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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017173
Report Date: 02/09/2022
Date Signed: 02/09/2022 03:20:53 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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:NORWALK CHILD DEVELOPMENT CENTERFACILITY NUMBER:
198017173
ADMINISTRATOR:CAMPOY, KATYAFACILITY TYPE:
850
ADDRESS:14000 SAN ANTONIO DRIVETELEPHONE:
(760) 942-3433
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY:20CENSUS: 28DATE:
02/09/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Site Supervisor Maria Brena TIME COMPLETED:
02:30 PM
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On 2/9/22 Licensing Program Analyst (LPA) Jeanette Estrada conducted an unannounced required 1 year inspection. LPA met with Site Supervisor Maria Brena who guided analyst on a tour of the facility. This is a preschool program which consists of one single classroom. Facility operates from Monday through Friday. Program operates two sessions: The AM session operates from 8:00AM to 11:00AM and the PM session operates from 12:00 PM to 3:00 PM. Present during today's inspection were 18 children in the AM and 10 children in the PM session with 3 staff.

All areas identified on the facility sketch were inspected. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Children have their own cubby to store their belongings. Per Site Supervisor there is no napping time at this facility due to it being a half day program. The isolation area is located in the office. Age appropriate sinks and toilets were inspected for availability and good repair in both restrooms. There are two restrooms available for children with one toilet and one sink in each. General sanitation was observed. Availability of indoor drinking water was observed in classrooms via a water dispenser. Per Site Supervisor, Teachers assist children with the drinking water. Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Per Site Supervisor, there are no poisons stored at the facility and medications are stored in a locked file cabinet in the office. Per Site Supervisor, there are no children who require medication at this time. A combination Carbon monoxide/ smoke detector was observed in the classroom and it is operable.

The outdoor playground area was evaluated. Outdoor equipment is in a safe condition, free of sharp, loose or pointed parts. All areas around or under high climbing equipment and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard. Availability of outdoor drinking water was observed via a water dispenser. There is a sink available outside for hand washing.

SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette EstradaTELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:

DATE: 02/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2022
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 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 CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 198017173
VISIT DATE: 02/09/2022
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Per Site Supervisor there are no firearms stored on the premises. There are no pools or bodies of water at the facility. The 2A10BC fire extinguisher is located by the front entrance and was last serviced on 10/2021

Site Supervisor 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.

There is at least one person trained in CPR and Pediatric First Aid present during this inspection. 4 out of 4 staff present had a current certification on file which expires 1/29/24 for all.

Children’s Records were reviewed for completeness. (The name, address, and telephone number of child’s authorized representative and medical assessment are on file). Inspection of required forms was made and documented on the LIC 857.

LPA also reviewed staff records. The review of Staff records was documented on the LIC 859. Staff present did have proof of the AB 1207 Mandated Reporter Training certificate on file. Staff present did have proof against TB, measles, pertussis, and influenza. All staff have been given on the-job training sanitation principles, housekeeping, including universal health precautions.


Children's roster was reviewed and is current. Sign-In and Sign-Out sheets were reviewed. Children present were signed in. Disaster drill log was available, last drills were conducted on 1/24/22(Fire Drill) and 1/26/22(Earthquake drill).

Menus are posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request. The facility provides Breakfast and a snack for the AM session and Lunch and a snack for the PM session

First Aid supplies were observed in the classroom mounted on a wall, accessible to staff. According to the Site Supervisor, medication will only be administered to a child when accompanied with a doctor's note and will be stored in the office.

SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette EstradaTELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:

DATE: 02/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2022
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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: NORWALK CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 198017173
VISIT DATE: 02/09/2022
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Incidental Medical Services (IMS) policy was discussed. LPA provided PIN 22-02-CCP For IMS information see Evaluator Manual - Regulation 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

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


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/tion-process. A current email address was collected during today's visit.

There were no deficiencies cited during today’s inspection

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and Appeal Rights and report were reviewed with the Site Supervisor Maria Brena.

SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette EstradaTELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:

DATE: 02/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2022
LIC809 (FAS) - (06/04)
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