198019321-6-12-2023-33-CC-CRES-CSR22M-20230612170059

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019321
Report Date: 06/12/2023
Date Signed: 06/12/2023 05:01:08 PM

Document Has Been Signed on 06/12/2023 05:01 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	ESGVJCC KOKORO NO SATO INFANT CENTER		FACILITY NUMBER:	198019321
ADMINISTRATOR:	PEARL OMIYA		FACILITY TYPE:	830
ADDRESS:	1203 WEST PUENTE AVENUE		TELEPHONE:	(626) 960-2566
CITY:	WEST COVINA	STATE: CA	ZIP CODE:	91790
CAPACITY:	8	CENSUS: 7	DATE:	06/12/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Pearl Omiya		TIME COMPLETED:	01:00 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	Licensing Program Analyst (LPA) Cynthia Reyes, conducted an unannounced annual site inspection, as well as to inspect and measure the requested new toddler option. Licensee is requesting a capacity of 8 toddlers (18 to 36 months) added to the already licensed infant (0-2 year old) capacity of 8. This inspection is to ensure the health and safety standards as required by the regulations governing child care centers are met. LPA met with Pearl Omiya, Director and a copy of the Entrance Checklist for Child Care Centers form (LIC 125) was provided. The facility operates Monday-Friday 6:30 AM-6:30 PM. Facility is located on the premise of the East San Gabriel Valley Japanese Community Center. Licensee has been informed that children shall be kept separate physically from any community center activities during the day care operation days and hours. 9:15AM, LPA began the tour of the facility with Pearl and Melissa Kozono, Assistant Director, who was also present during this inspection, beginning at the office. Pearl states infant/Toddler parents will enter and exit the gate from the back parking lot of the facility. Parents will sign the children in and out using the Bright Wheel application. Parents will walk the child inside the class room where health checks will be conducted at that time. LPA observed a parent board in each class room with all the required licensing forms visible for all to see. The ill/isolation area is located in the main office and is close to the staff rest room for an ill child to use. The ill/isolation area has a mat/pack in play for a child to rest if needed. A staff lounge/lunch area is located in the kitchen area that is used just for snack/meal prep and no cooking. PAGE 1 OF 5

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 06/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2023

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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: ESGVJCC KOKORO NO SATO INFANT CENTER	FACILITY NUMBER: 198019321
	VISIT DATE: 06/12/2023

NARRATIVE

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Licensing staff was then guided through the Infant/toddler class room. Toys, furniture and equipment was inspected for age appropriateness, clean, safe and in good repair. Napping equipment (Cribs & mats) were also inspected and observed to be in good condition. Linens are provided and washed weekly by the facility. Appropriate Individual storage space was observed to be available for each child and cleanliness was observed. The Infants/toddlers will bring their own labeled water bottle/zippy cup. Telephone service, heating, lighting and ventilation were evaluated. Building/Rooms are centrally heated and air conditioned. Overhead lights as well as natural light is used.

Menus were reviewed to ensure that they are being posted at least one week in advance and visible to an authorized representative. Menus for the past 30 days are available upon request. The parents bring breakfast, lunch and PM snack. Infants will bring their own formula and water is provided by the school. Food/Snacks are prepared in each class rooms small kitchen area. Facility will provide snack if needed and snacks were reviewed for availability, quantity and appropriateness to children in care. All kitchen, food preparation, and storage areas are clean, free of litter, rubbish, and rodents/vermin. The licensee takes measures to keep the facility free of flies, other insects and rodents. All food is protected from contamination. Facility has extra linen and food available if needed. LPA inspected and consulted that any contaminated food is discarded immediately. All storage containers for solid waste, including moveable bins, have tight fitting covers on and are in good repair.

Cleaning compounds are inaccessible to the children. Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were observed to be inaccessible to children. Pearl states there are no poisons, weapons or firearms on the premises. There is a fully equipped first aid kit available in each room and were observed to contain the required first-aid supplies.

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SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 06/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2023

LIC809 (FAS) - (06/04)

Page: 2 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: ESGVJCC KOKORO NO SATO INFANT CENTER	FACILITY NUMBER: 198019321
	VISIT DATE: 06/12/2023

NARRATIVE

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Teacher child ratios were discussed in accordance with Title 22 Regulations and observed. Staff names were recorded. LPA discussed that children should be under supervision and observation, including visual supervision, of a teacher at all times. The licensed facility is within the conditions, limitations, and capacity specified on the license.

Infants do not have a bathroom, however LPA observed a diaper changing area with a changing table within arms reach of a sink. LPA consulted regarding changing pad to have no exposed foam. Toddler bathroom was observed to be in good repair, water temperature, paper towels, toilet paper, all area inspected for safety and sanitation. One toilet and one sink with a changing table in arms reach.

The tour continued as the LPA was guided to the Infant outdoor play area, in which the licensee is requesting a waiver for a staggered play schedule with the toddlers as a waiver has already been granted for shared space with the preschoolers. The outdoor play yard is self contained by a gate around it for separation from the open walk area of the facility by guest. 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.

LPA advised Pearl & Melissa that the Infant and toddler children need to be within the direct care and supervision, including visual observation and supervision of the teacher(s) at all times. There is drinking water available indoors and outdoors by use of a water dispenser/jugs and disposable cups. Sippy cups & water bottles will be labeled with the child's name.

Pearl & Melissa 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.
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SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 06/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2023

LIC809 (FAS) - (06/04)

Page: 3 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: ESGVJCC KOKORO NO SATO INFANT CENTER	FACILITY NUMBER: 198019321
	VISIT DATE: 06/12/2023

NARRATIVE

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Children’s Records (Infants) were reviewed for completeness; Inspection of required forms were made and documented on the LIC 857. LPA reviewed Staff records, which are documented on the LIC 859. Staff present have proof against TB, measles, pertussis, and influenza, as well as current Mandated reporter. LPA observed during staff file review, that there is at least one person trained in Pediatric CPR and Pediatric First Aid present during this inspection and at all times.

Medication: This facility provides Incidental Medical Services – IMS. 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

Children's roster was reviewed for completeness. Disaster drill log was available and last drill was document on 01/24/2023. Medication is only administered to a child when accompanied with a doctor's note and is stored in the office. No transportation is being conducted by the facility.

Update: Effects of Lead Exposure and 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. were discussed.

LPA observed carbon monoxide detectors and smoke detectors in each class room and are in operable condition. Smoke and Carbon Monoxide detectors should be checked, and batteries replaced as needed. A fire extinguisher type 2A-10BC that meets statutory requirements was observed in each class room and the valve on each indicated that they are fully charged and each has a tag with a service date of 06/28/2022. Fire extinguishers need to be serviced annually or as often as necessary. PAGE 4 OF 5

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 06/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2023

LIC809 (FAS) - (06/04)

Page: 4 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: ESGVJCC KOKORO NO SATO INFANT CENTER	FACILITY NUMBER: 198019321
	VISIT DATE: 06/12/2023

NARRATIVE

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INFANT CARE: LPA advised director, Cribs or play yard shall not hinder the entrance or exit from the sleeping space, mattresses shall be firm and covered with a fitted sheet that overlaps the underside so it cannot be dislodged. Cribs and play yards shall be free of loose articles and objects. No objects shall be hanging above or attached to the side of the crib. LPA advised no infants to be swaddled while in care. LPA advised the licensee that infants shall be placed on their backs for sleeping and shall be supervised. Infants shall be checked on every 15 minutes and the time of each 15-minute check shall be documented with child’s name and date. The LIC 9227 Individual Infant Sleeping Plan shall be completed for each infant up to 12 months of age. A copy of the LIC 9227 was provided to Licensee. LPA provided the licensee with a copy of A Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics. LPA also consulted and explained Child Abuse Reporting, Never Shake a Baby, and Safe Sleeping practices.

SAFE SLEEP: LPA discussed the safe sleep regulations and discussed the Child Care Licensing Safe Sleep webpage at http://www.cdss.ca.gov/inforescources/child-care-licensing/public-information-and-resoucrces/safe-sleep as an additional resource. LPA also informed applicant/licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at http://www/cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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/process.

Based on LPA measurements taken and observations of the new toddler class room, the indoor measurements allow for 8 Toddlers, and no outdoor play yard (Waiver request is needed to share the yard with infants and preschoolers. Fire clearance is on file and approved for a capacity of 8 Toddlers

There were no deficiencies cited during today’s inspection.
A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative, Pearl Omiya, Director PAGE 5 OF 5

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 06/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2023

LIC809 (FAS) - (06/04)

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