198019555-12-9-2019-33-CC-CRES-BJPSSX-20191209130841

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019555
Report Date: 12/09/2019
Date Signed: 12/09/2019 01:08:49 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	AZUSA USD- PARAMOUNT ELEMENTARY CSPP		FACILITY NUMBER:	198019555
ADMINISTRATOR:	LESLIE FORD		FACILITY TYPE:	850
ADDRESS:	409 WEST PARAMOUNT AVE		TELEPHONE:	(626) 815-4724
CITY:	AZUSA	STATE: CA	ZIP CODE:	91702
CAPACITY:	60	CENSUS: 0	DATE:	12/09/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:25 AM
MET WITH:	Antonio Flores (Principal)		TIME COMPLETED:	01:15 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 unannounced Random Site Inspection was conducted on this date, by LPA's Cynthia Reyes and Nolan Tcheng. Classroom 22 and the playground were inspected and checked the following: Fingerprint clearances, staff/child ratio, children and staff records, food preparation area, storage and refrigeration, rest rooms, equipment, outside play area and over all conditions of facility. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Appropriate storage and cleanliness. Storage for children's belongings and an isolation area for a sick child with a sink, toilet, and mats/cots was inspected and housed in the Nurse office located in the school front office. Availability of drinking water was reviewed. Age appropriate sinks and toilets were inspected for availability, good repair, water temperatures, toilet paper, paper towels, area safety and sanitation. First Aid supplies were inventoried. A review of medication policy, including administering, labeling, storage, and records was made. (Please contact your analyst for regulations if considering using Nebulizer or administering Blood-Glucose testing.) Incidental Medical Services was discussed. A notice of site visit was posted today and licensee was explained that it must remain posted for a period or 30 days. Failure to keep poster posted will result in a $100.00 civil penalty. Facility Days and Hours are: M-F 8-11 AM and 12-3 PM for the two half day programs.

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2019

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: AZUSA USD- PARAMOUNT ELEMENTARY CSPP	FACILITY NUMBER: 198019555
	VISIT DATE: 12/09/2019

NARRATIVE

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Food and snacks were reviewed for availability, quantity and appropriateness to children in care. LPA's observed menus posted on the parent board in the classrooms. Food preparation area is located in the kitchen of a high school, where the food comes from already prepared ready for the children to eat. No review of cleaning and food supply storage areas were made. Outdoor equipment was inspected for safety, cushioning material, good repair and age appropriateness. Required shade, fencing were inspected. Facilities have water fountains outside and inside the classrooms. However, it was recommended that an igloo with cups are placed on the outdoor playground for children to drink freely. Play area was inspected for hazards and inaccessibility to bodies of water. Teacher child ratios were observed and staff names recorded. Care and supervision was evaluated to determine if the basic needs of children are met appropriately. Staff was questioned to establish their familiarity of emergency reporting requirements, emergency disaster plans and other site operations. LPA's reviewed the emergency drill log. Sign in and out sheets were reviewed and procedures were reviewed with staff, policy of checking children for illnesses. Personal Rights of children were discussed and observed by LPA. No transportation policy and procedures were reviewed for safety requirements. Staff and children records were reviewed for completeness including but not limited to Criminal Record Clearances for adults, Director Qualifications and verification of CPR/First Aid and health preventive practices documentation. Inspection of required forms was made. Children and Staff confidential name report (lic 811) was given and documented on this date. No weapons or bodies of water on premises. The smoke detectors, carbon monoxide & fire extinguisher are in operable condition. The smoke detectors are maintained by in house maintenance and fire extinguishers are taken to the fire department to service at the end of each year.

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2019

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: AZUSA USD- PARAMOUNT ELEMENTARY CSPP	FACILITY NUMBER: 198019555
	VISIT DATE: 12/09/2019

NARRATIVE

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AB1207 Mandated Child Abuse Reporting – Implementation was discussed with Licensee. Website provided: http://mandatedreporterca.com/

HSC 1596.8662(B)(1)
On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

Health & Safety Code 1597.622(a1) Employees or volunteers at Child Care Center; immunization requirements; records; exemptions Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

The following deficiencies were observed in accordance to Title 22 of the California Code of Regulations. No Citations and Consultation was conducted on this date.

Recent regulatory changes were discussed (including SB 933). Exit interview was conducted including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.

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.htm

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2019

LIC809 (FAS) - (06/04)

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