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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018969
Report Date: 07/13/2021
Date Signed: 07/13/2021 01:14:29 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:LBUSD-POWELL CHILD DEVELOPMENT CENTERFACILITY NUMBER:
198018969
ADMINISTRATOR:NANCY PEREZFACILITY TYPE:
850
ADDRESS:150 VICTORIA ST.TELEPHONE:
(310) 631-8987
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY:48CENSUS: 0DATE:
07/13/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:35 AM
MET WITH:Nancy Perez & Cristabel RodriguezTIME COMPLETED:
01:20 PM
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Licensing Program Analyst (LPA) Rita Ramos conducted an unannounced annual inspection on 07/13/21 at 11:35 AM. LPA met initially met with Nancy Perez, Coordinating Teacher, who guided analyst on a tour of the facility. LPA was later met by Cristabel Rodriguez, Program Coordinator. This is a preschool program which consists of 2 classrooms; RM K1 and RM K4 Facility operation hours are Monday to Friday from 6:30 AM to 5:30 PM in Room K4. Room K1 operates 2 part-time sessions. The AM session operates from 8:30AM to 11:30AM and the the PM session operates from 12:30PM to 3:30PM. There were no children present upon arrival.

All areas identified on the Facility Sketch were inspected. Upon arrival, the following staff were present during this inspection: Room K1: Staff #1. The following was observed during the tour of the facility.

Furniture and equipment were inspected for age appropriateness and good repair. Age appropriate sinks and toilets were inspected for availability and good repair in all restrooms. General sanitation was observed. Availability of indoor drinking water was observed in classrooms.

Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Program Coordinator states that there are no poisons stored at the facility. Carbon monoxide detector was observed and is operable.

All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish, rodents, and/or any other vermin. All storage containers for solid waste, including moveable bins have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have solid waste bags that are discarded immediately after each meal.
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SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Rita RamosTELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2021
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: LBUSD-POWELL CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 198018969
VISIT DATE: 07/13/2021
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Outdoor playground equipment is in a safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under high climbing equipment, slides, 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. LPA advised that no children shall be left without the supervision of a teacher at any time.

All floors were observed to be clean and safe. All materials accessible to children were observed to be toxic-free There are no firearms stored on the premises. There are no pools or bodies of water at the facility.

All individuals present have obtained a criminal record clearance or criminal record exemption as a condition of employment with the Long Beach Unified School District. There is at least one person trained in CPR and Pediatric First Aid present during this inspection.

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

Children's roster was reviewed and is current. The facility uses an electronic sign-in and sign-out system.

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 have been given on the-job training on sanitation principles, housekeeping, including universal health precautions.



Menus are posted one month in advance where it is visible by the child's authorized representative. Preschoolers in the full day program are provided with a breakfast, lunch and snack. Children from the AM session are provided with a full breakfast and children from the PM session are provided with a full lunch.

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SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Rita RamosTELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2021
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: LBUSD-POWELL CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 198018969
VISIT DATE: 07/13/2021
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According to the Coordinating Teacher, medication is only administered to a child when accompanied with a doctor's note and is stored in a locked box in the classroom. The facility was observed to be equipped with an isolation area for any child who becomes ill and it is located in the nurse's office.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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 Program Coordinator to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov. LPA provided the Program Coordinator with a copy of the Effects of Lead Exposure form during the inspection and discussed the following Provider Information Notices (PINs) Required Lead Testing: PIN 20-01 CCP Effects of Lead Exposure, and Guardian User Account Access - PIN 20-20-CCLD.



There were no deficiencies cited during today’s inspection.

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. Exit interview was conducted with Cristabel Rodriguez, Program Coordinator, and Nancy Perez, Coordinating Teacher, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.

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SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Rita RamosTELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2021
LIC809 (FAS) - (06/04)
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