198400381-8-18-2021-54-CC-AJLO-C5ZTLA-20210818144914

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198400381
Report Date: 08/18/2021
Date Signed: 08/18/2021 02:49:33 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:	GROW AND LEARN CENTER		FACILITY NUMBER:	198400381
ADMINISTRATOR:	PETER, DEBRA		FACILITY TYPE:	850
ADDRESS:	12183 FIRESTONE BLVD.		TELEPHONE:	(562) 556-1338
CITY:	NORWALK	STATE: CA	ZIP CODE:	90650
CAPACITY:	30	CENSUS: 0	DATE:	08/18/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Debra Peter & Betty Hannah, Applicants		TIME COMPLETED:	03:20 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) A. Lucero met with Applicants Debra Peters and Betty Hannah for the purpose of conducting a Pre-Licensing Inspection. Applicants are applying for a Preschool License. Applicants are requesting a total capacity of 15 preschool children. The proposed program will operate Monday through Friday from 6:00am to 6:00pm. A granted Fire Clearance of 15 was received by the Licensing Department. Facility is located at 12183 Firestone Blvd., Norwalk, CA 90650. LPA began an outdoor tour of the facility at about 10:15am. The program will enter through the rear door of the facility that leads to a parking lot. LPA obtained photos of the facility entrance and parking lot. Facility plans on using the large outdoor play yard next to the parking lot. LPA obtained photos of the playground in relation to the parking lot and facility building. At about 10:25am, LPA noted to applicants that they will need to provide official documentation of the property lines as the parking lot and proposed large play yard may belong to the church located at 12191 Firestone Blvd., Norwalk, CA 90650. Measurements were taken of the large play yard. LPA observed that there was no shade available. Drinking fountain was observed and operational. The outdoor area is completely fenced. The applicant states that there are no bodies of water on the premises and none were observed during this visit. At about 10:40am, LPA conducted an inspection of the small play yard next to the proposed facility. Measurements were taken of the small play yard and obtained photos of the play yard. LPA observed chili peppers in a planter garden that would need to be removed as a plan of correction as children may gain access to the chili peppers. LPA also observed at about 10:55am that there was no shade or drinking water located at the small playground. Report Continues on Next Page

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Armando J Lucero	TELEPHONE: (323) 981-3435
LICENSING EVALUATOR SIGNATURE:	DATE: 08/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2021

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: GROW AND LEARN CENTER	FACILITY NUMBER: 198400381
	VISIT DATE: 08/18/2021

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
26
27
28
29
30
31
32

At about 11:10am, a tour of the indoors was taken. Measurements were taken of Classroom #1 and Classroom #2. The applicants state that the director's office will be used as the ill isolation area and children will use the staff restroom. The facility will provide a morning and afternoon snack. Lunch will be provided by parents and warmed at the facility. The facility does not plan to administer prescription and non-prescription medications.

A first aid kit is kept in the classroom. Carbon monoxide detectors and smoke detectors are present and in operable condition and was observed to dual. LPA determined the dual detector to be a Kidde model i9010. Fire Extinguisher was serviced in May 2021. A review of CPR/First Aid cards was conducted at about 2:05pm. LPA observed the CPR/First Aid cards to be issued by the American Heart Association for both Debra Peters and Betty Hannah. Both cards stated Pediatric First Aid, Child/Infant CPR AED. Renewal date for Debra Peter is 07/2023 and 08/2022 for Betty Hannah as stated on the cards provided.

LPA discussed protocol in place in regards COVID-19. Applicant stated protocol in place is having parents not fully enter the facility and sign in and out will take place at the front door entrance. The child care area is big enough to meet the 6 feet distance. Applicant will scan the children for any symptoms such as fever, running nose, cough or child's behavior and will inform parent child cannot stay if any symptoms related to COVID-19 or if symptoms appear during the day, applicant will isolate the child and call parent for pick up. Children will wash their hands during arrival, entering the facility from outdoor play, meal times, covering their cough and using the restroom. LPA observed hand washing posters posted in the bathroom and COVID-19 symptoms poster in the front entrance and hand sanitizer for parents (inaccessible to children). Applicant stated she is aware of cleaning, disinfecting and sanitizing and the importance of the constant hand washing. Technical Assistance was conducted on the date of this inspection.

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

Report Continues on Next Page

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Armando J Lucero	TELEPHONE: (323) 981-3435
LICENSING EVALUATOR SIGNATURE:	DATE: 08/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2021

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: GROW AND LEARN CENTER	FACILITY NUMBER: 198400381
	VISIT DATE: 08/18/2021

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
26
27
28
29
30
31
32

Sign in/out procedures will be implemented at the entrance to the facility. LPA observed sufficient storage space for children’s belongings. There is water available indoors and outdoors in large playground. Containers used to discard food have tight fitting lids. Cleaning compounds and any poisons are locked and in an off-limits area (kitchen). Applicant Debra Peter had to leave prior to finish of inspection at 2:00pm, applicant Betty Hannah concluded inspection with LPA.

The following requirements are needed prior to the applicant obtaining a preschool license:

Official documentation indicating that the large playground and parking lot belong to the facility property address of: 12183 Firestone Blvd., Norwalk, CA 90650
Shade for the small/large playgrounds
Removal of the chili pepper and tomato plant in the small playground

THE ABOVE CORRECTIONS ARE DUE ON OR BEFORE 09/03/2021 by Close of Business (COB).

Once the above items have been corrected, and all application documents reviewed, the department will make its determination on whether or not to approve the applicants for a preschool license.

Measurements of the facility are as follows:

Large playground - 38
Small Playground - 17
Classroom #1 - 12
Classroom #2 - 13
One toilet and one hand washing sink for children

The following was discussed with the Applicant:
Rooms that are off-limits need to be made inaccessible during operating hours. Smoking is prohibited. The Applicant was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Sudden Infant Death Syndrome (SIDS) and Never-Shake-a-Baby were discussed. LPA also provided Applicant with a complete packet of the Provider Information Network (PIN) 19-02-CCP dated February 20, 2019 regarding Safe Sleep Awareness Campaign.

Report Continues on Next Page

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Armando J Lucero	TELEPHONE: (323) 981-3435
LICENSING EVALUATOR SIGNATURE:	DATE: 08/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2021

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: GROW AND LEARN CENTER	FACILITY NUMBER: 198400381
	VISIT DATE: 08/18/2021

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
26
27
28
29
30
31
32

The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and Carbon Monoxide detectors should be checked and batteries replaced as needed. Changes should 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.

Mandatory Forms for the children’s files and staff files, requirements for fire drills, earthquake drills and documentation were discussed. Role and responsibilities of being a Mandated Reporter were reviewed. The Applicant was advised how to access forms and Regulations online at www.ccld.ca.gov. Applicant was made aware that it is his/her responsibility to know the regulations as well as anyone who assists in providing care. The Applicant was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care.

LPA advised Applicant 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.

LPA informed Applicant to log onto web site www.ccld.ca.gov to obtain forms and LIVE SCAN application. Records for all children and staff must be maintained for three (3) years after separation from the facility.

The Applicant 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. Director advised to visit www.shotsforschool.org for immunization information.

Applicant advised that indoor and outdoor supervision required at all times. If outdoor area not adequately fenced, provider must be with children at all times when outdoors.

Exit interview, copy of report and Notice of Site Visit was given.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Armando J Lucero	TELEPHONE: (323) 981-3435
LICENSING EVALUATOR SIGNATURE:	DATE: 08/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2021

LIC809 (FAS) - (06/04)

Page: 4 of 4