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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019938
Report Date: 06/12/2019
Date Signed: 06/12/2019 11:42:09 AM

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:KIDDY TYME CHILD CARE/LEARNING CENTERFACILITY NUMBER:
198019938
ADMINISTRATOR:BENJAMIN WANGFACILITY TYPE:
830
ADDRESS:1465 N MONTEBELLO BLVDTELEPHONE:
(909) 527-9950
CITY:MONTEBELLOSTATE: CAZIP CODE:
90640
CAPACITY:20CENSUS: 11DATE:
06/12/2019
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
11:09 AM
MET WITH:Angela TsaiTIME COMPLETED:
11:55 AM
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An unannounced Pre-licensing inspection was conducted by Licensing Program Analyst (LPA), Timothy Fields. This is a change of ownership. LPA met with director Angela Tsai who guided analyst on a tour of the facility. All areas identified on the facility sketch were inspected.

Operating hours are Monday - Friday, 6:30am - 6pm. Two classrooms are used to operate the infant program. The facility was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. Changing tables were within arms reach of a sink. There was age appropriate toys and equipment.

Playground is adequately fenced. There was no swimming pool, spa or other bodies of water observed on the premises. Based on measurements of the indoor and outdoor activity space accessible to children in care, LPA has determined the facility is capable of caring for 20 infants. LPA inspected the refrigerators and food storage space in each classroom. The facility has a record keeping procedure for daily feeding and changing schedules.

The required fire extinguisher, smoke detectors, and carbon monoxide detector are in operable condition. An approved fire clearance is on file. Applicant/Director states there are no weapons, firearms in the facility at this time. Applicant/Director has completed the child CPR/First Aid indicated on the certificates and Preventative Health practices.

Report continued on attached LIC 809C.
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Timothy FieldsTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2019
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: KIDDY TYME CHILD CARE/LEARNING CENTER
FACILITY NUMBER: 198019938
VISIT DATE: 06/12/2019
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The director's office will be used as an isolated area for sick children. Applicant/Director states only doctor prescribed medication is administered to children in care. Parents are required to sign an authorization letter before medication will be administered.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A 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

Website address to order forms: http://www.dss.cahwnet.gov


INTERNET ADDRESS: http://www.ccld.ca.gov – To access licensing forms, updates and Title 22.
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Timothy FieldsTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2