300600560-8-7-2023-06-CC-ABOI-CUH2Y8-20230807174819

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 300600560
Report Date: 08/07/2023
Date Signed: 08/07/2023 05:48:38 PM

Document Has Been Signed on 08/07/2023 05:48 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	LA PALMA CHRISTIAN SCHOOL		FACILITY NUMBER:	300600560
ADMINISTRATOR:	LOVETERE, ZSALENE		FACILITY TYPE:	850
ADDRESS:	8082 WALKER STREET		TELEPHONE:	(714) 527-3231
CITY:	LA PALMA	STATE: CA	ZIP CODE:	90623
CAPACITY:	59	CENSUS: 24	DATE:	08/07/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:40 PM
MET WITH:	Zsalene Lovetere		TIME COMPLETED:	06:20 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	On 08/07/2023 Licensing Program Analyst (LPA), A. Bootorabi conducted an onsite visit for the purpose of a 1 year required inspection. LPA and director Zsalene Lovetere toured the facility inside and outside and the floor and yard plan (LIC 999) were verified. Currently the center is using 4 of 5 of the classrooms as part of the facility sketch. The classroom that is not being utilized for children is being used as storage/supply room. The director was reminded that the licensing would need to be informed when rooms are being removed or added. During the tour the LPA observed children napping a the "Napping Room". Census was taken upon entry of each classroom: 24 Children: 2 Teachers in the Napping Room During the inspection, it was determined the facility is operating within its licensed capacity. Facility hours were confirmed with director. The director confirmed hours are 7 a.m.- 5 p.m., Monday through Friday. Hours of operation do not match license. The LPA provided a consultation. The LPA and director toured the facility inside. The facility sketch (LIC 999) was verified. Areas stated to be off-limits by the facility sketch were made off-limits by means of gates and closed doors. *Documents reviewed and to be posted in a prominent, publicly accessible area at the facility:* Facility License, Waivers (if applicable), Menus, LIC 613A Personal Rights, PUB 269, PUB 393 Notification of Parent Rights, and LIC 610 Emergency Disaster Plan. LPA consulted on updated LIC 610

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Araceli Bootorabi	TELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2023

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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: LA PALMA CHRISTIAN SCHOOL	FACILITY NUMBER: 300600560
	VISIT DATE: 08/07/2023

NARRATIVE

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Documents to be reviewed during inspection: Verification of Disaster and Fire Drill, Daily Activity Schedule, Sign In/Out Sheets, and LIC 9148 Earthquake Preparedness. The facility had 2 of 4 documents completed and available for review today.

LIC9148 Earthquake Preparedness was not completed and a consultation was provided during the tour.

The last Fire Drill was conducted in June 2023. The daily activity schedule was posted by the classrooms.

SIGN IN AND SIGN OUT : The facility is currently using an app to to sign in/out. LPA reviewed sign in and out sheet for 08/07/2023 that is printed through the app the center uses.

CLASSROOMS: Classrooms 4 of 4 that are being used for child care were toured with the director. Classrooms 4 of 4 were inspected and the activity space, and items that could pose a danger to children (detergents, cleaning compounds, and medications) were observed to be stored out of the reach of children.

LPA provided a consultation on the importance of keeping items out of reach of children in care. The director was advised that personal items should be out of reach of children to ensure their safety.

The tables and chairs were observed to be scaled to the size of the children in the classrooms. All play equipment and materials used by children were observed to be age appropriate. The facility provided a variety of age-appropriate equipment, toys, and materials in good condition and in sufficient quantity to allow children present to fully participate in planned activities. Furniture and equipment were observed to be maintained in good condition, free of sharp, loose, or pointed parts.

OUTDOOR ACTIVITY SPACE: The surface of the outdoor activity space was observed to be maintained in a safe condition for activities. The surface of the outdoor activity space was observed to be free of hazards including, but not limited to, holes, broken glass, and other debris.

The cushioning material used underneath the large climbing structure in the outdoor space for children consists of foam like material. The outdoor equipment and toys were in good repair and were free of sharp edges. There are no bodies of water present at the facility. The facility’s outdoor grounds are safe, sanitary,

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Araceli Bootorabi	TELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2023

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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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: LA PALMA CHRISTIAN SCHOOL	FACILITY NUMBER: 300600560
	VISIT DATE: 08/07/2023

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NAPPING EQUIPMENT: Mats used for napping were observed to be maintained in a safe condition.
Napping equipment was observed to be arranged so that each child has access to a walkway without having to walk on or over the cots or mats of other children.

Napping equipment was observed to be arranged so that each child has access to a walkway without having to walk on or over the cots or mats of other children. The bedding was observed to be stored so that each child’s bedding is identifiable and no child’s used bedding comes into contact with other bedding.

DRINKING WATER: The facility was reminded that drinking water from a non contaminating fixture or container shall be readily available both indoors and in the outdoor activity area. The children in care shall be free to drink as they wish. Anchored steps or a broad based platform shall be utilized when a drinking fountain is too high for the children in care.

The director stated that children had access to water through each individuals child water bottler and the facility refills each bottle. The director stated that the water cart used for the facility is brought in and out of the classroom.

FOOD SERVICES: The facility does not provide meals to children. Children bring their meals from home. LPA observed lunch bags hanging outside the facility by the playground. Each child had their own designated hook.

The facility provides snacks and prepares them in the kitchen.

Incidental Medical Services (IMS) policy was discussed and director stated she does not have children with IMS services or allergies at this time. 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) or (800) 514-0383 (TTY) and link to the publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.
CARBON MONOXIDE – SMOKE DETECTOR – FIRE EXTINGUISHER: A functioning carbon monoxide detector alarm were tested by the director during today’s visit and were observed to be functioning. A fire extinguisher was observed by playground exit next to the office and was last serviced in July 2023.

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Araceli Bootorabi	TELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2023

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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: LA PALMA CHRISTIAN SCHOOL	FACILITY NUMBER: 300600560
	VISIT DATE: 08/07/2023

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and in good repair. A consultation was provided on the outdoor flooring/cushion material.
LPA observed a large climbing structure outside, outdoor children meal tables, bikes, and a restroom. Shading area was observed during the inspection above the large climbing structure.

PERSONNEL RECORDS: The LPA requested to review staff records of adults working directly with children. The following documents were requested for review exemptions or exemptions, Staff Qualifications, Immunization Records, LIC 9052 Employee Rights, LIC 9108 Statement Acknowledging Requirement to report Child Abuse, 1 CPR First Aid Certification of staff present at the facility at all times, TB clearance, and a Mandated Reporter Training Certificate.
The facility had one separate file for each staff member. The files reviewed during today’s visit were observed to be incompleted. There are 0 of 3 staff certified in CPR & First Aide. All staff had current Mandated Reporter Training and director was reminded that training should be retaken every 2 years.

BACKGROUND CLEARANCE: A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
The facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to the initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

CCLD website www.ccld.ca.gov was provided to licensees to access regulations, updates, and licensing forms.

Children’s Records Reviewed: The LPA requested complete children’s records of 5 children enrolled in the program. Children's records were reviewed, and there was a separate, complete, and current record for each child. The LPA reviewed files to verify the following documents Immunization Records, LIC 700 Identification, Consent for Emergency Medical Treatment LIC 627 ,LIC 701, LIC 613A Personal Rights and LIC 995A Notification of Parents’ Rights. The children’s records were not complete currently. LIC 995 and LIC

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Araceli Bootorabi	TELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2023

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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: LA PALMA CHRISTIAN SCHOOL	FACILITY NUMBER: 300600560
	VISIT DATE: 08/07/2023

NARRATIVE

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613 had attached bottom portions, unfilled top portions, and a different phone number for CCLD. LPA did not observe blue sheets for immunization record keeping. A consultation was provided to the director regarding children's files.

During the inspection the director updated the Parent Rights & Children Rights through an email blast on the app and updated the contact for information for CCLD. The director also sent out the emergency consent form to get updated for all children enrolled.

LPA requested a complete LIC9040. During the record review the LPA attempted to verify the files with the LIC9040 and records did not match children on LIC9040 form. A consultation was provided.

Child Care Licensing Program Webinars: The Child Care Licensing Program is pleased to continue offering
webinars to share important information with the childcare licensing community in 2023.
2023 Webinar Schedule
• Tuesday, June 27, 2023, 6:00 p.m.
• Tuesday, September 26, 2023, 6:00 p.m.
• Tuesday, December 12, 2023, 6:00 p.m.
To register for webinars, see Provider Information Notice (PIN), PIN 22-30-CCP.

myChildCarePlan.org : The facility representative was informed of the www.MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Safe Sleep: LPA discussed the safe sleep regulations with the director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed 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.

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Araceli Bootorabi	TELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2023

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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: LA PALMA CHRISTIAN SCHOOL	FACILITY NUMBER: 300600560
	VISIT DATE: 08/07/2023

NARRATIVE

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Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

LPA verified that the lead testing was completed in accordance with the Written Directives outlined in PIN 21-21.1-CCP.

CCC COMPLETED TESTING

The facility did not meet the California Code of Regulations, Title 22 Division 12, and regulations not met were observed, discussed, and cited at the time of the visit.

The following violations of the California Code of Regulations, Title 22; Division 12, were observed and cited today: CCR 101216(f)

Notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the director Zsalene Lovetere.

During the exit interview, the director Zsalene Lovetere , confirmed that there are no Registered Sex Offenders living in the facility.

Appeal Rights were explained. The Licensee was provided a copy of appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. First-level appeals should be sent to the regional manager at the address listed above. The Notice of Site Visit was posted and discussed as required by H&S Code Sec. 1596.817.

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Araceli Bootorabi	TELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 08/07/2023 05:48 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: LA PALMA CHRISTIAN SCHOOL	FACILITY NUMBER: 300600560
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101216(f)

Personnel Requirements

(f) At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on director nterview and record review, the licensee did not comply with the section cited above by means of not having a staff member CPR & First Aide Certified which posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 08/21/2023
	Plan of Correction
1 2 3 4	The director has contacted the person who recertifies everyone to schedule a closer date. The director stated she had a date for September during the visit. The director will provide proof of completion via email to LPA.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Araceli Bootorabi	TELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2023

LIC809 (FAS) - (06/04)

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