198020956-3-15-2022-33-CC-CRES-CCJPCL-20220315111207

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020956
Report Date: 03/15/2022
Date Signed: 03/15/2022 11:12:41 AM

Document Has Been Signed on 03/15/2022 11:12 AM - 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:	MACY INTERMEDIATE HEAD START		FACILITY NUMBER:	198020956
ADMINISTRATOR:	DANIEL OROSCO		FACILITY TYPE:	850
ADDRESS:	2101 S LUPINE AVE		TELEPHONE:	(323) 722-0260
CITY:	MONTEREY PARK	STATE: CA	ZIP CODE:	91755
CAPACITY:	24	CENSUS: 0	DATE:	03/15/2022
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Filiberto Arizmendi		TIME COMPLETED:	11:30 AM

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 ensure the facility is following the state laws and the health and safety regulations, as well as to measure the requested Head Start Preschool component for capacity determination. LPA met with Filiberto Arizmendi, and Luis Gonzalez Applicant, Program Specialist, Vanessa Guzman and Maricela Arellano Teachers. 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 24 preschool children. The facility days & hours will be Monday-Friday 815 AM-215 PM. The preschool is located on the Macy Intermediate school campus. At 9:30 AM, LPA began the tour of the facility with Filiberto, Vanessa, and Maricela beginning at the Front gate of the day care. There is a gate where the preschool children's parents will enter and exit during Covid or not. Parents will sign the child in/out electronically at a podium located at the front door to the class room. A parent board will be located by the podium with Licensing and Covid-19 posting which are visible for all to see as well as temperatures and health checks which will be conducted. Use of hand sanitizer will also be available. Parents will only stop at the podium and not enter the classroom 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 classroom 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.)

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2022

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: MACY INTERMEDIATE HEAD START	FACILITY NUMBER: 198020956
	VISIT DATE: 03/15/2022

NARRATIVE

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The ill/isolation area is located in the staff office located in the classroom. The ill child will use the staff rest room located right next to the office. The ill/isolation area has a cot/mat for a child to rest if needed.

1015 AM Licensing staff was then guided to the preschool outdoor play areas, The facility has 3 play yards located around the head start class room. The class room and the yards are self-contained by a gate around all for separation from other areas located in this entire gated facility. 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 canopy's. All areas around and under play equipment and slides are cushioned with material to absorb a fall. Measurements were taken of the outdoor play yards (3 Yards) and the total outside capacity allows for 73, however the applicant is asking for a capacity of 24 preschoolers. LPA advised Filiberto, Vanessa, and Maricela 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 classroom which was inspected and measured for capacity determination. LPA observed in all classrooms, toys to be age appropriate clean and safe. Age appropriate furniture and equipment were also inspected to be in good condition. Napping equipment (cots/mats) were inspected and observed to be in good condition.

Preschool children have a bathroom located in the classroom, with 3 toilet and 3 sinks and on their outside of the bathroom their are 2 more sinks and all are in good condition, water temperature, paper towels, toilet paper were observed and everything was 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: 03/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2022

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: MACY INTERMEDIATE HEAD START	FACILITY NUMBER: 198020956
	VISIT DATE: 03/15/2022

NARRATIVE

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1045 AM Children will bring their own blanket and a sheet will be provided by the school. Parents will take home the blanket and sheet at the end of each week to wash. Individual storage space was observed to be available, appropriate and clean for each child in all rooms. The children will be provided jugs of water and disposable cups in all classrooms.

There is a fully equipped first aid kit available in the classroom containing all the required supplies. The facility has central cooling and Heating, lighting and ventilation were all evaluated by the LPA.

Breakfast, lunch and PM snack will be provided by the school district and brought from their kitchen to the preschool. Menus were observed on the parent board. Food preparation area will be in the class room kitchen, where a refrigerator and cold drinks and food items will be located. The kitchen was inspected for safety and cleanliness. Containers used to discard food have tight fitting lids. Facility has extra linen and food available if needed.

Carbon monoxide detectors and smoke detectors were observed to be in operable condition and located in each class room. Smoke and Carbon Monoxide detectors should be checked regularly, and batteries replaced as needed. LPA observed fire extinguishers located in each classroom which were type 2A-10BC and the valve on each indicated that they are all fully charged.

Each has a tag with a service date of 09/22/2022. Fire extinguishers need to be serviced annually or as often as necessary. Hazardous items including poisonous cleaning compounds were observed to be stored inaccessible to children. Facility does not provide transportation for preschool children.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2022

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: MACY INTERMEDIATE HEAD START	FACILITY NUMBER: 198020956
	VISIT DATE: 03/15/2022

NARRATIVE

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1115 AM LPA reviewed with applicant, Filiberto, the LIC 311A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted. LPA also discussed with Filiberto,, Reporting and Notification Requirement

LPA discussed the safe sleep regulations with applicant Filiberto and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed [applicant, licensee, or facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2022

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: MACY INTERMEDIATE HEAD START	FACILITY NUMBER: 198020956
	VISIT DATE: 03/15/2022

NARRATIVE

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Applicant, Filiberto was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Based on LPA measurements taken on this date and observations of the facility, the total indoor and outdoor capacity will be approved for the requested 24 preschool children. The Department has received an approved fire clearance for a capacity of 24 preschool children on 01/13/2022.

The following corrections will need to be made prior to submitting the application for approval. Final file review. Applicant will then be licensed for the requested capacity of 24 preschoolers.

1130 AM Exit interview conducted, and report was reviewed with the applicant, Filiberto Arizmendi.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2022

LIC809 (FAS) - (06/04)

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