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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191870758
Report Date: 05/22/2023
Date Signed: 05/22/2023 05:20:19 PM

Document Has Been Signed on 05/22/2023 05:20 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:ONE HUNDRED SECOND STREET EARLY EDUCATION CENTERFACILITY NUMBER:
191870758
ADMINISTRATOR:VENUS STOVALLFACILITY TYPE:
850
ADDRESS:1925 EAST 102ND STREETTELEPHONE:
(323) 569-8159
CITY:LOS ANGELESSTATE: CAZIP CODE:
90002
CAPACITY: 112TOTAL ENROLLED CHILDREN: 112CENSUS: 19DATE:
05/22/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Rhonda Pannel, Facility RepresentativeTIME COMPLETED:
05:30 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Denise Gibbs and Lilia Hernandez conducted an unannounced annual required inspection at the above facility on 5/22/23 at 2:30PM. LPAs met with Rhonda Pannel, Facility Representative (FR).

This is a preschool program. Hours of operation Monday-Friday, 8:30AM-4:30PM.

There were 19 children and seven staff present when LPAs arrived. Facility is in compliance with license and Title Five ratio guidelines. All individuals present have obtained a criminal record clearance or criminal record exemption as a condition of employment with the Los Angeles Unified School District.

LPAs reviewed required posted documentation located in the main entrance which included, Facility License, Publication (PUB) 393- Notification of Parent Rights, Licensing Form (LIC) 610- Facility Disaster Plan, PUB 269- Child Passenger Restraint System, LIC 613A- Notification of Personal Rights and Lunch/Snack Menu. All documents observed.

Facility records were reviewed for LIC 9040- Facility Roster, 9148- Earthquake Preparedness form, Daily schedule and Disaster drill log, last drill conducted on 4/2023. All documents observed.

LPAs toured the outdoor play area. Outdoor area was observed to have age appropriate toys and material for children, free of loose, sharp, and/or pointed parts. LPAs observed required cushioning under climbing structure to absorb fall. Shade was observed throughout the outdoor area and water was observed to be readily available via operable water fountains and fill stations. Per FR, there are no weapons or firearms stored at the facility and there is no smoking allowed on the premises.

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SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE: DATE: 05/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/22/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 9
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: ONE HUNDRED SECOND STREET EARLY EDUCATION CENTER
FACILITY NUMBER: 191870758
VISIT DATE: 05/22/2023
NARRATIVE
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LPA toured Classrooms Room #1 General Ed/PCC, #2A/B and #3. All classrooms had furniture in good condition, free of loose, sharp and/or pointed parts.

The floors and surfaces in the classrooms were clean and safe. Rugs were observed to lay flat on the ground to avoid tripping hazards. Water is made readily available by via operable water fountains in Room's #1 and #3. LPA's observed water bottles for children in Room#2 provided by facility. Children have cubbies to store personal belongings separate from each Children use cots for nap. Bedding is provided by facility and washed weekly. There are currently children with medication. Medication is stored in a locked cabinet inaccessible to children. Facility has completed required water lead testing and corrected all identified lead exceedance. Posting of lead results was discussed with FR.

LPAs toured the children’s restrooms located behind Room#1. Restrooms were observed to be safe and sanitary with operable sinks and toilets.

LPAs toured the kitchen located adjacent to the main office. Facility provides AM snack, PM snack and lunch. Food is not cooked at facility. Prepackaged food is brought from the neighboring elementary school. Extra food is discarded. No food is stored in the kitchen. Kitchen was observed to be clean, free of litter, insects and rodents. LPA observed trash cans for solid waste have tight fitting lids. Cleaning supplies are stored separate from the food. Per FR, carbon monoxide detector is combined with facility smoke/fire alarm.

LPAs reviewed Sign In/Out sheets located outside the front entrance. Children present were signed in with date and full signature of child's guardian. LPAs reminded FR that parents must document the time of drop of and pick up.

Children’s records were reviewed for Emergency Card, Immunization Records, Licensing Form (LIC) 627- Consent for Medical Treatment, LIC 995 Notification of Parents’ Rights, LIC 701- Physician’s Report, LIC 613A- Personal Rights, signed request for medication to be given and signed Admissions Agreement. All files were complete.

Staff records were reviewed for approved Pediatric First Aid and CPR certification, LIC 9052- Employee Rights, Proof of immunization against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse, Transcripts or Permit and current Mandated Reporter Training Certificate. ------------------PAGE 2
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023
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: ONE HUNDRED SECOND STREET EARLY EDUCATION CENTER
FACILITY NUMBER: 191870758
VISIT DATE: 05/22/2023
NARRATIVE
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During inspection all children were observed to be treated with dignity and respect, they were observed to be receiving safe, healthful and comfortable accommodations, furnishings and equipment, and free from corporal and/or unusual punishment.

Incidental Medical Services (IMS):
This facility provides Incidental Medical Services- IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personal, and administrative records. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm

Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809D (deficiency page) 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.

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.

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 Rhonda Pannel.


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SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023
LIC809 (FAS) - (06/04)
Page: 3 of 9
Document Has Been Signed on 05/22/2023 05:20 PM - It Cannot Be Edited


Created By: Denise Gibbs On 05/22/2023 at 04:20 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ONE HUNDRED SECOND STREET EARLY EDUCATION CENTER
FACILITY NUMBER: 191870758

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/22/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in ONE OUT OF FIVE STAFF FILES which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/22/2023
Plan of Correction
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PER FR, SHE WILL ASK STAFF TO BRING IN IMMUNIZATONS AND EMAIL PROOF TO LPA BY POC DATE 6/22/23
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 5 OUT 5 STAFF FILES which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/22/2023
Plan of Correction
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PER FR, STAFF DO HAVE CURRENT TRAININGS, THEY CANNOT BE LOCATED. WHEN SHE FINDS THEM SHE WILL EMAIL LPA CERTIFIATED BY POC DATE 6/22/23.
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:Denise Gibbs
LICENSING EVALUATOR SIGNATURE:
DATE: 05/22/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/22/2023


LIC809 (FAS) - (06/04)
Page: 4 of 9
Document Has Been Signed on 05/22/2023 05:20 PM - It Cannot Be Edited


Created By: Denise Gibbs On 05/22/2023 at 04:20 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ONE HUNDRED SECOND STREET EARLY EDUCATION CENTER
FACILITY NUMBER: 191870758

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/22/2023

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
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Based on record review, the licensee did not comply with the section cited above. STAFF ON SITE HAVE EXPIRED CPR/1ST AIDE CERTIFICATIONS, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/22/2023
Plan of Correction
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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:Denise Gibbs
LICENSING EVALUATOR SIGNATURE:
DATE: 05/22/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/22/2023


LIC809 (FAS) - (06/04)
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