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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019107
Report Date: 11/17/2023
Date Signed: 11/17/2023 11:55:50 AM


Document Has Been Signed on 11/17/2023 11:55 AM - 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:GOLDEN CITY CHILD DEVELOPMENT CENTER INC.FACILITY NUMBER:
198019107
ADMINISTRATOR:ANGELICA HERRERAFACILITY TYPE:
840
ADDRESS:812 E. CARSON ST.TELEPHONE:
(310) 634-5664
CITY:CARSONSTATE: CAZIP CODE:
90745
CAPACITY:15CENSUS: 0DATE:
11/17/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Angelica HerreraTIME COMPLETED:
12:20 PM
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Licensing Program Analyst (LPA) Raul Navarro conducted an unannounced annual inspection on 11/17/2023 at 11:00am. LPA met with Director Angelica Herrera who guided analyst on a tour of the facility. This is a School-Age program which consists of 1 classroom. Facility operation hours are Monday to Friday from 3:00 PM to 6:30 PM.

All areas identified on this report were inspected. There were no children present during the inspection. Teacher/child ratios were observed to be in accordance with Title 22 Regulations. Per Director, all children are under visual supervision of a teacher at all times.Children's roster was reviewed and is current. Sign in and out sheets were reviewed. Children present were signed in. Disaster drill log was available, last drill was conducted on 09/2023. LPA observed required licensing documents posted on bulletin board.

Furniture and equipment were inspected for age appropriateness and good repair. LPA observed material and equipment are free of sharp, loose, or pointed parts. Telephone service, heating, lighting and ventilation were evaluated. Age appropriate sinks and toilets were inspected for availability and good repair in all restrooms. Bathrooms were observed to be gender specific and they provide individual privacy for children. General sanitation was observed. Disinfectants, cleaning solutions, and other items that are dangerous to children, were inaccessible to children. According to the Director, no medication is administered. Facility Representative understands that storage areas for poisons must be locked with a key or combination lock. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements.



First Aid supplies were observed in the classroom. Menus were reviewed to ensure that they are being posted at least one week in advance and visible to an authorized representative. The facility provides a lunch and a PM snack. LPA observed that children bring their own water in their personal water containers.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul NavarroTELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:
DATE: 11/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/17/2023
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: GOLDEN CITY CHILD DEVELOPMENT CENTER INC.
FACILITY NUMBER: 198019107
VISIT DATE: 11/17/2023
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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. All foods/beverages are stored in covered containers at 45˚ (F) or less.

Outdoor play equipment was observed to be in good condition, free of sharp, loose or pointed parts. Outdoor activity space surface is maintained in a safe condition as is free of hazards.

Areas around and/or under climbing equipment and slides have cushioning material to absorb a fall. The outdoor area had adequate shade. LPA did not observe any bodies of water during this visit. Director states there are no weapons or firearms on the premises.

All individuals present have obtained a criminal record clearance or criminal record exemption. There is at least one person trained in CPR and Pediatric First Aid present during this inspection.

Children’s Records were not reviewed to ensure that Identification and Emergency form and a medical assessment are on file, Immunization Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, and LIC 613A Personal Rights.

Staff records were reviewed for approved Pediatric First Aid and CPR certification, LIC-501: Personnel Record, LIC 9052- Employee Rights, Proof of immunization against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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.html

SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul NavarroTELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2023
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: GOLDEN CITY CHILD DEVELOPMENT CENTER INC.
FACILITY NUMBER: 198019107
VISIT DATE: 11/17/2023
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Facility representative was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES:


Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

Facility Representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

At this time, the facility is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today. Exit interview was conducted with Director Angelica Herrera.

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.

SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul NavarroTELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2023
LIC809 (FAS) - (06/04)
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