304270109-9-10-2019-06-CC-YVIA-BFVUYK-20190910160005

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304270109
Report Date: 09/10/2019
Date Signed: 09/10/2019 04:00:18 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	CENTRALIA HEAD START		FACILITY NUMBER:	304270109
ADMINISTRATOR:	ERIKA TAMAYO		FACILITY TYPE:	850
ADDRESS:	6627 LA CIENEGA		TELEPHONE:	(714) 228-9004
CITY:	BUENA PARK	STATE: CA	ZIP CODE:	90620
CAPACITY:	80	CENSUS: 48	DATE:	09/10/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Erika Tamayo, Director		TIME COMPLETED:	04:30 PM

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Licensing Program Analysts (LPAs) Yesenia Villa and Jordan Nelson conducted an unannounced random inspection on this day to ensure the health and safety of the children in care. LPAs met with Erika Tamayo, Director who guided analyst on a tour of the facility. This is a preschool program which consists of 4 classrooms. Classrooms #1, #2 and #4 serve ages from 3-5 yrs of age full day programs from 7:30 am-5:30pm. Classroom#3 is a part-time program with morning hours from 8 am-11:30am and 12:30pm-4:00pm.

The capacity for the preschool license is for 80 children. Facility operates from Monday through Friday 7:30am-5:30pm. All individuals present have not obtained a criminal record clearance and civil penalties will be cited on this inspection. During this inspection it was discovered that Teacher Paul Castellon was not cleared and associated. Also during this inspection Teacher Nawl Rizjkalla was not associated to the facility. This poses an immediate risk to the health and safety of the children in care. A technical advisory was also issued during this inspection informing Director Erika Tamayo that all staff assigned to this location must be associated to the facility they are assigned to.

All areas identified on the facility sketch were inspected. Upon arrival, there were 48 napping children present with eight teachers. The facility was within ratio. The following was observed during the tour of the facility:

Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Children have their own cubby to store their belongings. Linens are washed weekly by the center. Napping equipment (cots) were observed in the classrooms. Per Director, the isolation area is located in the office. Age appropriate sinks and toilets were inspected for availability and good repair in all restrooms. General sanitation of the children’s restroom was observed. Availability of indoor drinking water was observed in the classrooms via water jugs and cups. Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Director was reminded that all poisons must be under lock or combination.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Yesenia Villa	TELEPHONE: (714) 293-9465
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2019

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: CENTRALIA HEAD START	FACILITY NUMBER: 304270109
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/10/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed Type A 09/11/2019 Section Cited	1 2 3 4 5 6 7	101170(e)(2) Criminal Record Clearance All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility Request a transfer of a criminal record clearance as specified in Section 101170(f) ...
	8 9 10 11 12 13 14	This requirement was not met as evidence by: During this inspection LPAs observed an uncleared adult at the facility by the name of Paul Castellon. This poses an immediate risk to the health and safety of the children in care. Civil penalty of $500.00 will be assesed	8 9 10 11 12 13 14
Deficiency Dismissed Type A 09/11/2019 Section Cited	1 2 3 4 5 6 7	101170(e)(3) Criminal Record Clearance All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility Request and be approved for a transfer of a criminal record exemption
	8 9 10 11 12 13 14	as specified in Section 101170.1(r), unless, upon request for a transfer, the Department permits the individual to be employed, reside or be present at the facility. This requirement was not met as evidence by: Nawl Rizkalla Teacher was not associated to the facility. This poses an immediate risk to the health and safety of the children in care.	8 9 10 11 12 13 14

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: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Yesenia Villa	TELEPHONE: (714) 293-9465
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2019

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: CENTRALIA HEAD START	FACILITY NUMBER: 304270109
	VISIT DATE: 09/10/2019

NARRATIVE

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First Aid supplies were observed in the classroom and all medication is stored in each classroom in a blue back pack inaccessible from the children. The medication was inspected for expiration dates and proper documentation.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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

LPAs advised the Director where to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

If the facility receives a Type 'A' violation the licensee shall post and provide copies of the report to parents/guardians of the children in care at the facility by the next business day and shall provide to the parents/guardians of children newly enrolled at the facility during the next 12 months. In addition, the licensee shall immediately post upon receipt the Proof of Correction for 30 consecutive days and provide a copy to current and enrolling parents. The licensee is to keep Acknowledgement Receipt (LIC9224) signed by parents in each child’s file.

In the areas that were evaluated the facility was not in compliance and violations of the California Code of Regulations, Title 22, Division 12 were observed, discussed and cited at the time of the inspection. Based on LPAs observations the following violations were observed are being cited in accordance with California Code of Regulations, Title 22, Division 12, Sections: 101170 (e)(2) and 101170 (e)(3) are being cited on the attached LIC 809 D.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. Exit interview was conducted with (Director, Erika Tamayo.) Including, but not limited to provider rights and appeal rights.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Yesenia Villa	TELEPHONE: (714) 293-9465
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2019

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: CENTRALIA HEAD START	FACILITY NUMBER: 304270109
	VISIT DATE: 09/10/2019

NARRATIVE

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This facility does not have a kitchen area. All meals are delivered on a daily basis by the local head start kitchen. Snacks are provided by the facility. The preparation area was observed to be clean and orderly. Food supplies were inspected for quantity and all requirements were met.

The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under high climbing equipment, slides, and similar equipment are cushioned with sand. There is adequate shade in the play yard towards the back provided by a large tree. Availability of outdoor drinking water is provided via a water fountain. There is at least one person trained in CPR and Pediatric First Aid present during this inspection. Children’s Records were reviewed for completeness; Inspection of required forms was made. LPA issued the Children’s Record Review (LIC 811) to the Director during this inspection. In review of children’s records, files contain information 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.

Staff files were reviewed for completion of immunization's, MMR, TDAP & Influenza, along with the completion of the Mandated Reporter training.

Children's roster was reviewed and is current. Sign-In and Sign-Out sheets were reviewed. Children present were signed in. Disaster drill log was available, last drill was conducted in August of 2019 per Director.

Menus are posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request. Snacks were reviewed for availability, quantity and appropriateness to children in care. First Aid supplies were observed in the classroom and all medication is stored in each classroom in a blue back pack inaccessible from the children. The medication was inspected for expiration dates and proper documentation. .

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Yesenia Villa	TELEPHONE: (714) 293-9465
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2019

LIC809 (FAS) - (06/04)

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