198019051-11-9-2021-33-CC-CRES-C8LUPT-20211109144604

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019051
Report Date: 11/09/2021
Date Signed: 11/09/2021 02:46:11 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:	MENDOZA C.D.C., RM. P9		FACILITY NUMBER:	198019051
ADMINISTRATOR:	KYM ALLEN		FACILITY TYPE:	850
ADDRESS:	851 S. HAMILTON BLVD.		TELEPHONE:	(909) 397-4438
CITY:	POMONA	STATE: CA	ZIP CODE:	91768
CAPACITY:	24	CENSUS: 0	DATE:	11/09/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	11:31 AM
MET WITH:	Kym Allen		TIME COMPLETED:	02:45 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) Cynthia Reyes, conducted an unannounced site Inspection to inspect and measure the requested increase incapacity of the already licensed preschool for capacity determination. LPA met with Kym Allen, Facilities and Licensing Planner. Due to COVID- 19 precautionary measures were taken during the entire inspection and all individuals present during this inspection wore appropriate personal protective equipment. The licensee is requesting a capacity increase of 24 preschool children in room P-10 to be added to the already licensed preschool capacity of 24 which are located in room P-9. The facility is located on the premise of Mendoza Elementary School. The Preschool program will operate Monday through Friday 7:30am to 11:00am (AM Session) and 11:45am - 3:15pm (PM Session). The program operates under the Pomona Unified School District calendar schedule. Applicant has been informed that preschool children and private elementary school children shall be kept separate physically at all times. 12: 10 PM The entire indoors and outdoors of the facility was inspected. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. There is a smoke detectors, a carbon monoxide detector and a fire extinguisher that meets statutory requirements. Building/Rooms are centrally heated and air conditioned. Overhead lights as well as natural light is used. There are drinking fountains indoors and outdoors. The isolation area for an ill child is located in the office that is located in the classroom. Medications will be administered with proper authorizations. If refrigeration is required the facility has sufficient refrigerator space and microwave inside the class room. Incidental Medical Services discussed and explained. The classroom is equipped with a first aid kit. There are storage for personal equipment. The facility offers breakfast and snack for the AM session and lunch and snack for the PM session. Food will be delivered daily from the central kitchen located at Garey High School. Napping equipment was inspected for good condition, appropriate storage and cleanliness. Containers used to discard food have tight fitting lids. Cleaning compounds are inaccessible to the children.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 11/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2021

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: MENDOZA C.D.C., RM. P9	FACILITY NUMBER: 198019051
	VISIT DATE: 11/09/2021

NARRATIVE

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1:15 PM, The tour continued as the LPA was guided to the outdoor play area. The preschool has their own outdoor play yard (Padding (side yard with apparatus) & (Cement bike path in from t of class rooms), and is self contained by a gate around it for separation from the Mendoza elementary school children yard to prevent children from commingling. Water jugs with disposable cups or labeled bottles will be used for children while outdoors. LPA observed age appropriate outdoor toys and play equipment to be clean safe and in good repair, as well as adequate shade is available. All areas around play equipment and slides are cushioned with material to absorb a fall. Measurements were taken of the outdoor play yard and the total outside capacity allows for 48 preschool children. LPA advised Kym Allen, Facilities and Licensing Planner, that the children need to be within the direct care and supervision, including visual observation and supervision of the teacher(s) at all times.

Preschool bathroom were observed to be in good repair, water temperature, paper towels, toilet paper, all area inspected for safety and sanitation. LPA observed in the class room 2 toilets for capacity of 30, and 3 sinks for capacity of 45.

Based on measurements taken today of the indoors and outdoors, capacity for the increase in the preschool program, will be (24) as requested, for a total capacity of 48 in 2 rooms P-9 and P-10. Fire clearance has been approved for a total of 48. No corrections are needed.

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

2: 30 PM Exit interview conducted with Kym Allen and a signed copy of this report, notice of site visit and appeal rights were provided on this date.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 11/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2021

LIC809 (FAS) - (06/04)

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