<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018831
Report Date: 01/14/2020
Date Signed: 01/14/2020 04:56:09 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:PINE TREE PRESCHOOLFACILITY NUMBER:
198018831
ADMINISTRATOR:MARLENE YBARRAFACILITY TYPE:
850
ADDRESS:311 S. NORMANDIE AVE.TELEPHONE:
(213) 365-0909
CITY:LOS ANGELESSTATE: CAZIP CODE:
90020
CAPACITY:63CENSUS: 9DATE:
01/14/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Gloria PortilloTIME COMPLETED:
04:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Janeth Chavez conducted an unannounced Annual inspection. LPA met with Director, Gloria Portillo who guided LPA on a tour of the facility. The program operates from 7:00am-6:00pm (M-F). The preschool is licensed for 63 children (51 preschoolers and 12 Toddlers). Upon arrival, LPA observed 9 children and 2 staff present. Teacher-child ratios were observed to be in compliance with Title 22 Regulations. All adults present have obtained a criminal record clearance or exemption. As per Mrs. Gloria there are currently 19 children enrolled at the moment. Per Director, there are no Toddlers enrolled in the facility at the moment.

This preschool consists of 4 classrooms: Dragonflys Classroom: 0 Children; Monkey Classroom: 9 Children with 2 Staff; Bunny Classroom: 0 Children 0 Staff; Chipmunks Classroom: 0 Children. Mrs. Portillo stated that only the Monkey Classroom is the only classroom used. LPA did not observe any children in the Dragonflys, Bunny or Chipmunks classroom. All areas used by the children were inspected. LPA observed a wall heater not barricaded in the Chipmunks' classroom. This is a potential health and safety risk to children in care. All children were observed to be under visual supervision of a teacher at all times. LPA observed all required forms are posted near the entrance and is visible to the children’s authorized representatives. The Licensee is within the conditions, limitations, and capacity specified on the license.

Furniture and equipment were inspected for good repair, free of sharp, loose, or pointed parts. All indoor classrooms were inspected to ensure that the floors have a surface that is safe and clean. All toilets and hand washing facilities are in safe and sanitary operating conditions. As per Mrs. Portillo, the office and staff restroom is used as an isolation area. The parents are contacted immediately when children are determined to be ill. First Aid supplies are available and complete in the office. Sufficient individual storage space for children was observed in the classrooms. Each child has a cubby. LPA observed sufficient napping equipment (cots) for children in each classroom. The facility provides breakfast, lunch, AM & PM snack only. The food is prepared on site. The kitchen was inspected and was observed to be clean and free or rodents/vermin. LPA observed the detergents and cleaning supplies are kept under the kitchen sink. Snack menus were reviewed to ensure that they are being posted at least one week in advance and visible to authorized representative. LPA observed paper cups and water pitchers in the classroom for indoor drinking water. LPA observed a water fountain with two faucets as outdoor drinking water.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) -98-3417
LICENSING EVALUATOR NAME: Janeth ChavezTELEPHONE: (323) 981-3376
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2020
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: PINE TREE PRESCHOOL
FACILITY NUMBER: 198018831
VISIT DATE: 01/14/2020
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
LPA observed storage containers for solid waste, including moveable bins, have tight fitting covers on and are in good repair. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are stored in the kitchen area to daycare children. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. The licensee takes measures to keep the facility free of flies, other insects and rodents. Outdoor play equipment was observed to be in good condition, free of sharp, lose or pointed parts. Outdoor activity space surface is maintained in a safe condition as is free of hazards. Per Mrs. Portillo, there are no bodies of water. LPA did not observe any bodies of water during this inspection. Areas around and/or under climbing equipment, slides have cushioning material to absorb a fall. Per Mrs. Portillo, there are no weapons or firearms on the premises.

Sign in and out sheets were reviewed. A random sample of Children’s Records were reviewed to ensure that they are complete. Criminal Record Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed. The Director has current CPR card and it expires on 11/2021.



LPA reviewed staff files and Staff #1, 2, & 4 are missing proof of AB 1207 Child Care compliant training. This is a potential health and safety risk to children in care. Staff has complied with SB 792 Immunization requirements.

Incidental Medical Services (IMS) policy was discussed. 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. As per Director, there are no children with medication at this time.

REMINDER: Failure to obtain a criminal record background check clearances prior to initial presence in the facility will result in an immediate $100.00 dollar or more per day Civil Penalty. LPA advised the licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov. Tools Resources-Quarterly Updates-Child Care Program.



Deficiencies cited are on LIC 809 D page. 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 Gloria Portillo. Appeal Rights and Procedures explained and provided.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) -98-3417
LICENSING EVALUATOR NAME: Janeth ChavezTELEPHONE: (323) 981-3376
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2020
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: PINE TREE PRESCHOOL
FACILITY NUMBER: 198018831
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/14/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/28/2020
Section Cited

1
2
3
4
5
6
7
Fireplaces and open-faced heaters shall be made inaccessible to children to ensure children's safety.***This requirement is not met as evidenced by LPA observing a wall heater in the Chipmunks' classroom not barricaded. This is a potential health and safety risk to children in care.
Type B
01/28/2020
Section Cited

1
2
3
4
5
6
7
On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years
8
9
10
11
12
13
14
following the date on which he or she completed the initial mandated reporter training.***This requirement is not met as evidenced by LPA reviewing staff files and for Staff #1, 2, & 4 there is no proof of certificate of AB1207 on their files. This is a potential health & safety risk to children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
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: Claudia GuangorenaTELEPHONE: (323) -98-3417
LICENSING EVALUATOR NAME: Janeth ChavezTELEPHONE: (323) 981-3376
LICENSING EVALUATOR SIGNATURE:
DATE: 01/14/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/14/2020
LIC809 (FAS) - (06/04)
Page: 3 of 3