198019478-10-23-2023-33-CC-CTUA-CWVVB2-20231023161648

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019478
Report Date: 10/23/2023
Date Signed: 10/23/2023 04:17:36 PM

Document Has Been Signed on 10/23/2023 04:17 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:	PUENTE AVE PRESCHOOL INFANT CARE CENTER		FACILITY NUMBER:	198019478
ADMINISTRATOR:	KIMBERLY NGUYEN		FACILITY TYPE:	830
ADDRESS:	14032 DILLERDALE AVE		TELEPHONE:	(626) 338-3464
CITY:	LA PUENTE	STATE: CA	ZIP CODE:	91746
CAPACITY:	45	CENSUS: 38	DATE:	10/23/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Kimberly Nguyen		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	On 10/23/2023, Licensing Program Analyst (LPA) Carolyn Tuba conducted an unannounced required Annual inspection. A Covid risk assessment was conducted. LPA met with Director, Kimberly Nguyen. LPA was guided on a tour of the facility indoors and outdoors. LPA took a census of 38 children with 8 staff, and visit was conducted during nap time. This is an infant program licensed for 45 children, which operates Monday through Friday from 6:00 AM to 6:00 PM. Per the Director, there are 45 children currently enrolled, and the facility follows Title 5 regulations as well. The following classrooms was inspected: Infant room AB which serves ages birth to 12 months. Infant C serves ages 12 months to 24 months, Toddler 1 / 2 which serves ages 18 months to 30 months and Toddler 3 which serves ages 18 months to 30 months. Teacher-child ratios were observed to be in accordance with Title 22 Regulations. Staff names were recorded. All children were observed to be under supervision, including visual supervision. Licensed facility is within the conditions, limitations, and capacity specified on the license. Infant classrooms is currently part of a preschool and school-age licensed child care center. The classroom furniture and equipment were inspected for good repair, free of sharp, loose, or pointed parts. Indoor classroom was inspected to ensure that the floors have a surface that is safe and clean. Telephone service, heating, lighting, and ventilation were evaluated. Storage for infants’ belongings and napping equipment/cribs was inspected and meet all regulatory requirements. Availability of drinking water was reviewed and per Director the classroom provides water for the children by either using filtered water from the kitchen or using bottled water and placed in a pitcher. The children have their own sippy cups ad bottles with their names written on them. Changing table has raised sides at least three inches high and is within an arm’s reach of a hand washing sink. Toys observed to be clean. Page 1 of 4

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn Tuba	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2023

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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Document Has Been Signed on 10/23/2023 04:17 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: PUENTE AVE PRESCHOOL INFANT CARE CENTER	FACILITY NUMBER: 198019478
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/23/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101439.1(b)(1)

Infant Care Center Sleeping Equipment

(b) A crib or portable -crib meeting United States Consumer Product Safety Commission safety standards shall be provided for each infant who is unable to climb out of a crib. (1) Mattresses shall be firm and covered with a fitted sheet that is appropriate to the mattress size, fits tightly on the mattress, and overlaps the underside of the mattress so it cannot be dislodged. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in 13 children did not have fitted sheets on their napping cots, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/23/2023
	Plan of Correction
1 2 3 4	LPA observed that fitted sheets were placed on cots after consulation. LPA and Director had a discussion that she will make sure that fitted sheets are availble on Monday for naptime.

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: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn Tuba	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2023

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: PUENTE AVE PRESCHOOL INFANT CARE CENTER	FACILITY NUMBER: 198019478
	VISIT DATE: 10/23/2023

NARRATIVE

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Carbon monoxide detectors and smoke detectors are present in the facility. Fire extinguishers are serviced annually and was last serviced 6/8/2022. Per the Director, she will be taking Fire extinguishers to be serviced on 10/24/2023 and she will be taking a photo of the new service tag and will text a photo to LPA for proof of service. Storage cabinet in classrooms was locked and hazardous items including poisonous cleaning compounds were stored inaccessible to children. Emergency disaster drill was last conducted on 10/2023. There is a First Aid kit available inside the classroom; the supplies were inventoried and found to be in good condition.

Facility provides bedding and launders for the children at the end of each week. Storage for children's belongings was reviewed. Food preparation areas were toured for safety, cleanliness, and proper equipment. Bottles, dishes, and containers were labeled with infants’ names; dates were visible on all children's bottles and other refrigerated items. Table food items are served by the Center using a food program: Breakfast, AM Snack, Lunch and PM Snack. Formula and baby food is provided by facility unless a parent wants to provide a different brand of formula. Food Menu is posted in the classrooms, on the parent app and the playground.

LPA provided the Director with a Safe Sleep Handout and reviewed the 15-minute log for children 0-24 months, which LPA observed is being documented.

Smoking is prohibited. No infant walkers, no Johnny Jumpers, no baby saucers or any other item that falls into that category are allowed in the facility. The Director was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Sudden Infant Death Syndrome (SIDS) and Never-Shake-a-Baby were discussed.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Licensee was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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

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SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn Tuba	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2023

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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: PUENTE AVE PRESCHOOL INFANT CARE CENTER	FACILITY NUMBER: 198019478
	VISIT DATE: 10/23/2023

NARRATIVE

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$100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

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.
For childcare center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).
LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

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

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/. Per Director there is no one on medication at this time.

Outdoor playground equipment is in safe condition, free of sharp, loose, or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under

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SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn Tuba	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2023

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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: PUENTE AVE PRESCHOOL INFANT CARE CENTER	FACILITY NUMBER: 198019478
	VISIT DATE: 10/23/2023

NARRATIVE

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climbing equipment, slides, and similar equipment are cushioned with soft material. There is adequate shade in the play yard. There is enough equipment for the children to use in the play yard. Area is gated with iron gates at least 6 feet tall and staff check the area for any harmful objects prior to children playing in the play area. Per Director staff sweep for any fallen leaves.

Sign in and out sheets are kept in each classroom for easy access for parents. LPA reminded Director that parents should be using full signature when signing in or out their child.

Children files were reviewed and complete. Staff files were reviewed and complete. Clearance for adults and verification of CPR/First Aid, current mandated reporting certificates, educational requirements and health preventative practices documentation was reviewed. Children’s records were reviewed to ensure that Identification and Emergency form and a medical assessment are on file. The Director and staff currently have immunization documentation.

AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018 any person who works in a childcare facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers.

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

The following deficiencies on the attached LIC 809 deficiencies page is being cited in accordance with CA code of Regulations Title 22. 101212(d)(1) Reporting Requirements.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director, Kimberly Nguyen.

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SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn Tuba	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2023

LIC809 (FAS) - (06/04)

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