198019051-8-5-2022-33-CC-CRES-CGZUQQ-20220805154732

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019051
Report Date: 08/05/2022
Date Signed: 08/05/2022 03:47:47 PM

Document Has Been Signed on 08/05/2022 03:47 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 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:	48	CENSUS: 0	DATE:	08/05/2022
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	02:10 PM
MET WITH:	Kym Allen		TIME COMPLETED:	04:00 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	An announced pre-licensing site inspection was conducted today by Licensing Program Analyst (LPAs) Cynthia Reyes and Crystal Green to inspect and measure facility for capacity determination. Licensee is requesting to decrease the preschool capacity and add a new toddler option program to the existing license. Licensing staff met with Kym Allen, Facilities and Licensing Planner, who guided analysts on a tour of the facility. This facility is located on the premises of Mendoza Elementary School which operates under Pomona Unified School District. The facility is currently licensed to care for 48 preschoolers in classroom P9 and P10. Licensee is requesting to remove classroom P10 which will reduce the overall preschool capacity to 24. The new toddler option program capacity requested is 8 will be housed in classroom P10. LPAs observed the classrooms to each have their own entrance. This facility is currently active; however no children were present during this inspection. 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. Licensing staff was guided through a tour of the facility. Licensing staff observed the new toddler classroom (P10) to have age appropriate furniture and equipment. The children in the toddler room will have access to 2 toilets and 2 sinks. There is a changing table located within the classroom with arms reach of a sink. There is also a kitchen area located in the classroom which contains a refrigerator, microwave, and a sink. Individual storage space was observed to be available for each child inside the classrooms. Furniture and equipment were inspected for age appropriateness and good repair. There are smoke detectors and fire extinguishers located throughout the premises. The isolation area for an ill child is in the office that is located in the classroom. There is a fully equipped first aid kit available in the office. Locking medications cabinets are in each classroom.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 08/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2022

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MENDOZA C.D.C., RM. P9	FACILITY NUMBER: 198019051
	VISIT DATE: 08/05/2022

NARRATIVE

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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.

Licensing staff was guided through the outdoor activity space. Per Mr. Allen, the preschoolers will use the outdoor play area located in front of the classrooms and the proposed designated outdoor toddler space will be the side yard with apparatus. Licensing staff observed that the toddler would have to cross through the preschool play yard in order to use their designated outdoor space. Licensing staff advised Mr. Allen that a waiver must be requested to allow toddlers to cross through the preschool yard to access their designated play area. All waivers are subject to review and final approval by the Regional Office.

Licensing staff obtained measurements from both indoors and outdoors. The indoor capacity for the preschool classroom P9 measured for a capacity of 31 and the toddler classroom P10 measured for a capacity of 31. Measurements obtained for the outdoor activity space for the preschooler allows for a capacity of 34 and the designated toddler outdoor space allows for 17. This facility will be licensed for a overall capacity 32 (24 preschoolers and 8 toddlers).

Exit interview conducted and report was reviewed with the Kym Allen, Facilities and Licensing Planner.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 08/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2022

LIC809 (FAS) - (06/04)

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