198020812-1-25-2022-33-CC-CRES-CAZSCC-20220125124518

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020812
Report Date: 01/25/2022
Date Signed: 01/25/2022 12:45:29 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:	PASSONS ACADEMY		FACILITY NUMBER:	198020812
ADMINISTRATOR:	GOMEZ, LETICIA		FACILITY TYPE:	850
ADDRESS:	8415 S. PASSSONS BLVD.		TELEPHONE:	(562) 231-4373
CITY:	PICO RIVERA	STATE: CA	ZIP CODE:	90660
CAPACITY:	30	CENSUS: 0	DATE:	01/25/2022
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Leticia Gomez		TIME COMPLETED:	12:53 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	Licensing Program Analyst (LPA) Cynthia Reyes, conducted an announced pre-licensing site Inspection to inspect and measure the requested Preschool component for capacity determination. LPA met with Leticia Gomez, Applicant/Director. Due to COVID- 19 precautionary measures were taken during the entire inspection and all individuals present during this inspection wore appropriate personal protective equipment. The applicant is requesting a total capacity of 30 preschool children. The days & hours of this toddler option will be Monday-Friday 7 AM-6 PM At 9:30 AM, LPA began the tour of the facility with Leticia beginning at the walk way entrance to the school from the parking lot located off the street named Passon, where the preschool children's parents will enter and exit during Covid or not. Parents will sign the child in/out at a table located right outside class room #1, where the walk way starts and where a parent board is located above the table with Licensing and Covid-19 posting are visible for all to see as well as temperatures and health checks will be conducted. Use of hand sanitizer will also be available. Parents will only stop at the table and not enter the class rooms at this time, unless they request to enter the entire class room, which at that time all precautionary measures will be taken for that individual entering. Facility staff will walk the child inside the class room and bring the child out at pick up time. Facility was observed to be adhering to local public health guidelines. (According to CDC guidelines, children under the age of (2) are not required to wear masks.) The ill/isolation area is located in the Directors office located next to class room 3. The ill child will use the staff rest room located next door to the Directors office. The ill/isolation area has a cot/mat for a child to rest if needed. Preschool children have a bathroom located in between class room 1 & 2 which contain 1 toilet & 1 sink and is in good condition, water temperature, paper towels, toilet paper, and all were inspected for safety and sanitation.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2022

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: PASSONS ACADEMY	FACILITY NUMBER: 198020812
	VISIT DATE: 01/25/2022

NARRATIVE

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10 AM Licensing staff was then guided to the preschool outdoor play area which is located around the corner from the class rooms. Children will need to walk through half of the parking lot, along a walk way path along the perimeter of the building. Leticia states half of the parking lot will be blocked off by several colored cones. Along the path to the gated outdoor play area is another bathroom for the children to use, witch has 1 Toilet, 2 Urinals, and 1 sink. Preschool children have their own play yard with grass. The yard is self contained by a gate around it for separation from other areas located in this entire gated yard. Water jugs with disposable cups will be used for children while outdoors. LPA observed age appropriate outdoor toys and play equipment to be clean, safe and in good repair, as well as adequate shade is available by the building itself and Leticia states they will also be placing a pop up tent. All areas around play equipment and slides are cushioned with material to absorb a fall (Grass). Measurements were taken of the outdoor play yard and the total outside capacity allows for the 30 requested preschoolers. LPA advised the staff that the children need to be within the direct care and supervision, including visual observation and supervision of the teacher(s) at all times.

LPA was then guided through the preschool classrooms (1,2, & 3). LPA observed in all classrooms, toys to be age appropriate clean and safe. Furniture and equipment was inspected for age appropriateness and good repair. Napping equipment (cots) were inspected and observed to be in good condition. Children are provided a sheet & blanket by the facility and parents will take home at the end of each week to wash. Appropriate storage and cleanliness was observed in all rooms. Individual storage space was observed to be available for each child. The children will be provided jugs of water and disposable cups. AM/PM snack will be provided by the facility and preschool children will bring their own cold lunch. Menus were observed on the parent board. Containers used to discard food have tight fitting lids. Facility has extra linen and food available if needed.

Food preparation area will be in the Directors office where a refrigerator will also be located. The space will be inspected for safety and cleanliness once it is set up. There is a fully equipped first aid kit available in each room. LPA observed wall heaters in the class rooms, however Director states will have them check to see if they work or portable heaters will be used. Wall air conditioners are used in each class room as well as ceiling fans. Overhead lights as well as natural light, is used.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2022

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: PASSONS ACADEMY	FACILITY NUMBER: 198020812
	VISIT DATE: 01/25/2022

NARRATIVE

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Carbon monoxide detectors and smoke detectors are present and are in operable condition in the facility. Smoke and Carbon Monoxide detectors should be checked and batteries replaced as needed. The fire extinguisher type 2A-10BC (Service date 06/2021) must be serviced annually or as often as necessary. Hazardous items including poisonous cleaning compounds were observed to be stored inaccessible to children.

11 AM Items discussed during this Inspection:
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.
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.
Current Children’s Roster LIC 9040: 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 children roster must be updated and available to the licensing agency upon request.
Pediatric First Aid and CPR: At least one person in the facility, along with the Director/Administrator must be trained in Pediatric First Aid and CPR and present in the facility.
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.
Qualifications and staff files: Educational background, training, and/or experience and all required documents by the department for each staff present must be available for review.
Children’s Records: All required licensing documents 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. Director advised to visit www.shotsforschool.org for immunization information.
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, & measles.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2022

LIC809 (FAS) - (06/04)

Page: 3 of 5

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: PASSONS ACADEMY	FACILITY NUMBER: 198020812
	VISIT DATE: 01/25/2022

NARRATIVE

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Continued: Items discussed during this Inspection:

Criminal background clearance: LPA advised Director that all adults 18 years of age and older providing Care & Supervision and/or have continuous presence in the facility shall adhere to a criminal background clearance with the Department of Justice, FBI and Child Abuse Index Check.
Reporting Requirements Section 101212: Changes at the facility must be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your location. The Director was also advised of the requirement to report Unusual Incidents and/or injuries to the parent/guardian and to CCL within the time frame specified by the regulation.

12 PM Facility has no transportation policy for preschool children. Applicant states that any lifesaving medication will be stored in a locked area inaccessible to children in care in the office or office refrigerator.

Incidental Medical Services (IMS): This facility will not 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.

LPA consulted with applicant regarding COVID-19 health and safety guidelines on this date. Applicant was provided forms to post via email. Licensing staff observed COVID- 19 postings posted in different areas of the day care for parents, as well as for children at eye level in their class rooms and in the bathrooms. During this inspection LPA also discussed PIN 20-06 CCP, Social and Physical Distancing Guidance and Healthy Practices for Child Care Facilities in Response to The Global Corona virus (COVID-19) Pandemic Written in Collaboration with The California Department of Education. Applicant sent in the Child Care Covid-19 Self-Assessment guide before this inspection.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2022

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: PASSONS ACADEMY	FACILITY NUMBER: 198020812
	VISIT DATE: 01/25/2022

NARRATIVE

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Based on LPA measurements taken on this date and observations of the facility, the 3 preschool classroom measurements can accommodate a total capacity of 28. The outdoor measurements can accommodate 10. The total of 2 toilets= 15. 2 Urinals= 15 and 2 sinks= 30. Fire clearance approved 30.
The following corrections will need to be made prior to submitting the application for approval.

1) Play yard needs more space or a request for a waiver for a staggered play schedule.

2) Documents needed are: Staff personnel policies (Mandated reporter training and Hiring practices and conditions of employment included)

3) Need all Covid-19 posting in the class rooms and in the bathrooms, as well as on the parent board.

4) Fix light in class room #1
5) Have gas company check the heaters or use of portables?
6) Set up directors office and food preparation area
7) Remove all hazardous items from outdoor yard walk way area (Wood pieces)
8) Remove the teachers desk from room 2 and 3.

12:45 PM Exit interview was conducted with Leticia Gomez, Applicant/Director in person with Consultation regarding the licensing state laws and regulations, which were conducted through out this inspection. Once licensed, the applicant is required to adhere to the terms and limitations stated on the license.

Helpful Resources:

Access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

Reporting Unusual Incidents: MPROIncidentReports@dss.ca.gov.

CCL Resources for Parents & Providers: https://ccld.childcarevideos.org/

Provider Information Notices (PINs): https://www.cdss.ca.gov/inforesources/community-care-licensing/policy/provider-information-notices/child-care

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2022

LIC809 (FAS) - (06/04)

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