198018969-6-3-2022-54-CC-RRAS-CF2RZS-20220603132826

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198018969
Report Date: 06/03/2022
Date Signed: 06/03/2022 01:28:36 PM

Document Has Been Signed on 06/03/2022 01:28 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	LBUSD-POWELL CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	198018969
ADMINISTRATOR:	NANCY PEREZ		FACILITY TYPE:	850
ADDRESS:	150 VICTORIA ST.		TELEPHONE:	(310) 631-8987
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90805
CAPACITY:	48	CENSUS: 26	DATE:	06/03/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:05 AM
MET WITH:	Nicole Vasallo, Coordinating Teacher		TIME COMPLETED:	01:35 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 Analysts (LPAs) Rita Ramos and Katrina Chicote conducted an unannounced required 1 year inspection to the above facility on 06/03/22. LPAs arrived at the facility at 11:05AM, identified self and met with Nicole Vasallo, Coordinating Teacher, who guided analysts on a tour of the facility. LPAs provided Coordinating Teacher with a copy of the LIC 125 Entrance Checklist to help facilitate the inspection. This is a preschool program which consists of 2 classrooms; RM K-1 and RM K-4. Facility operation hours are Monday to Friday from 6:30AM to 5:30PM in RM K-4. RM K-1 operates 2 part-day sessions. The AM session is from 8:30AM to 11:30AM and the PM session is from 12:30AM to 3:30PM. This facility is located within Powell Elementary School in the city of Long Beach. All areas identified on this report were inspected. Upon arrival, the following staff were present during this inspection: Room K-4: Staff #1, #2, #3 and #4 with 20 preschoolers; Room K-1: Staff #5 and #6 with 6 preschoolers. The facility was observed to be within the license capacity and limitations. The following was observed during the tour of the facility: Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Children have their own cubby to store their belongings. Linens are taken home each week to be washed. Napping equipment (cots) were observed to be stored in Room K-4. Per Coordinating Teacher the isolation area is located in the nurse's office. 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. Coordinating Teacher states that there are no poisons stored at the facility. Carbon monoxide detectors were observed and tested to ensure that they are operable. -----Page 1 of 3

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Rita Ramos	TELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2022

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LBUSD-POWELL CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 198018969
	VISIT DATE: 06/03/2022

NARRATIVE

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All meals and snacks are brought and delivered to the facility from the elementary school cafeteria. Trash cans used to discard food have tight fitting lids or solid waste bags shall be discarded immediately after each meal. All meals and snacks are provided the Long Beach Unified School District.

At approximately 11:18AM, LPAs toured the outdoor playground area and observed 2 construction workers working on the fencing. There was a temporary fence installed that was not completely secured. Part of the fencing had openings and the 2 workers were welding all while children from RM K-1 were playing outside. LPAs advised Coordinating Teacher that although the 2 workers are attempting to maintain a safe space, it is not entirely safe for children in care and the construction should have been reported to the department. Per Coordinating Teacher the construction commenced on 05/31/22. 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 staff 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. Inspection of required forms was made and documented on the LIC 857.

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

LPA did not review confidential or medical staff records during the inspection due to the staff files being stored at the administrative office. ---Page 2 of 3

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Rita Ramos	TELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2022

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LBUSD-POWELL CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 198018969
	VISIT DATE: 06/03/2022

NARRATIVE

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Children's roster was reviewed and is current. Sign-In and Sign-Out sheets were reviewed. Children present were signed in. Disaster drill log was available, last drill was conducted on 06/01/22.

Menus were observed to be are posted. Children enrolled in the full-day program are provided with a breakfast, lunch, and snack. Children from the part-day AM program are provided with a full breakfast and children from the part day PM program are provided with a full lunch.

First Aid supplies were observed in the classrooms. According to Coordinating Teacher, medication is only administered to a child when accompanied with a doctor's note and is stored in the 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

LPA advised the licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/tion-process.

The following deficiency listed on the attached deficiencies page are being cited in accordance with California Code of Regulations Title 22.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Coordinating Teacher, Nicole Vasallo. ---Page 3 of 3

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Rita Ramos	TELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2022

LIC809 (FAS) - (06/04)

Page: 8 of 9

Document Has Been Signed on 06/03/2022 01:28 PM - It Cannot Be Edited

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
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/03/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101238.2(d)(2)

Outdoor Activity Space

(d) The surface of the outdoor activity space shall be maintained: (2) Free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, and record review, the licensee did not comply with the section cited above due to LPAs observing that there is construction occuring at the facility in the outdoor playground while children are playing and in care which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/10/2022
	Plan of Correction
1 2 3 4	Construction was stopped during the inspection. Per Coordinating Teacher, since the yard is spacious, the yard will be blocked off so that children can access the area that is not being worked on and staff will be present at all times to supervise. A plan will be created as to when children can access the yard with a sketch and/or pictures and copies will be submitted by POC due date.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Rita Ramos	TELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2022

LIC809 (FAS) - (06/04)

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