191571456-4-4-2024-33-CC-LBAK-D3ZS4F-20240404133239

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191571456
Report Date: 04/04/2024
Date Signed: 04/04/2024 01:33:07 PM

Document Has Been Signed on 04/04/2024 01:33 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:	YMCA SUNSHINE P/S STARBUCK SITE		FACILITY NUMBER:	191571456
ADMINISTRATOR/ DIRECTOR:	SUSETTE SEPULVEDA		FACILITY TYPE:	850
ADDRESS:	15740 E STARBUCK STREET		TELEPHONE:	(562) 943-7241
CITY:	WHITTIER	STATE: CA	ZIP CODE:	90603
CAPACITY: 104	TOTAL ENROLLED CHILDREN: 22	CENSUS: 17	DATE:	04/04/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:15 AM
MET WITH:	Director,Adriana Allen		TIME VISIT/ INSPECTION COMPLETED:	01:50 PM

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On 4/4/24, Licensing Program Analysts (LPAs) Lilli Babcock and Priscilla Ochoa conducted an unannounced annual inspection. A Covid risk assessment was conducted. LPAs met with Director, Adriana Allen, to whom the reason for the visit was explained. Director guided LPAs on a tour of the facility. This is a preschool program which is currently licensed and operates Monday – Friday from 6:30 am – 6:30 pm. Per Director there are 22 children enrolled.

Census was taken upon arrival and the following staff and children were observed by LPAs to be present: Room 1: 1 staff caring for 6 children; Room 2: 1 staff caring for 11 children. Teacher-child ratios were observed to be in accordance with Title 22 Regulations. Staff names were recorded. LPAs confirmed all individuals present have obtained a criminal record clearance. All children were observed by LPAs to be under supervision, including visual supervision, of a teacher at all times. The licensed facility is within the conditions, limitations, and capacity specified on the license.

All areas identified on the Facility Sketch were inspected and the following was observed:

All indoor classrooms were inspected to ensure that furniture and equipment are age-appropriate and in good repair, and the floors have a surface that is safe and clean. Napping equipment including cots and bedding were inspected for good condition and appropriate storage. Per Director, children take

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE:	DATE: 04/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024

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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Document Has Been Signed on 04/04/2024 01:33 PM - It Cannot Be Edited

Created By: Lilli Babcock On 04/04/2024 at 12:32 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: YMCA SUNSHINE P/S STARBUCK SITE	FACILITY NUMBER: 191571456
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/04/2024

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 record review, the licensee did not comply with the section cited above in 4 out of 4 staff without valid pediatric CPR/1st Aid which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/18/2024
	Plan of Correction
1 2 3 4	Director stated the facility will have staff trained in Pediatric CPR/1st Aid by the American Heart Association, American Red Cross, or a training company approved by the Emergency Medical Services Authority (EMSA) where the certificate/card contains the 2 required EMSA stickers by the due date of 4/18/24.

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:

Brandi VanOosten

LICENSING EVALUATOR NAME:

Lilli Babcock

LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024

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: YMCA SUNSHINE P/S STARBUCK SITE	FACILITY NUMBER: 191571456
	VISIT DATE: 04/04/2024

NARRATIVE

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their bedding home to wash weekly. Storage for children's belongings were inspected and LPAs observed children have their own labeled cubbies to store their belongings in both Room #1 and Room #2. Water and cups are provided by the facility and children are allowed to drink freely at any time.

LPAs observed toys and materials for children in the classrooms. Age- appropriate sinks and toilets were inspected for availability and good repair in restrooms used by children.

Per Director, the office area of Classroom #1 is used as an isolation area and ill children use the staff restroom located in Classroom #1. Per Director, staff provide 100% supervision when ill child is using the isolation area and/or restroom, and parents are contacted immediately when children are determined to be ill and staff are ensuring that children with obvious symptoms of illness are not being accepted.

Food menus were reviewed to ensure that they are being posted at least one week in advance and visible to an authorized representative. Menus for the past 30 days are available upon request. The facility provides breakfast, lunch, and PM snack. All food provided is delivered weekly from US Foods. All kitchen, food preparation, and food storage areas are clean, free of litter, rubbish, rodents, and other vermin. All food is protected from contamination, and LPAs inspected that any contaminated food is discarded immediately. LPAs inspected food to be in good quantity. LPAs observed some refrigerated and frozen food in unopened packaging without expiration dates. LPAs observed packaged food delivered by US Foods that has not been opened but does not have expiration dates listed. Director stated the expiration dates are on the main box the items came in. LPAs counseled Director to write the expiration dates on all food products that do not have expiration dates on them when they are taken out of the box.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE:	DATE: 04/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024

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: YMCA SUNSHINE P/S STARBUCK SITE	FACILITY NUMBER: 191571456
	VISIT DATE: 04/04/2024

NARRATIVE

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All storage containers for solid waste, including moveable bins, have tight fitting covers on and are in good repair. Disinfectants, cleaning solutions, and other items that are dangerous to children, were inaccessible to children. Director states there are no poisons or firearms on the premises, and none were observed on this day. First aid kits were available in each classroom.

Telephone service, heating, lighting and ventilation were evaluated. Per Director, the facility has a cell phone that remains at the facility at all times.

LPAs observed the facility to have operable carbon monoxide detectors on this day that meet the standards established in Chapter 8 of Part 2 of Division 12.

The facility has an outdoor play area that is fully fenced. Outdoor playground equipment is free of sharp, loose, or pointed parts. LPAs did observe spider webs and dried leaves in the playhouse located on the outdoor play area. All areas around or under high climbing equipment, slides, and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard. There are safe toys, play equipment and materials observed for children outside on playground. Availability of outdoor drinking water was observed. Per Director, teachers will bring out a water jug and cups, on a tray, each time the classroom goes outdoors.

LPAs reviewed the Disaster Drill log. Last drill was conducted on 3/16/24. LPAs observed all required posted forms to be posted at the entrance of each classroom.

Staff Records and Children’s Records were reviewed. LPAs observed children’s files reviewed to be complete. Inspection of required forms were made. Children’s files reviewed 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

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE:	DATE: 04/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024

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: YMCA SUNSHINE P/S STARBUCK SITE	FACILITY NUMBER: 191571456
	VISIT DATE: 04/04/2024

NARRATIVE

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authorized representative cannot be reached when necessary.LPAs reviewed staff files. LPAs observed staff to have current Mandated Reporter Training (AB1207), LIC 9108, LIC 9052, LIC 501, and proof of negative TB Test. LPAs observed Staff #1 is missing proof of pertussis immunization and LIC 503 Health Screening. LPAs observed staff do not have proof of current Pediatric CPR/1^st Aid from either American Red Cross or American Heart Association, or an approved Emergency Medical Services Authority (EMSA) Training Company. LPAs observed the file for Staff #1 contained a current CPR/1st aid certificate from American Academy, but does not have EMSA stickers showing it is from an approved EMSA training company. Director confirmed on this day that the 3 other employees present do not have proof of pediatric CPR/First Aid.

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

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection- process.

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 initial presence in a

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE:	DATE: 04/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024

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: YMCA SUNSHINE P/S STARBUCK SITE	FACILITY NUMBER: 191571456
	VISIT DATE: 04/04/2024

NARRATIVE

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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.

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. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. PIN 22- 05-CCP

LPA discussed the safe sleep regulations with facility representative 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 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.

Incidental Medical Services (IMS) policy was discussed. 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 publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/. PIN 22-05-CCP

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE:	DATE: 04/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024

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: YMCA SUNSHINE P/S STARBUCK SITE	FACILITY NUMBER: 191571456
	VISIT DATE: 04/04/2024

NARRATIVE

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Facility representative was informed of the 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.

Based on the LPAs observations and records review, the following deficiency listed on the attached LIC 809D (deficiency page) is being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health and safety.

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

Exit interview conducted and report was reviewed with the facility representative Adriana Allen.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE:	DATE: 04/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024

LIC809 (FAS) - (06/04)

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