198018831-1-13-2021-33-CC-JMOA-BX8QS6-20210113112502

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198018831
Report Date: 01/13/2021
Date Signed: 01/13/2021 11:25:30 AM

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 PRESCHOOL		FACILITY NUMBER:	198018831
ADMINISTRATOR:	MARLENE YBARRA		FACILITY TYPE:	850
ADDRESS:	311 S. NORMANDIE AVE.		TELEPHONE:	(213) 365-0909
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90020
CAPACITY:	63	CENSUS: 0	DATE:	01/13/2021
TYPE OF VISIT:	Office	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Marlene Ybarra		TIME COMPLETED:	11:25 AM

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	A virtual Informal Office meeting was conducted today to discuss concerns the Department has regarding the above facility. Present on this Zoom call were Director, Marlene Ybarra, Ana Chico, Licensing Program Manager, and Judy Mora, Licensing Program Analyst. The Following was discussed: Personal Rights. · 05/11/17: LPA S. Lee determined that a staff member in the toddler in the preschool classroom was behaving inappropriately with the children. The staff member was terminated for her conduct in October of 2017. Ratio. · 11/09/16: LPA S. Lee observed a classroom with 21 children and 1 teacher. There was 1 qualified aid and 1 adult present along with the teacher. Responsibility for Providing Care and Supervision. · 06/02/17: LPA S. Lee discovered children from the toddler component were being watched in the same room as preschool aged children in the beginning and end of the day. Building and Grounds. · 07/30/19: LPA C. Green observed several broken screen windows in classrooms, children had access to broken springs. · 01/29/19: LPA W. Birks observed play equipment in the potential hazard for children in care. · 01/29/19: LPA W. Birks observed electrical outlets coverings missing, and the toilet in disrepair. · 06/02/17: LPA S. Lee observed exposed pipes in the girl’s bathroom due to broken sink. *REPORT CONTINUES ON NEXT PAGE

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Judy Mora	TELEPHONE: (323) 896-6847
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2021

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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: PINE TREE PRESCHOOL	FACILITY NUMBER: 198018831
	VISIT DATE: 01/13/2021

NARRATIVE

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The Director will be required to view the following videos on the Department website at https://ccld.childcarevideos.org/

· Children’s Personal Rights in a Child Care Center
· Supervising Children in Child Care Centers
· Teacher-to-Child Ratios in Child Care Centers
· Locks and Inaccessibility Requirements in Child Care.

The Director will submit a written statement indicating the importance of each topic above. The Director will also be required to provide an In Service training to all staff in regards to the topics above. The Director will be required to submit copies of an agenda, materials used for the training and a staff sign in sheet by 01/27/21.

The Director was advised that copies of this report should be given to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months. The Director will obtain signature and date from the child’s parent/guardian on the Acknowledgement of Receipt of Licensing Reports, LIC 9224 (form provided in email). The licensee will keep a record immediately upon receipt of the completed and signed LIC 9224 acknowledging receipt of this report in the child's file.

The licensee has been advised that the Department will continue to conduct more frequent visits to the facility in the next two years to ensure compliance.

Director was advised that a copy of this report will be forwarded to the local Resource & Referral Agency.

Exit interview conducted. A copy of this report has been signed by LPA Mora. This report along with the form LIC 9224 will be sent via e-mail to the Director, who understands that an electronic “Read Receipt” and/or confirmation of receipt of the e-mail confirms receipt of the report and constitutes an electronic signature. A hard copy of this report and the LIC 9224 will be mailed and Director agrees to sign the bottom of each page of the LIC 809 and return the originals to LPA Mora in-person or via U.S. Mail.

*END OF REPORT

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Judy Mora	TELEPHONE: (323) 896-6847
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2021

LIC809 (FAS) - (06/04)

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