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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018831
Report Date: 10/23/2024
Date Signed: 10/23/2024 02:12:04 PM


Document Has Been Signed on 10/23/2024 02:12 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:PINE TREE PRESCHOOLFACILITY NUMBER:
198018831
ADMINISTRATOR:ADA CABRERA-VELASQUEZFACILITY TYPE:
850
ADDRESS:311 S. NORMANDIE AVE.TELEPHONE:
(213) 365-0909
CITY:LOS ANGELESSTATE: CAZIP CODE:
90020
CAPACITY:63CENSUS: 6DATE:
10/23/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:43 AM
MET WITH:Ada Cabrera-VelasquezTIME COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA) Veronica Martinez Garza conducted an unannounced Annual/Random inspection at the above facility on 10/23/24 at 09:43 a.m. LPA met with Director Ada Cabrera-Velasquez who guided LPA on a tour of the facility. The preschool is licensed for 63 children (51 preschoolers and 12 Toddlers). The program operates Monday through Friday from 08:00am - 06:00pm. Per director, there are 06 children enrolled.

All areas identified on the facility sketch were inspected. This preschool consists of 3 classrooms: Tulips: 03 Children with 01 staff; Sunflowers: 0 Children with 0 Staff; and Bluebells: 0 Children with 0 staff. Teacher-child ratios were observed to be in accordance with Title 22 Regulations. Staff names were recorded on the attached LIC859. All children were observed to be under supervision, including visual supervision, of a teacher at all times.

LPA observed the facility to be clean and sanitary conditions. All indoor classrooms were inspected to ensure that the floors have a surface that is safe and clean. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. Drinking water was readily available indoors and outdoors. LPA observed a water jugs with disposable cups readily available. Staff take a water jug with disposable cups outdoors. LPA observed cots are used as napping equipment. LPA also observed all children have their own cubby. At this time, the "office" is used as an isolation area. A cot is available for an ill child to rest on. Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids. The facility was observed to be free of flies, other insects, and rodents.




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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-GarzaTELEPHONE: (323) 558-2710
LICENSING EVALUATOR SIGNATURE:
DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/23/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: PINE TREE PRESCHOOL
FACILITY NUMBER: 198018831
VISIT DATE: 10/23/2024
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LPA observed all required forms/publications to be posted in the entrance of the facility. Snack menus were reviewed to ensure that they are being posted at least one week in advance and visible to an authorized representative. Snacks were reviewed for availability, quantity, and appropriateness to children in care. Facility provides AM/PM snacks and parents provide lunch. All food is protected from contamination. Director states there are no weapons, firearms, or bodies of water on the premises.

First Aid supplies are available. LPA observed a current Emergency disaster drill. Last drill documented was on 08/09/24. LPA observed a functioning carbon monoxide detector.

LPA took a tour of the (2) outdoor play areas and inspected the outdoor play equipment for any lose or pointed parts. LPA observed age-appropriate toys, equipment, and materials for children. LPA also observed the outdoor area has adequate shade. Outdoor activity space surface is maintained in a safe condition as is free of hazards. Areas around and/or under climbing equipment have cushioning material to absorb a fall. LPA advised the director to check with the American Standard Testing Materials for Playground Guidelines and/or to use the manufactures recommendations for the playground equipment in efforts to be more in line with safety guidelines.

Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. Facility uses the application called Brightwheel. Children’s roster was reviewed.

Children’s Records were reviewed to ensure that Identification and Emergency form and a medical assessment are on file. LPA observed all children’s files are complete.

Staff Records were reviewed to ensure that appropriate documentation of education credits is on file. Criminal Records Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed. LPA observed director’s Mandated Reporter Training expires on 11/18/24 and Pediatric CPR/FA expires on 07/26/26. LPA also observed staff 3 (S3) is missing proof of LIC 501. Director reviewed staff 3's file and provided a copy for staff to complete. Once staff 3 completes the form, it will be placed in the file.

SB792 (Immunization Requirements for Staff and Employees) was discussed with the director.



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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-GarzaTELEPHONE: (323) 558-2710
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2024
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: PINE TREE PRESCHOOL
FACILITY NUMBER: 198018831
VISIT DATE: 10/23/2024
NARRATIVE
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AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018, any person who works in a child care facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-proces.

Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES:

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.
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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-GarzaTELEPHONE: (323) 558-2710
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: PINE TREE PRESCHOOL
FACILITY NUMBER: 198018831
VISIT DATE: 10/23/2024
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For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

At this time, the facility is in compliance with California Title 22 Regulations. Therefore, there are no deficiencies being issued today.

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



Exit interview conducted and report was reviewed with the director Ada Cabrera-Velasquez.





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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-GarzaTELEPHONE: (323) 558-2710
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2024
LIC809 (FAS) - (06/04)
Page: 4 of 4