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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191597452
Report Date: 05/20/2022
Date Signed: 05/20/2022 01:44:00 PM

Document Has Been Signed on 05/20/2022 01:44 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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:JACKSON CHILD DEVELOPMENT CENTERFACILITY NUMBER:
191597452
ADMINISTRATOR:ELIDA GARCIAFACILITY TYPE:
850
ADDRESS:8535 CONTRERAS ST.TELEPHONE:
(562) 602-6900
CITY:PARAMOUNTSTATE: CAZIP CODE:
90723
CAPACITY: 53TOTAL ENROLLED CHILDREN: 0CENSUS: 16DATE:
05/20/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Rita Cruz, Program DirectorTIME COMPLETED:
02:03 PM
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Licensing Program Analyst (LPA) Susann Sanchez conducted an unannounced annual inspection on 5/20/2022 at 10:15AM. LPA met with Site Supervisor, Margarita Siordia. LPA provided Ms. Siordia with a copy of the Entrance Checklist for Child Care Centers form (LIC 125). Around 10:45am, Program Director Rita Cruz, arrived and gave LPA a tour of the facility after LPA checked in at the main office of the Wirtz Elementary School. LPA also met with Elementary School Principal Roxanne Allessandro where LPA explained purpose of visit and the role of the LPA. This is a preschool program and consists of two sessions: Mornings from 7:50am - 10:50am and afternoon from 12:00pm - 3:00pm.

All areas identified on the Facility Sketch were inspected. There was 9 children present with 2 staff members in room 135 and in room 150 there was 7 children with 2 staff members. The facility was observed to be within the license capacity and limitations. 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. Children do not nap at the facility. Age appropriate sinks and toilets were inspected for availability and good repair in all restrooms. General sanitation was observed. Availability of indoor drinking water was observed in the classroom.



Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Director states there are no poisons stored at the facility. Carbon monoxide detectors were observed and are operable.

There is a kitchen in each classroom that has snacks. Lunches are provided by the elementary school. 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 or solid waste bags shall be discarded immediately after each meal.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE: DATE: 05/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/20/2022
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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: JACKSON CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191597452
VISIT DATE: 05/20/2022
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Outdoor playground equipment is in a 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 adequate shade in the play yard. Availability of outdoor drinking water was observed. LPA advised that no children shall be left without the supervision of a teacher at any time.

All floors were observed to be clean and safe. All materials accessible to children were observed to be toxic-free. There are no firearms stored on the premises. There are no pools or bodies of water at the facility.

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 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.



There is at least one person trained in CPR and Pediatric First Aid present during this inspection and expires on 12/14/2023. 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 on 4/15/2022.

LPA did not review staff and children's files during the inspection due to the staff and children's files being stored at the administrative office. LPA will review staff files at a later time and date. If staff files were to be incomplete during the time and date that LPA reviews files, a case management inspection will occur at the facility to reflect the incomplete files. Facility does maintain a copy of children ID form and medical, which LPA reviewed during inspection.

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. Preschoolers are provided breakfast for the AM program and lunch, for the PM program.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2022
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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: JACKSON CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191597452
VISIT DATE: 05/20/2022
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First Aid supplies is located in the classroom. Medication is only administered to a child when accompanied with a doctor's note and is stored in the child’s classroom. The facility was observed to be equipped with an isolation area for any child who becomes ill and is located in each classroom.

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

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 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.

There were no deficiencies cited during today’s inspection A notice of site visit was given and must remain posted for 30 days. Appeal rights were given and explained. Exit interview conducted and report was reviewed with the Program Director Rita Cruz.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2022
LIC809 (FAS) - (06/04)
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