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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020452
Report Date: 05/06/2020
Date Signed: 05/08/2020 12:34:43 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:MULBERRY TREE PRESCHOOLFACILITY NUMBER:
198020452
ADMINISTRATOR:MICHELLE BENITEZFACILITY TYPE:
840
ADDRESS:13841 CHRISTINE DR.TELEPHONE:
(562) 696-5114
CITY:WHITTIERSTATE: CAZIP CODE:
90605
CAPACITY:14CENSUS: 1DATE:
05/06/2020
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Michelle Benitez, Applicant TIME COMPLETED:
03:45 PM
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On May 6 at approximately 8:17 am, due to COVID -19 precautionary measures, Licensing Program Analyst (LPA) Roxana Lopez conducted an announced tele-pre-licensing inspection to the above facility via Zoom. Also present were LPA Jose Guzman and Licensing Program Manager (LPM) Ana Chico. Licensing staff met with Applicant Michelle Benitez, who guided staff on a video tour of the facility’s indoor and outdoor areas. Upon conclusion of the tele-inspection, Licensing staff arrived at the facility at approximately 12:37 pm to take indoor and outdoor measurements of the proposed school-age program. This is a proposed School- Age Program which consists of one classroom, one restroom and one yard. This program will serve children from Kindergarten to 12th grade. Licensing Staff advised Applicant that materials provided should be conducive to the age group being served, to make sure their needs are being met. Applicant will submit a new application to reflect this change as initial application stated 6 years to 11 years old. This program will operate Monday - Friday 6:30 AM - 6:00 PM. This facility is currently operating under license # 198013139 as applicant is applying for change of ownership. Applicant is also applying for a pre-school license (#198000568) and a private school also operates on site under a private school affidavit (license exempt).

The center hours are Monday to Friday from 6:30 to 6:00pm. Children will be signed in upon entrance to each classroom where a daily sign-in binder will be available, and a health check will be conducted prior to children being signed-in and out on a daily basis. Parents will enter through the office where all posting requirements were observed to have been met. In addition to the required Title 22 postings, safety guidelines poster pertaining to COVID 19 was observed and recommended hand washing guidelines will also be posted throughout the facility.
There is drinking water readily available in the classroom via a water pitcher and disposable cups. 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. Per Applicant, the isolation -------------------------------------------------------------- Pg.1 of 4 ------------------------------------------------------------
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Roxana LopezTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2020
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: MULBERRY TREE PRESCHOOL
FACILITY NUMBER: 198020452
VISIT DATE: 05/06/2020
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area will be in the director’s office which is located close to the entrance. Ill children will use the staff restroom if needed. Age appropriate sink (1) and toilet (1) were inspected for availability and good repair in all. There was only one private bathroom in the facility, Licensing staff advised applicant to put a sign up to make it gender specific. During physical inspection, LPA Lopez observed a double sided sign (boy/girl) on the door. Licensing staff advised applicant to put a safety gate in the hallway to make the private school restroom inaccessible to school age children and prevent co-mingling. Licensing Staff observed that facility does have a carbon monoxide detector, smoke detector, and a serviced fire extinguisher.

Disinfectants, cleaning solutions, and other items that are dangerous to children, will be inaccessible to children and stored in the staff bathroom.

All kitchen areas/food preparation areas and food storage areas were observed to be clean and are free of litter, rubbish, rodents, and/or any other vermin. 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 will be providing AM and PM snacks, lunch will be brought from home. All food preparation areas have working sinks with hot water. A refrigerator is available to store children’s lunch and applicant was advised that all food must be covered at all times. A weekly snack menu is available and posted in both the classroom and front office.

The outdoor activity area is surrounded by a chain-linked fence and is set up as an indoor/outdoor classroom, providing several learning opportunities. Gate that separates the school age program from preschool program and private school must remain closed during operating hours to prevent commingling of children. Outdoor equipment was inspected, via Zoom, for safety, cushioning material, good repair and age appropriateness. Required shade and fencing were inspected, via Zoom. Drinking water was available outdoors for children to drink freely via a water jug using disposable cups. Licensing Staff observed the structure does not have cushioned material all around it to absorb a fall. Licensing staff did observe a mat underneath one slide and a rug underneath another slide used as cushioning material. Licensing staff provided applicant with information regarding health and safety regulations for playgrounds. There is adequate shade in the play yard. Play area was inspected and no bodies of water or hazards were observed. Shade is provided via an outdoor canopy and trash cans with tight fitting lids were observed.


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SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Roxana LopezTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2020
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: MULBERRY TREE PRESCHOOL
FACILITY NUMBER: 198020452
VISIT DATE: 05/06/2020
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Incidental Medical Services (IMS) policy was discussed. 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

Applicant states that medication will be stored in the office in a locked cabinet. First aid kits are available in the office and were observed to contain the required first-aid supplies.



At 10:16 am the following items were discussed during this visit:
I. Licensing does not tolerate the following: Refused Entry to a Facility or Any Part of a Facility is a violation of Section 1596.852, 1596.853 or 1597.09. Regulations 101238 (g) (2), The Presence of an Excluded Individual, Fire Clearance Violations, Accessible Bodies of Water, Accessible Firearms, Ammunition or Both.
II. Breakfast/Lunch/Snack Menus: Menus are required to be posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days must also be available upon request.
III. Current Children’s Roster: Each child day care facility shall maintain a current roster of children who are provided care in the facility. The roster shall include the name, address, and daytime telephone number of the child's parent or guardian, and the name and telephone number of the child's physician. This roster shall be available to the licensing agency upon request.
IV. Pediatric First Aid and CPR: At least one person trained in Pediatric First Aid and CPR must be present.
V. Designated Staff: The name of the childcare center director or fully qualified teacher(s) designated to act in the director's absence must be on file.
VI. Qualifications: Educational background, training, and/or experience for each staff present must be available for review.
VII. Children’s Records: must be available for review; 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.
VIII. Immunization Requirements: Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles.
IX. LIC 311A - Records to be Maintained at the Facility: Child Care Centers was provided and
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SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Roxana LopezTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2020
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: MULBERRY TREE PRESCHOOL
FACILITY NUMBER: 198020452
VISIT DATE: 05/06/2020
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discussed with the applicant during this visit.
X. AB1207: The following was discussed: As of January 1, 2018, Health & Safety Code 1596.8662 requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. New employees shall have 90 days from date of employment to complete training as required. The training may be met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules at: http://www.mandatedreporterca.com/

REMINDER: Failure to obtain a criminal record background check clearances prior to initial presence in the preschool will result in an immediate $100.00 dollar or more per day Civil Penalty.

Check our website at: www.ccld.ca.gov. for regulations and quarterly updates

- An approved fire clearance granted on 12/17/2019 is on file for a capacity of 14. Based on measurements taken during today's visit and the approved fire clearance, the capacity approved will be for 12.

Prior to Licensing the following items are to be corrected and in compliance with Title 22, California Code of Regulations:

1. Put a safety gate to divide restrooms, making private restroom inaccessible
2. Applicant to decide to add recommended cushioning material around the playground structure or remove the structure completely.

The above items are due on or before 5/29/2020

A Child Care license may be granted upon receipt of proof of corrections and Licensing Program Manager (LPM) Approval. Once licensed, the applicant is required to comply with the terms and limitations stated on the license.
Exit interview was conducted with Michelle Benitez, via tele-inspection/ zoom on May 8th, 2020 during which appeal rights were explained. This report along with a copy of the appeal rights will be sent to the Applicant via email with a read receipt or confirmation of receipt of email, which will act as the Applicants signature.

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SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Roxana LopezTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2020
LIC809 (FAS) - (06/04)
Page: 4 of 4