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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191594282
Report Date: 06/09/2023
Date Signed: 06/09/2023 01:04:38 PM


Document Has Been Signed on 06/09/2023 01:04 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:MAPLE AVE PRESCHOOLFACILITY NUMBER:
191594282
ADMINISTRATOR:CHUANG, LINDAFACILITY TYPE:
850
ADDRESS:332 N. MAPLE AVE.TELEPHONE:
(323) 724-3939
CITY:MONTEBELLOSTATE: CAZIP CODE:
90640
CAPACITY:45CENSUS: 0DATE:
06/09/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:20 AM
MET WITH:Owner Linda Chuang and Director Irene LopezTIME COMPLETED:
11:15 AM
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Licensing Program Analyst (LPA) Veronica MartinezGarza conducted an unannounced 1-year required inspection at the above facility on 06/09/23 at 08:20 a.m. A COVID-19 risk assessment was conducted prior to entering the facility. LPA met with Director Irene Lopez and Owner Linda Chuang who guided LPA on a tour of the facility. This is a preschool age program licensed for 45 children which operates Monday – Friday from 07:00 a.m. – 05:30 p.m. Per the Owner, there are 0 children enrolled.

Per Director and Owner, the facility has been closed since 03/17/2020. According to the Owner, the facility initially closed due to COVID and has remained closed due to no enrollment. Owner would like to remain on an Active status. LPA consulted with the owner on possibly going on an Inactive status since no children have been enrolled since 2020, however, owner would like to remain on an Active status. Staff names were recorded on the attached LIC859.

All areas identified on the Facility Sketch were inspected. The following rooms were inspected: Preschool #1, Preschool #2, Preschool #3, kitchen, and children’s restrooms. Facility has a total of 3 classrooms, 3 toilets, and 3 sinks for children to use. LPA observed all required forms/publications to be posted in the main entrance of the facility. LPA observed the facility to be clean and sanitary. All indoor classrooms were inspected to ensure that the floors have a surface that is safe and clean. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. LPA observed some furniture to be in despair. Per Owner, she has been purchasing new furniture form Lakeshore. LPA observed furniture boxes from Lakeshore in Preschool #2 classroom. Owner is in the process of removing old furniture and replacing it with the newly purchased items. Children bring their own water cups; however, facility does provide drinking water. LPA observed cots stacked for children to nap. All toilets and hand washing facilities are safe, sanitary and are operating properly. At this time, the "back classroom" located next to Preschool #3 is used as an isolation area. A cot is available for an ill child to rest on. Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children.

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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-GarzaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 06/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/09/2023
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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MAPLE AVE PRESCHOOL
FACILITY NUMBER: 191594282
VISIT DATE: 06/09/2023
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Snack menus were reviewed to ensure that they are being posted at least one week in advance and visible to an authorized representative. Though the facility has not been operating, LPA observed snack menus updated and posted throughout the facility. LPA observed some dry snacks available for children with expired dates. LPA advised Director to discard expired dry snacks and purchase snacks once children are enrolled. The facility provides AM snack, lunch, and PM snack. All food prep and storage areas are clean, free of litter, rubbish, and rodents/vermin. All food is protected from contamination. LPA observed the facility kitchen to be outdated and the kitchen floor deteriorated. LPA observed kitchen floor vinyl peeling throughout. 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.

First Aid supplies are available and complete. Facility has a functioning carbon monoxide detector that meets statutory requirements and is in operable condition. LPA observed (4) Fire Extinguishers throughout the facility last serviced on 02/06/23, per service tag. Owner states there are no weapons, firearms, or bodies of water on the premises.

At 9:45am the outdoor play equipment was observed to be in good condition, free of sharp, lose or pointed parts. Outdoor activity space surface is maintained in a safe condition as is free of hazards. Areas around and/or under climbing equipment have cushioning material to absorb a fall. Drinking water is readily available outdoors. There is adequate shade in the play yard.

A sample of the sign in and out sheets were reviewed. LPA did not review children’s file due to no enrollment and facility is required to maintain files for 3 years. The 3-year requirement has past, therefore facility does not have records for LPA to review.

Staff Records were reviewed to ensure that appropriate documentation of education credits is on file. Criminal Records Clearance for adults and verification of CPR/First Aid for Director expires 05/2025 documentation was reviewed. Proof of immunization against influenza, pertussis and measles for staff was readily available during today's inspection. Director is the only staff currently at the facility and file was observed to be complete.

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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-GarzaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 06/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MAPLE AVE PRESCHOOL
FACILITY NUMBER: 191594282
VISIT DATE: 06/09/2023
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SB792 (Immunization Requirements for Staff and Employees) was discussed with the Director.

AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018, any person who works in a child care facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers.

This facility provides Incidental Medical Services – IMS. There are no children enrolled. 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

Director 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 online at: www.ccld.ca.gov




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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-GarzaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 06/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MAPLE AVE PRESCHOOL
FACILITY NUMBER: 191594282
VISIT DATE: 06/09/2023
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Analyst reviewed new Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, which requires the testing of water for lead in Child Care Centers (CCCs) with facility director during the inspection. Per AB 2370, all CCCs that are located in buildings constructed before January 1, 2010, must have their water tested and post the results by January 1, 2023, and every 5 years after the date of the first testing. Facility tested for LEAD on 05/11/23 and LEAD there was no LEAD exceedance. LPA provided Director with a copy of the LEAD report and must be posted for 5 years.

At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.

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 conducted and report was reviewed with Director Irene Lopez and appeal rights were provided.






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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-GarzaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 06/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2023
LIC809 (FAS) - (06/04)
Page: 4 of 4