198400135-11-6-2019-54-CC-TTRN-BHP28U-20191106161054

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198400135
Report Date: 11/06/2019
Date Signed: 11/06/2019 04:11:02 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	SUNRISE HEAD START		FACILITY NUMBER:	198400135
ADMINISTRATOR:	MARCIE HOUCHEN		FACILITY TYPE:	850
ADDRESS:	2821 E. 7TH ST.		TELEPHONE:	(323) 263-6744
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90023
CAPACITY:	40	CENSUS: 0	DATE:	11/06/2019
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Program Manager		TIME COMPLETED:	04:20 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), Tiffanie Tran arrived at 2821 E. 7th St. Los Angeles, CA 90023 for the purpose of an announced pre-licensing inspection. Upon arrival, LPA met with Program Manager and about 2:20 p.m. we toured the entire facility. The application documents were reviewed; licensee has submitted all needed documents. The fire inspector has approved the capacity of 30 preschoolers requested. The facility had sufficient indoor and outdoor space including toilets and sinks to accommodate 30 preschool children. This is a Head Start Program located on the Elementary School premises. The facility is utilizing in room 1 & 2 to operate child care for preschool children. The hours of operation from 8:00 a.m. – 4:00 p.m. LPA observed an operating telephone in the Child Care Center, 2:10 ABC fire extinguisher, carbon monoxide detectors are located in the hallway area and in the classroom area, smoke detector alarms are located in the classroom. Classrooms were set up with age appropriate equipment and materials. The outdoor space is located by the side of the classroom facing the street. LPA observed outdoor space all fenced in. Manager stated, Kindergarten children will be passing the the Head Start play area during their dropping off and picking time. Other than that, Head Start Program does not need to share the yard with any other programs on this premises. LPA advised to submit outdoor waiver request to ensure the adequate care and supervision. Play area does not have any hazards or bodies of water. Inspection of the outdoor play area was conducted. LPA observed bikes path, and other materials that can be rotate for children to utilize. Children in care shall not be present during the time of any major construction to the play area. Drinking water is readily available on the play yard and in the classroom via water fountains and water jug with cups. There is adequate shade for the children in care. Playground is free from miscellaneous debris such as tree branches, trash, leaves, etc. LPA observed children's restroom located between classroom 1 and 2 with 2 toilets and 1 sink. In addition, each classroom had one sink. Classroom 2 had a changing table within arm reach of the sink. Furniture/Equipment/Toys/Books: Licensee has napping mats for children in care. Licensee is reminded that should children nap there must be a sheet and blanket available for the children to use. Children shall not sleep on a bare cot or mat. Cots and Mats must be sanitized daily after use. Classrooms were equipped with age appropriate furniture/toys/equipment and were clean and orderly. All trash cans in the classrooms has lids on.

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie Tran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 11/06/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2019

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: SUNRISE HEAD START	FACILITY NUMBER: 198400135
	VISIT DATE: 11/06/2019

NARRATIVE

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Staff Bathroom: The staff bathroom is located in the Elementary teacher's lounge. Children shall not have access or use the staff bathroom. Licensee is to ensure that proper ratios are always maintained when staffs need to leave to go to the rest-room area.
Food Preparation area: The facility serve breakfast and lunch. The facility have private vendor deliver the food daily to the facility. Food preparation area located in the Elementary kitchen. Head Start will have a space by the teacher's lounge where refrigerator and food warmer will be in place. Menu are to be posted for parents to view. Food preparation area is adequately equipped with sink, was clean and free from hazards. Cleaning supplies shall be kept out of reach of children and will be stored separately and away from food. There is hot and cold running water in the food preparation area. Licensee is reminded that children must be served a balanced and nutritious snack. Licensee has adequate food supply.
Required Postings/Licensee shall have posted in the Child Care Center at all time the following:
Facility license, Personal Rights form (LIC 613A), Menus, Child passenger restraint system poster. (PUB 269), Daily activity schedule, Emergency Disaster Plan (LIC 610) and Earthquake Preparedness Checklist (LIC 9148), Parent’s Rights Poster (PUB 393), Notice of Site Visit (LIC 9213), Any licensing report documenting a type “A” citation must be posted for 30 days, Any licensing report or other document verifying compliance or non-compliance with the Department’s order to correct a Type A deficiency must be posted for 30 days
Medication Administration/Incidental Medical Services:
Medication if administered is to be properly labeled and stored in the original container. Director advised that children should be screened every morning for illness and unusual marks. First Aid supplies are stored in the classrooms and the facility director's office.
The applicant was discussed the Incidental Medical Services. Per applicant, they accept children who require administering epi pens and inhalers only. They will submit updated plan of operation pertaining to IMS
Children's Records are to be maintained by the facility and must contain the following:
Identification and Emergency Information - Child Care Centers (LIC 700, Child's Preadmission Health History Parents’ Report (LIC 702), Child's Preadmission Health Evaluation if not enrolled in a public or private elementary school - Physician's Report (LIC 701), Consent for Medical Treatment (LIC 627), Written statement from parent(s) or authorized representative exempting child from medical assessment, immunizations, and treatment because of adherence to a religious faith that practices healing by prayer or other spiritual means; or physician's statement that immunization is not indicated. California School

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie Tran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 11/06/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2019

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: SUNRISE HEAD START	FACILITY NUMBER: 198400135
	VISIT DATE: 11/06/2019

NARRATIVE

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Immunization Records (“blue cards”, PM 286) for non-school-age children, Current Admission Agreement, with authorized signature(s), Centrally Stored Medication and Destruction Record (LIC 622), if medications are handled, Documentation of unusual behavior or signs of illness, special needs, Unusual Incident/Injury Report (LIC 624), Signed and dated receipt of Notification of Parents’ Rights (LIC 995). Personal Rights — Community Care Facilities, Child Care Facilities (LIC 613A) receipts, signed and dated, Authorizations for dispensing medication, signed by each child’s authorized representative, Documentation required for health-related services, if needed (e.g., blood-glucose monitoring and nebulizer care).(LIC 9166). Gastrostomy Tube Care: Physician’s Checklist (LIC 701A). Acknowledgement of receipt of licensing reports (LIC 9224), if applicable.
Licensee shall maintain Administrative Records which shall have the following:
Written inspection procedures for accepting children on a daily basis.
Sign-in/sign-out sheets kept for current 30 days, or approved waiver to use electronic pin system.
Admission policies, including admission criteria, ages of children who will be accepted; medical assessment requirements; program activities, supplemental services, if any; field trip provisions, transportation arrangements, food service, if any.
Designation of Facility Responsibility (LIC 308).
Personnel Report (LIC 500) showing current roster.
Licensee affidavit regarding persons exempt from fingerprint requirements (Use back of LIC 500).
Emergency Disaster Plan (LIC 610) (a posting requirement; see below) with verification that disaster drills are conducted every six months. Documentation of drills shall be maintained for at least one year.
Up-to-date list of qualified teacher substitutes.
Documentation of exceptions and waivers: Facility Waiver Request (LIC 956) and Exception/Exemption Request (LIC 971).
Annual licensing reports and substantiated complaints from the last three years (must be available at the center for public review). And a Child Care Facility Roster (LIC 9040).
The applicant was advised to access the Licensing website at ccld.ca.gov to obtain information about the most recent regulatory changes, and especially the Quarterly Updates.

The license will be granted for a preschool license for the capacity of 30 children once the outdoor waiver is submitted and upon approval.

Exit Interview conducted and a copy of this report was provided to the applicant.

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie Tran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 11/06/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2019

LIC809 (FAS) - (06/04)

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