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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019661
Report Date: 07/18/2023
Date Signed: 07/18/2023 03:38:44 PM


Document Has Been Signed on 07/18/2023 03:38 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:DOVE DAY SCHOOLFACILITY NUMBER:
198019661
ADMINISTRATOR:JACQUELINE ALMEIDAFACILITY TYPE:
840
ADDRESS:908 W. ARROW HIGHWAYTELEPHONE:
(626) 919-1417
CITY:SAN DIMASSTATE: CAZIP CODE:
91773
CAPACITY:60CENSUS: 35DATE:
07/18/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:11 PM
MET WITH:Leticia Alvarado TIME COMPLETED:
02:15 PM
NARRATIVE
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Licensing Program Analyst (LPA) Jennifer Hua conducted an unannounced Required - 1 year inspection. Upon arrival, LPA met with Director Leticia Alvarado. A COVID-19 risk assessment was conducted. LPA provided Director with a copy of the LIC 125 Entrance Checklist to facilitate the inspection. At 12:12pm, Director guided analyst on a tour of the facility.

This is school-age program which consists of 3 classrooms; Room 4, Room 5, Room 6. Facility operation hours are Monday to Friday from 7:00 AM to 5:30 PM. This facility also has an infant component #198016683 and a preschool component #198016681. The facility has a private school affidavit on file for grades K-3. They are housed in the same classrooms during "regular school" hours.

All areas identified on sketch were inspected. LPA observed the following during this inspection: Room #4 - 12 children with 1 staff, #5 - 11 children with 1 staff, #6 - 12 children with 1 staff.

Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Indoor drinking water available for children. Per director, children bring their water bottles daily and will be filled as needed. Children have their own cubby to store their belongings. The isolation area is located in the office. Age appropriate sinks and toilets were inspected for availability and good repair in all restrooms. General sanitation was observed. .

Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were observed to be inaccessible to children. Per director, there are no poisons stored at the facility.

SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jennifer HuaTELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:
DATE: 07/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/18/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4


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: DOVE DAY SCHOOL
FACILITY NUMBER: 198019661
VISIT DATE: 07/18/2023
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The swimming pool in on the premises of the facility. The pool is surrounded by 3 side brick walls and one side with a rod iron fence that is above 5 feet. The bottom part of the fencing is approximately one inch from a hard surface the vertical bars are approximately 2 and a half inches apart. Fence door swings away from pool and has padlocks on them in order for children to not have access to entering. Per director, the swimming pool is off-limits during hours of operation and it is only for lessons with parental permission and is ran by a different company.

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. Trash cans used to discard food have tight fitting lids.

Outdoor playground equipment is in a safe condition. 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, swings, 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.

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 reviewed for completeness; Inspection of required forms was made, review of children’s records, files contain information including, but not limited to the following: Name, address and telephone number of the child's authorized representative and of relatives or others who can assume responsibility for the child if the authorized representative cannot be reached when necessary.

Staff records reviewed

Children's roster is maintained in the computer and can print out as needed and is current. This facility uses electronic Sign-In and Sign-Out method. Per director, documents can be print out and is maintained for more than 30 days. Children present were signed in. Disaster drill log was available, last drill was conducted on 07/10/2023.

SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jennifer HuaTELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:

DATE: 07/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: DOVE DAY SCHOOL
FACILITY NUMBER: 198019661
VISIT DATE: 07/18/2023
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Menus are posted for the month where it is visible by the child's authorized representative. Per Director, the parents are also provided with a copy of the menu electronically. Snacks/lunch were reviewed for availability, quantity and appropriateness to children in care. children are provided with breakfast, lunch, and snack at the facility.

First Aid supplies were observed in the classrooms in bags or boxes. Medication is only administered to a child when accompanied with a doctor's note and are stored in office, in in locked metal box..

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

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. Exit interview was conducted with director, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.

LPAs advised director to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

Deficiencies cited on attached 809D

SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jennifer HuaTELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:

DATE: 07/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 07/18/2023 03:38 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: DOVE DAY SCHOOL
FACILITY NUMBER: 198019661

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/18/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(g)(1)
Personnel Requirements
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on (record review)], the licensee did not comply with the section cited above in staff #2 lack record which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/18/2023
Plan of Correction
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Per director, will correct and submit copy to LPA by POC due date
Type B
Section Cited
CCR
101216.1(g)
Teacher Qualifications and Duties
(g) A photocopy of the teacher's Child Development Permit as specified in (c)(3) above, or a photocopy of the teacher's transcript(s) documenting successful completion of required course work, shall be maintained at the center.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review], the licensee did not comply with the section cited above in staff #2's transcripts not in file which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/18/2023
Plan of Correction
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Per director, staff will get copy of transcripts, but in the meantime, staff will always work under a qualified teacher. Will correct and submit copy to LPA by POC due date.
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 ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jennifer HuaTELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:
DATE: 07/18/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/18/2023
LIC809 (FAS) - (06/04)
Page: 4 of 4