191606626-2-5-2025-54-CC-TTRN-DDLVGT-20250205152603

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191606626
Report Date: 02/05/2025
Date Signed: 02/05/2025 03:26:12 PM

Document Has Been Signed on 02/05/2025 03:26 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	MELBOURNE HEAD START/STATE PRESCHOOL		FACILITY NUMBER:	191606626
ADMINISTRATOR/ DIRECTOR:	ISABEL DELGADILLO		FACILITY TYPE:	850
ADDRESS:	21314 CLARETTA		TELEPHONE:	(562) 229-7931
CITY:	LAKEWOOD	STATE: CA	ZIP CODE:	90715
CAPACITY: 37	TOTAL ENROLLED CHILDREN: 32	CENSUS: 20	DATE:	02/05/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:40 PM
MET WITH:	Veronica Ocampo		TIME VISIT/ INSPECTION COMPLETED:	03:45 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 2/5/25, at 1:40PM. Licensing Program Analyst (LPA), T. Tran conducted an unannounced annual random visit at Melbourne Head Start. Upon arrival, LPA met with Head teacher, Veronica Ocampo. LPA announced the purpose of today’s visit. About 2:00PM, we toured the facility inside and outside. LPA observed children were napping. No concerns with the level of care and supervision and ratio. All center staff that were present during today’s inspection had fingerprint cleared and associated to the designated license number. This is a head start program located on the Elementary School premises. Facility consists of two full-day classes. the hours of operation are 8:30am - 2:30pm Monday - Friday. There is no extended care offered. LPA observed all posting requirements for operation on the posting board LIC 203A-License, LIC 610 A-Emergency Disaster Plan, LIC 9148-Earthquake Preparedness Check List, PUB 394-Notification of parent’s rights poster, LIC 613A- Personal Rights, PUB 269- Child Car Seat Law, Menus, Activity Schedule, and completion testing and remediated lead exceedances. LPA completed children records were reviewed. Per staff, all the staff records located at the main office. No staff records were reviewed. LPA observed current CPR and First Aid Certification for all center staff. LPA inspected classrooms furniture and learning materials for age appropriateness and good repair. Facility have working telephone service, heating, lighting, and proper ventilation. Children napping equipment met the requirement regulation. Individual storage for children's belongings, restrooms,, and isolation areas were inspected. Children drinking water was observed by filtered water. First Aid supplies were inventoried. A review of medication policy, including administering, labeling, storage, and records was made. Documentation of current Fire & Earthquake drill was observed. Facility provided breakfast, lunch, and snack. Food items were delivered daily from the school cafeteria. Food and snack items are properly stored. The food preparation area was toured for safety, cleanliness, and proper equipment. Facility is reminded that smoking is prohibited on the premises.

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Tiffanie Tran
LICENSING EVALUATOR SIGNATURE:	DATE: 02/05/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2025

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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: MELBOURNE HEAD START/STATE PRESCHOOL	FACILITY NUMBER: 191606626
	VISIT DATE: 02/05/2025

NARRATIVE

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Facility shared the outdoor space with another program. LPA did not observe outdoor waiver. Staff was advised to request for outdoor waiver to ensure proper care and supervision during outdoor for the record. Outdoor equipment was inspected for safety, cushioning material, good repair and age appropriateness. Required shade, drinking water and fencing were inspected. Play area was inspected for hazards and inaccessibility to bodies of water.

Facility was informed of responsibility to report suspected Child Abuse by calling the Child Abuse Hotline at 1-800-540-4000. LPA advised of the requirement to report Unusual Incidents and/or injuries to the parent/guardian and to CCL within the time frame specified by the regulation, this includes any changes as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your location.

LPA informed the Facility Representative of the Child Care Advocate Program (CCAP) to provide many other helpful resources to the licensees and the public. LPA advised 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 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.

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Tiffanie Tran
LICENSING EVALUATOR SIGNATURE:	DATE: 02/05/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2025

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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: MELBOURNE HEAD START/STATE PRESCHOOL	FACILITY NUMBER: 191606626
	VISIT DATE: 02/05/2025

NARRATIVE

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CCC COMPLETED TESTING AND REMEDIATED LEAD EXCEEDANCES.
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.
LPA referred FR to the Department website for lead: Lead Toxicity Prevention and Water Testing Information

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 PIN 22-02-CCP. 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/.

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.

The facility was found in compliance with Title 22 regulations, no deficiency was cited at this time. A notice of site visit was given and must remain posted for 30 days.
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. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview conducted and report was reviewed with the facility representative, Veronica Ocampo.

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Tiffanie Tran
LICENSING EVALUATOR SIGNATURE:	DATE: 02/05/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2025

LIC809 (FAS) - (06/04)

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