198019547-9-22-2021-54-CC-RRAS-C74V4L-20210922160632

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019547
Report Date: 09/22/2021
Date Signed: 09/22/2021 04:06:40 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	LBUSD-KING CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	198019547
ADMINISTRATOR:	KIMBERLY KELLY		FACILITY TYPE:	850
ADDRESS:	145 EAST ARTESIA BLVD		TELEPHONE:	(562) 428-3813
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90805
CAPACITY:	24	CENSUS: 9	DATE:	09/22/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Sandra Bobadilla & Kimberly Kelly		TIME COMPLETED:	04:25 PM

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Licensing Program Analyst (LPA) Rita Ramos conducted an unannounced required 1 year inspection to the above facility on 09/22/2021. LPA arrived at the facility at 2:00PM, identified self and met with Sandra Bobadilla and Angelica Zambrano, Teachers, who guided analyst on a tour of the facility. LPA provided teachers with a copy of the LIC 125 Entrance Checklist to help facilitate the inspection. This is a preschool program which consists of 1 classroom; RM 33 located within the premises of King Elementary School in the city of Long Beach. Facility operation hours are Monday to Friday from 12:00 PM to 3:00 PM.
All areas identified were inspected. Upon arrival, the following staff were present during this inspection: Staff #1, #2, #3 and #4 with 9 preschoolers. The facility was observed to be within the license capacity and limitations. Coordinating Teacher, Kimberly Kelly, arrived during the inspection. The following was observed during the tour of the facility:

Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Children have their own cubby to store their belongings. Children do not nap at this facility. The isolation area is located in the nurse's office. Age appropriate sinks and toilets were inspected for availability and good repair in all restrooms. General sanitation was observed. Availability of indoor drinking water was observed.

Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Sandra Bobadilla states that no poisons are stored at the facility. Carbon monoxide detectors were observed and are operable.

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 are in good repair. Trash cans used to discard food have tight fitting lids. ----Page 1 of 3

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Rita Ramos	TELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:	DATE: 09/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2021

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LBUSD-KING CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 198019547
	VISIT DATE: 09/22/2021

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Outdoor playground equipment is in a 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 high climbing equipment, slides, and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard. Availability of outdoor drinking water was observed. LPA advised that no children shall be left without the supervision of a teacher at any time.

All floors were observed to be clean and safe. All materials accessible to children were observed to be toxic-free. There are no firearms stored on the premises. There are no pools or bodies of water at the facility.

There is at least one person trained in CPR and Pediatric First Aid present during this inspection.

Children’s Records were reviewed for completeness; Inspection of required forms was made and documented on the LIC 857.

LPA also reviewed staff records. The review of Staff records was documented on the LIC 859. Staff present did have proof of the AB 1207 Mandated Reporter Training certificate on file. All staff have been given on the-job training sanitation principles, housekeeping, including universal health precautions.

Children's roster was reviewed and is current. Sign-In and Sign-Out sheets were reviewed. Children present were signed in. Disaster drill log was available, last drill was conducted on 09/21/21.

Menus are posted one month in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request. The facility provides a full lunch for children due to only having one part-time session.

First Aid supplies were observed in the classroom in a cabinet. According to Sandra Bobadilla, medication is only administered to a child when accompanied with a doctor's note and is stored in the locked metal box in the classroom. When inspecting the medication, LPA observed that Child #1s medication was expired. Sandra Bobadilla reminded parent to bring an updated medication since the facility had already requested an updated medication prior to LPAs arrival.

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SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Rita Ramos	TELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:	DATE: 09/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2021

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: LBUSD-KING CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 198019547
	VISIT DATE: 09/22/2021

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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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

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/tion-process.

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 Sandra Bobadilla, Teacher, and Kimberly Kelly, Coordinating Teacher.

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SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Rita Ramos	TELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:	DATE: 09/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2021

LIC809 (FAS) - (06/04)

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