191290460-5-23-2023-33-CC-NTCG-CS4SA7-20230523134152

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191290460
Report Date: 05/23/2023
Date Signed: 05/23/2023 01:42:12 PM

Document Has Been Signed on 05/23/2023 01:42 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	LONGFELLOW CHILDREN'S CENTER		FACILITY NUMBER:	191290460
ADMINISTRATOR:	REE HUDSON		FACILITY TYPE:	850
ADDRESS:	1065 E. WASHINGTON BLVD.		TELEPHONE:	(626) 797-6927
CITY:	PASADENA	STATE: CA	ZIP CODE:	91109
CAPACITY: 66	TOTAL ENROLLED CHILDREN: 66	CENSUS: 30	DATE:	05/23/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:10 AM
MET WITH:	Janine Montanez - Lead Teacher		TIME COMPLETED:	01:52 PM

NARRATIVE

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Licensing Program Analyst (LPA) Nolan Tcheng conducted an unannounced random annual inspection. Upon arrival at 11:10am, LPA met with Lead Teacher Janine Montanez. At 11:15am, LPA was led on a tour of the facility. This is a Pasadena Unified School District (PUSD) preschool program which consists of 2 classrooms. Facility is located on Longfellow Elementary School campus. Per licensee, there are currently 35 enrolled in the program. Hours of operation for this facility are 7am-6pm Monday-Friday.

Licensing staff observed all required forms/publications to be posted in the front entrance. Snack menus were reviewed to ensure that they are being 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.

PHYSICAL PLANT: At 11:15am, LPA entered and inspected Room 1: 13 children and 3 staff members, and Room 2: 17 children and 3 staff members. Classrooms are adjacent and separated by a sliding wall. Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. All floors are clean and safe. During the time of inspection, LPA observed cots being placed down in the classrooms for nap time. Cots are stored in the closet of the classrooms. All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids. The facility was observed to be free of flies, other insects and rodents. Sufficient individual storage space for children was observed and each child has a cubby. Drinking water was readily available indoors. At this time, the care area (by office) is used as an isolation area. A cot is available for an ill child to rest on. First Aid supplies are available and complete. Facility has a functioning carbon monoxide detector that meets statutory requirements. Director states there are no weapons, firearms, or bodies of water on the premises. All food preparation areas and food storage areas are kept clean and are free of litter, rubbish and rodents and/or any other vermin. Snacks were reviewed for availability, quantity and appropriateness to children in care. This facility provides breakfast, lunch, and pm snack.

REPORT CONTINUES PAGE 1 of 3

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:	DATE: 05/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2023

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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: LONGFELLOW CHILDREN'S CENTER	FACILITY NUMBER: 191290460
	VISIT DATE: 05/23/2023

NARRATIVE

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Food is brought from the Longfellow elementary school kitchen. Restrooms are available in between both classrooms. All toilets, hand washing, and bathing facilities are safe, sanitary and are operating properly. At 11:35am, a fire extinguisher was observed. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 05/04/2022, as indicated on service tag. Per State Fire Marshall standards, fire extinguishers shall be serviced annually. LPA discussed with lead teacher, that the child care center needs to have a serviced fire extinguisher at all times during operation hours. An Advisory Note: Technical Assistance is being provided to address it.

At 11:40am, LPA reviewed the outdoor play area. Outdoor playground equipment is in safe condition, free of sharp, loose or pointed parts. 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, swings, slides, and similar equipment are cushioned with material that absorbs a fall. There is one outside play space that has a play structure, swing set, benches, age appropriate toys/equipment, and a garden area for group activities. Outdoor play space is accessible through either classroom. Drinking water is readily available outdoors.

Teacher-child ratios were observed to be in accordance with Title 22 regulations. Staff names were recorded. All children were observed to be under visual supervision of a teacher during tour. The Licensee is within the conditions, limitations, and capacity specified on the license. All areas were identified on the Facility Sketch were inspected.

FACILITY RECORDS: Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. Disaster drills have been conducted at least every six months. Staff files were not reviewed during today's inspection. Staff files are kept at PUSD office and will be reviewed at a later date. A random sample of Children’s Records were reviewed to ensure that they are complete. During review of children's files, LPA observed that 2 of 3 files did not have a completed Physician's Report present. LPA discussed the importance obtaining form during enrollment.

INCIDENTAL MEDICAL SERVICES:

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 PAGE 2 of 3

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:	DATE: 05/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2023

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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: LONGFELLOW CHILDREN'S CENTER	FACILITY NUMBER: 191290460
	VISIT DATE: 05/23/2023

NARRATIVE

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Licensee 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 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.

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

LPA advised the licensee how to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov. AB1207 Mandated Child Abuse Reporting – Implementation was discussed with Licensee. Website provided: http://mandatedreporterca.com/

The deficiencies listed on the following pages were observed by the LPA and are being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809D for deficiencies that are being cited and need to be cleared to protect the children’s health & safety.

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.

Exit interview was conducted with Lead Teacher Janine Montanez, at 1:35pm, and Plan of Corrections were reviewed and developed. Copy of report provided.

END OF REPORT PAGE 3 of 3

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:	DATE: 05/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2023

LIC809 (FAS) - (06/04)

Page: 3 of 5

Document Has Been Signed on 05/23/2023 01:42 PM - It Cannot Be Edited

Created By: Nolan Tcheng On 05/23/2023 at 12:34 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
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: LONGFELLOW CHILDREN'S CENTER	FACILITY NUMBER: 191290460
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/23/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101220(a)

Child's Medical Assessments

(a) Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child. This medical assessment enables the licensee to assess whether the center can provide necessary health-related services to the child. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 2 out of 3 children's file, Child #2-3, did not have a Physician's Report completed in file, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/23/2023
	Plan of Correction
1 2 3 4	Per Licensee, they will make sure Child #2-3 have the LIC701 Physician's Report completed and placed in child's file. Copies will be submitted to LPA by POC date.

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:

Claudia Guangorena

LICENSING EVALUATOR NAME:

Nolan Tcheng

LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2023

LIC809 (FAS) - (06/04)

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