELEPHONE: (323) 981-3381
LICENSING EVALUATOR SIGNATURE:

DATE: 05/31/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2019
LIC809 (FAS) - (06/04)
Page: 5 of 5