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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018738
Report Date: 05/01/2019
Date Signed: 06/04/2019 01:55:26 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:ALPHA-SHEN PRESCHOOLFACILITY NUMBER:
198018738
ADMINISTRATOR:LINDA P. CHUFACILITY TYPE:
850
ADDRESS:618 N. MOORE AVENUETELEPHONE:
(626) 282-2011
CITY:MONTEREY PARKSTATE: CAZIP CODE:
91754
CAPACITY:44CENSUS: 49DATE:
05/01/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Linda ChuTIME COMPLETED:
04:05 PM
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An increased inspection was conducted by Licensing Program Analysts (LPA), Timothy Fields and Reiko Jones. LPAs met with Director, Linda Chu and was guided on a complete tour of the facility. Analysts were informed meals are prepared on-site. Prescription medication is administered to children as needed.

Medication was properly labeled and stored in the kitchen. LPA observed a rest area adjacent to the office for sick children. First aid kits were inventoried. There is a Kindergarten program on-site separate from the preschool.

Four classrooms identified as Pre K 1 and 2, Senior 3, and Junior 3 are used to operate the preschool program. There was a total of four teachers, four teacher assistants, and one floater supervising 49 children.
The license capacity is 44 children. Each classroom was inspected for cleanliness and good repair.

Analysts observed age appropriate toys and equipment. Sleeping equipment was properly stored. Analysts observed a source of drinking water. Children individual storage space was inspected. Lighting was in operable condition. The kitchen adjacent to Senior 3 classroom was inspected for cleanliness and good repair. Food was observed to be in good quality.

Outdoor area and equipment was inspected for safety, cushioning material, good repair and age appropriateness. Required shade and fencing were inspected. Play area was inspected for hazards and inaccessibility to bodies of water. Teacher child ratios were observed and staff names recorded.
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Timothy FieldsTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2019
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 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: ALPHA-SHEN PRESCHOOL
FACILITY NUMBER: 198018738
VISIT DATE: 05/01/2019
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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.

The licensee shall require each recipient (Parent/guardian) of a licensing report documenting a Type A citation resulting from a complaint investigation and any licensing document pertaining to a conference, and any summary of an accusation indicating the Department’s intent to revoke a license, to sign LIC 9224 form, indicating that he or she has received the documents and the date they were received.The licensee shall keep verification of receipt in each child’s file.

After a complete inspection of the facility, the following deficiencies were observed according to California Code of Regulations Title 22 Division 12 during today's visit as indicated on the 809D

  1. Licensee was not in compliance with Title 22 regulation, 101161(a) Limitations on Capacity and Ambulatory Status. There were 49 children present when the license capacity is 44.
  2. LPAs observed thorned rose bushes accessible to children on the playground which is not in compliance with Title 22 regulations, 101238(a) Building and Grounds.

Exit interview conducted with director. Appeal Rights provided and explained. Notice of Site Visit must be posted for (30) days. Failure to do so may result in a $100.00 civil penalty.

*** Director Linda Chu's signature is on hard copy of 809S.

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


SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Timothy FieldsTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2019
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: ALPHA-SHEN PRESCHOOL
FACILITY NUMBER: 198018738
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/01/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/08/2019
Section Cited
CCR
101161(a)
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Limitations on Capacity and Ambulatory Status:
A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation.

The requirement is not met as evidenced by
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Licensee states she will provide documentation of five children removed from the program to ensure no more than 44 children are present at all times by POC date.
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analysts observing 49 children in care. This poses an immediate 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: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Timothy FieldsTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2019
LIC809 (FAS) - (06/04)
Page: 4 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: ALPHA-SHEN PRESCHOOL
FACILITY NUMBER: 198018738
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/01/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/08/2019
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.

The requirement is not met as evidenced by
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Licensee states the Rose bushing will be removed by POC date.
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Analysts observing Thorned Rose bushes accessible to children on the playground.
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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: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Timothy FieldsTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4