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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020030
Report Date: 03/02/2022
Date Signed: 03/02/2022 12:15:34 PM


Document Has Been Signed on 03/02/2022 12:15 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:ARCADIA PLAYSCHOOLFACILITY NUMBER:
198020030
ADMINISTRATOR:DAVID VAN IWAARDENFACILITY TYPE:
850
ADDRESS:615 LIVE OAK AVETELEPHONE:
(626) 771-3131
CITY:ARCADIASTATE: CAZIP CODE:
91006
CAPACITY:65CENSUS: 25DATE:
03/02/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Ranum Magellan - LicenseeTIME COMPLETED:
12:27 PM
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Licensing Program Analyst (LPA) Nolan Tcheng conducted an unannounced random inspection. Upon arrival at 8:35am, LPA met with Licensee Ranum Magellan. At 8:40am,LPA was led on a tour of the facility. This is a Preschool program with a Toddler Option, which consists of 3 Preschool classrooms and 1 Toddler Classroom. Director David Van Iwaarden arrived later during time of inspection at 8:50am. Per licensee, there are currently 63 enrolled in the program. Hours of operation for this facility are 7-6pm, Monday-Friday.

Licensing staff observed all required forms/publications to be posted in the front hallway. Snack menus were reviewed to ensure that they are being posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request. Waiver for exception to outdoor play space was observed to be posted.

PHYSICAL PLANT: At 8:40am, LPA entered and inspected Toddler Classroom: 6 children with 2 staff members, Twos Classroom: 4 children with 1 staff member, Threes Classroom: 6 children with 2 staff members, and Pre-K Classroom: 9 children with 2 staff members. Toddler classroom was inspected first. There were age appropriate toys present. The restroom connected to the classroom had a Toilet Training seat and a Changing Pad available for children in care. LPA observed Diapers stored on shelves that were individually labelled. Tour continued to rest of facility. Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. All floors are clean and safe. All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids. The facility was observed to be free of flies, other insects and rodents. Sufficient individual storage space for children was observed and each child has a cubby. Drinking water was readily available indoors. At this time, the back office is used as an isolation area. A cot is available for an ill child to rest on. First Aid supplies are available and complete. Facility has a functioning carbon monoxide detector that meets statutory requirements. Director states there are no weapons, firearms, or bodies of water on the premises. REPORT CONTINUES PAGE 1 of 3

SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Nolan TchengTELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:
DATE: 03/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/02/2022
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: ARCADIA PLAYSCHOOL
FACILITY NUMBER: 198020030
VISIT DATE: 03/02/2022
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At 9:00am, LPA reviewed the storage of napping equipment. Napping equipment was observed to be cots. A fire extinguisher was observed. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 01/24/2022, as indicated on service tag. Per State Fire Marshall standards, fire extinguishers shall be serviced annually. LPA observed the restroom for Preschool children. All toilets, hand washing, and bathing facilities are safe, sanitary and are operating properly. The kitchen was observed next, where all food preparation areas and food storage areas are kept clean and are free of litter, rubbish and rodents and/or any other vermin. Snacks were reviewed for availability, quantity and appropriateness to children in care. This facility provides breakfast, lunch, am snack, and pm snack. Teacher-child ratios were observed to be in accordance with Title 22 regulations. Staff names were recorded. All children were observed to be under visual supervision of a teacher during tour. The Licensee is within the conditions, limitations, and capacity specified on the license. All areas were identified on the Facility Sketch were inspected.

OUTDOORS: At 9:10am, LPA reviewed the outdoor play area. 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 high climbing equipment, swings, slides, and similar equipment are cushioned with material that absorbs a fall. Fake grass was observed as the cushion. There is one outside play space for preschool children that has a play structure, sandbox, playhouses, and a bike path. Another outside play space observed specifically for the Toddler component, that has a playhouse, bike path, and sensory activities. The Toddler section was separate from the preschool area. Per licensee, the waiver they have is for staggered playtimes for preschool children.

FACILITY RECORDS: Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. Staff files were reviewed for a health screening report and immunizations that meet regulatory requirements. At 10:10am, during review of Staff #6 file, LPA observed that there was no LIC503 Health Screening Report present. Staff #6 was able to provide proof of visit during hire period through Kaiser Permanente's website. Per Staff #6, they forgot to bring the LIC503 form then. A Technical Violation is being provided to address the issue. Criminal Record Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed. The name of the child care center director or fully qualified teacher(s) designated to act in the director's absence is on file. Educational background, training, and/or experience for each staff present are on file and were reviewed. A random sample of Children’s Records were reviewed to ensure that they are complete


REPORT CONTINUES PAGE 2 of 3
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Nolan TchengTELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2022
LIC809 (FAS) - (06/04)
Page: 2 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: ARCADIA PLAYSCHOOL
FACILITY NUMBER: 198020030
VISIT DATE: 03/02/2022
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INCIDENTAL MEDICAL SERVICES:
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

During this inspection LPA discussed PIN 20-06 CCP, Social And Physical Distancing Guidance And Healthy Practices For Child Care Facilities In Response To The Global Coronavirus (COVID-19) Pandemic Written In Collaboration With The California Department Of Education and reviewed Child Care Covid-19 Self Assessment.

LPA reviewed SIDs, Never Shake A Baby, and safe sleeping practices. Infants should sleep mouth up, on their backs, free of clutter surrounding their sleeping space

LPA advised the licensee how to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov. AB1207 Mandated Child Abuse Reporting – Implementation was discussed with Licensee. Website provided: http://mandatedreporterca.com/

Licensee was reminded that all adults 18 and over, including employees and volunteers, 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 $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

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.

Exit interview was conducted with Licensee Ranum Magellan, at 12:05pm, Copy of Report was provided.



REPORT ENDS PAGE 3 of 3
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Nolan TchengTELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2022
LIC809 (FAS) - (06/04)
Page: 3 of 4