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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371489
Report Date: 04/05/2022
Date Signed: 04/05/2022 04:35:43 PM

Document Has Been Signed on 04/05/2022 04:35 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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:OUR TRIBE OUR VILLAGE CHILDCARE CENTERFACILITY NUMBER:
304371489
ADMINISTRATOR:MARIN, QUASHANIKAFACILITY TYPE:
850
ADDRESS:6441 LINCOLN AVENUETELEPHONE:
(562) 999-6783
CITY:BUENA PARKSTATE: CAZIP CODE:
90620
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 20DATE:
04/05/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:25 AM
MET WITH:Director Quashanika MarinTIME COMPLETED:
05:00 PM
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Licensing Program Analyst (LPA), Tina Nguyen conducted an onsite inspection for the purpose of a 1- Year Required. LPA met director Marin (Taylor) Quashanika. LPA Nguyen and facility director Quashanika toured the facility inside and outside and the floor and yard plan (LIC 999) were verified. The overall census observed was 10 staff members including the director providing care for 6 infants (under 18 months old), 4 toddler option children aged 18 months to 36 months, and 10 preschool children aged 2-6 years of age. The facility is licensed to care for 24 preschool children ages 2-6 years of age and 6 toddler option children ages 18-36 months.
During the inspection, it was determined the facility is not operating within its license beyond the conditions and limitations specified on the license. This program operates Monday through Friday, 8:00 a.m. to 6:00 p.m

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, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

During the inspection of the indoor activity space, items which could pose a danger to children (detergents, cleaning compounds, and medications) were observed to be stored out of the reach of children. Poisons/Hazardous Items are not kept on the premises. Snacks are provided by the facility. Menus were posted on the Sandbox app where they could be reviewed by parents. Solid waste receptacles have a tight-fitting cover and are in good repair. Floors, equipment, and furniture were clean and were observed to be in good repair and free of sharp edges. There is drinking water available to children indoors by water dispenser with disposable paper cups.
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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Tina Nguyen
LICENSING EVALUATOR SIGNATURE: DATE: 04/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/05/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: OUR TRIBE OUR VILLAGE CHILDCARE CENTER
FACILITY NUMBER: 304371489
VISIT DATE: 04/05/2022
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The children's bathrooms are clean and sanitary. The facility has conducted an emergency drill within the past six months. The facility has a working carbon monoxide detector and fire extinguisher. The California Child Passenger Safety Law was posted by the entrance of the facility.

The outdoor activity space was inspected for compliance. The playground was enclosed by a fence at least four feet in height. The surface of the outdoor activity space was well maintained and free of hazards.

Drinking water in the outdoor activity space is provided by a water fountain. The outdoor equipment and toys were in good repair and free of sharp edges. There are no bodies of water present at the facility. The facility grounds were safe, sanitary, and in good repair.

Six staff files were reviewed. Health screening and immunization as required were reviewed. Beginning September 1, 2016, Health and Safety (H&S) 1597.622 states, a person shall not be employed or volunteer at childcare if he or she has not been immunized against influenza, pertussis, and measles. Proof of immunization against pertussis, and measles for staff were reviewed and within compliance. At least one staff member present possesses current CPR/First Aid certifications, which expire 04/22/2023.

Beginning March 31, 2018, H&S Code 1596.8662 requires all directors and employees to complete mandated reporting training, and to renew the training every two years. Personnel records were reviewed and there are no Mandated reporter training certificates of Staff #1 (S1); Staff #2(S2), Staff #3(S3), Staff #4 (S4), Staff #5 (S5) and staff #6 (S6). The link for Mandated Reporter training was provided.

Children's records were reviewed, and there was a separate, complete and current record for each child. A random sample of 6 children's files were reviewed for documentation of the child’s name, address, and telephone number of the child’s authorized representative and of relatives or others that can assume responsibility for the child if the authorized representative cannot be reached when necessary (LIC 700) and a medical assessment. In the areas reviewed the children’s files were found to be in full compliance.


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.
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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Tina Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2022
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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: OUR TRIBE OUR VILLAGE CHILDCARE CENTER
FACILITY NUMBER: 304371489
VISIT DATE: 04/05/2022
NARRATIVE
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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

The director was informed that Licensing Quarterly Updates are available at www.ccld.ca.gov. Director may request to be added to an email list to receive a Quarterly Update by contacting the Child Care Advocate at childcareadvocatesprogram@dss.ca.gov or at www.ccld.ca.gov
LPA provided Guardian Information and website info: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian

Information on the additional nutrition training, immunization requirements for children, and Health Schools Act (http://www.cdpr.ca.gov/docs/pestmgt/schoolipm.htm) were provided. The director was informed, and website given, about the California Child Care Disaster Plan has been posted to the UCSF California Childcare Health Program website: cchp.ucsf.edu/content/disaster-preparedness Also provided was information about the E-Learning Modules available at https://ccld.childcarevideos.org A copy of the California Department of Social Services Lead Information Brochure was explained and provided to the facility representative.


Updated face covering guidance was provided and director was to continue to message the “Three W’s”: Wash your hands. Watch your physical distance. Wear a mask. This face
covering guidance is for all individuals 2 years and older, except for the exceptions (child’s development, medical exemptions, etc.) that are outlined by CDPH.
Important COVID-19 resources and links were provided. COVID-19 Update Guidance Childcare Programs/Providers link: https://files.covid19.ca.gov/pdf/guidance-childcare.pdf. CCLD COVID-19 Licensed childcare and facilities and provider FAQs link:https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/child-care-licensing/covid-19-child-care-resources/faqs-for-licensed-child-care-facilities-and-providers
Safe, free, and effective COVID-19 vaccines are now available to everyone age 16 and up. Every Californian can sign up at myturn.ca.gov or call (833) 422-4255 to get their COVID-19 vaccine appointment. (Continue page 4)
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Tina Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2022
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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: OUR TRIBE OUR VILLAGE CHILDCARE CENTER
FACILITY NUMBER: 304371489
VISIT DATE: 04/05/2022
NARRATIVE
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Based on LPA observations and record reviews the following violation was observed. The facility was cited type A violation under the California Code of Regulations, Title 22, Division 12, Chapter 1, Article 02. Licensing 101161 (a) Limitations on Capacity; and Type B violation under Health and Safety code 1596.8662(4)(b)(1). Please refer to the attached 809D for documentation of deficiency


This report cites a Type A violation and shall be provided to parents/guardians of children currently in enrolled and to parents/guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must sign Form LIC9224 to be kept in each child's file.

Exit interview was conducted. Notice of Site Visit was posted during the visit. The administrator was informed that the notice of site visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100. Licensee was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. First-level appeals should be sent to the regional manager to the address listed above.

Documents/Information to be updated and returned to the Licensing Office;
- Personnel Report (LIC 500)
- Emergency Disaster Plan (LIC 610)
- Designation of Administrative Responsibility (LIC 308)
- Administrative Organization (LIC 309)
- Fire Drill Log

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Tina Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/05/2022 04:35 PM - It Cannot Be Edited


Created By: Tina Nguyen On 04/05/2022 at 03:45 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: OUR TRIBE OUR VILLAGE CHILDCARE CENTER

FACILITY NUMBER: 304371489

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 04/05/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101161(a)
Limitations on Capacity and Ambulatory Status
(a) A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interviews conducted, it was revealed 6 children who are infants under 18 months old were being taken care of under the toddler option in preschool license with children ages 18 month and 36 months which poses an immediate risk to the health and safety of the children in care.
POC Due Date: 04/05/2022
Plan of Correction
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Director sent six infant children under 18 month old home during the inspection. Per director, all infant children under 18 month old can not return to the facility until the facility obtains the infant license. Facility director indicated that the facility will only accept the children under the conditions and limitations specified on the license. Facility director indicated that she will submit the application for infant license.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Thuy Ho
LICENSING EVALUATOR NAME:Tina Nguyen
LICENSING EVALUATOR SIGNATURE:
DATE: 04/05/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/05/2022


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Document Has Been Signed on 04/05/2022 04:35 PM - It Cannot Be Edited


Created By: Tina Nguyen On 04/05/2022 at 03:45 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: OUR TRIBE OUR VILLAGE CHILDCARE CENTER

FACILITY NUMBER: 304371489

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 04/05/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the facility did not comply with the section cited above; staff members did not have mandated reporter training certificate which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/05/2022
Plan of Correction
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Director indicated that she will email all the Mandated reporter training certificates to LPA Nguyen by 05/05/2022.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Thuy Ho
LICENSING EVALUATOR NAME:Tina Nguyen
LICENSING EVALUATOR SIGNATURE:
DATE: 04/05/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/05/2022


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