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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191670722
Report Date: 04/06/2023
Date Signed: 04/06/2023 12:15:09 PM

Document Has Been Signed on 04/06/2023 12:15 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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:LBUSD-GRANT CHILD DEVELOPMENT CENTERFACILITY NUMBER:
191670722
ADMINISTRATOR:KIMBERLY KELLYFACILITY TYPE:
850
ADDRESS:6405 WALNUT AVETELEPHONE:
(562) 422-4686
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY: 95TOTAL ENROLLED CHILDREN: 68CENSUS: 56DATE:
04/06/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Kimberly Kelly, Coordinating Teacher (CT)TIME COMPLETED:
12:35 PM
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On 04/06/2023 at 9:06 AM an unannounced Required – 1 Year Inspection was conducted by Licensing Program Analysts (LPAs) Katrina Chicote and Franchesca White. Facility is currently licensed for a capacity of 95. Licensing staff announced purpose of visit and initially met with Kimberly Kelly, Coordinating Teacher, who granted entry to facility. Facility is located on Grant Elementary School campus. The program currently operates a Full Day Program from 6:30 AM to 5:30 PM in RM-35 and RM-36 and a Part Day Program: AM from 8:00 AM to 11:00 AM and PM from 12:00 PM to 3:00 PM in RM-30. LPAs were taken on a guided tour of the facility of both indoors and outdoors. LPAs observed required licensing postings in each classroom.

At the initial start of the site visit, LPAs observed RM 35 to have 17 preschoolers with three staff (S1, S2, S3), RM 36 to have 19 preschoolers with three staff (S4, S5, and S6) and RM 30 to have 20 preschoolers with three staff (S7, S8, and S9) totaling census of 56 preschoolers nine staff present.

Beginning at 9:08 AM, furniture and equipment were inspected for age appropriateness and good repair in each classroom. LPAs observed rugs and floor to be free of hazards and child size tables and chairs available for children well maintained. LPAs observed learning stations for dramatic play, math, and science with toys well maintained free of loose and sharp parts and a library area available for quiet play. Telephone service, heating, lighting and ventilation were evaluated. There were cubbies observed as storage for children's belongings. Per CT, Full Day program naps and LPA observed blue cots stored in back of RM-36. Per CT, linens are provided by the facility and blankets taken home weekly for washing. Availability of drinking water was reviewed. LPAs observed water coolers available for children and children's personal water bottles. Age appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, area safety and sanitation. LPA observed shared bathroom available for RM-35 and RM-36 with five toilets and six sinks, and RM-30 to have two bathrooms available with one toilet and one sink each, totaling two toilets and two sinks.
Report Continues - Page 1 of 3
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE: DATE: 04/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/06/2023
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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: LBUSD-GRANT CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191670722
VISIT DATE: 04/06/2023
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Snack/lunch menus were reviewed and observed posted at time of inspection. All meals and snacks are provided by the Long Beach Unified School District and delivered to facility. Per CT, Full Day Programs are served Breakfast, Lunch, and Snack, AM Program served Breakfast, and PM Program served Lunch. LPAs observed trash cans available in each classroom with tight fitting lids available to discard food.

Beginning at 9:47 AM, outdoor equipment was inspected for safety, cushioning material, good repair and age-appropriateness. Required shade and fencing were inspected. LPAs observed children playing outside during inspection. LPAs observed multiple bench-tables with umbrellas as shaded area for children. LPAs observed a multi-level play structure with three slides and crawling tube to have cushioning material below to absorb fall all well maintained. LPAs observed bicycles, plastic playhouse, water play table, and other toys available for children to use outside that are well maintained. LPAs advised CT that the children need to be within the direct care and supervision, including visual supervision of the teacher(s) at all times. LPAs observed the children have access to their water bottles and a water cooler during outside play. Play area was inspected for hazards and inaccessibility to bodies of water; no bodies of water or hazards observed.

A first aid kit is kept in each classroom and was inventoried for necessary supplies. Carbon monoxide detectors were tested and observed operable in each classroom at time of inspection. LPAs observed smoke detectors observed present in the facility and fire extinguishers have been serviced on 08/09/2023. Per CT, last drill conducted was on 03/03/2023 but log was not available at time of inspection. Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. LPAs observed these items stored in Teacher Cabinet with a lock that latches on top. At 10:02 AM, LPAs observed medicines that is stored in RM-35 for C1-C3, LPAs did not observed medicines for C3 to have unaltered label at time of inspection. LPAs observed sick/isolation area labeled for children to be in Main Office.

Teacher-child ratios were observed and staff names recorded. Care and supervision was evaluated to determine if the basic needs of children are met and appropriate. Sign-in and out sheets and procedures were reviewed. Personal Rights of children were observed by LPA.

Beginning at 11:00 AM, staff and children’s records were reviewed. Children’s Records were reviewed for completeness. Inspection of required forms was made and documented on the LIC 857. The review of Staff records was documented on the LIC 859.
Report Continues - Page 2 of 3
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:

DATE: 04/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2023
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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: LBUSD-GRANT CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191670722
VISIT DATE: 04/06/2023
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Staff present did have proof of the AB 1207 Mandated Reporter Training certificate on file. LPAs observed Pediatric First Aid/CPR expires on 10/02/2023 for S1. LPAs did not review confidential staff files during the inspection due to the staff confidential files being stored at the administrative office. All staff and employees have obtained a criminal record clearance or criminal record exemption as a condition of employment with the Long Beach Unified School District.

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

Licensee (or facility representative) was reminded that all adults 18 and over in the facility, 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 licensed facility. 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.

Based on this information, the following deficiencies on the attached LIC 809D are 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 & safety.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.



Exit interview was conducted and report was reviewed with the Licensee (or facility representative), Kimberly Kelly.

Report Ends - Page 3 of 3

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:

DATE: 04/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/06/2023 12:15 PM - It Cannot Be Edited


Created By: Katrina Chicote On 04/06/2023 at 11:48 AM
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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LBUSD-GRANT CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191670722

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/06/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101226(e)(1)(B)
Health-Related Services
(e) In centers where the licensee chooses to handle medications: (1) All prescription and nonprescription medications shall be centrally stored in accordance with the requirements specified below: (B) Each container shall have an unaltered label.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA record review and interview, C1 has medications which LPA observed did not have label and was not in original packaging. This poses a potential health, safety ,and personal rights risk to children in care.
POC Due Date: 05/05/2023
Plan of Correction
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Facility Representative states that she will call parents and ask for the original container for the medicines and provide LPA with photo via email by POC date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Karen Chambers
LICENSING EVALUATOR NAME:Katrina Chicote
LICENSING EVALUATOR SIGNATURE:
DATE: 04/06/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/06/2023


LIC809 (FAS) - (06/04)
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