197403009-3-17-2022-54-CC-DGIS-CCLT32-20220317142136

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197403009
Report Date: 03/17/2022
Date Signed: 03/17/2022 02:21:50 PM

Document Has Been Signed on 03/17/2022 02:21 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:	LOS ANGELES FIRST PRESCHOOL EDUCATION CENTER		FACILITY NUMBER:	197403009
ADMINISTRATOR:	AHN, SU K.		FACILITY TYPE:	850
ADDRESS:	2029 WEST WASHINGTON BOULEVARD		TELEPHONE:	(213) 733-8827
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90018
CAPACITY: 175	TOTAL ENROLLED CHILDREN: 50	CENSUS: 42	DATE:	03/17/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Chong Ahn, Facility Representative		TIME COMPLETED:	02:30 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	Licensing Program Analysts (LPA) Denise Gibbs conducted an unannounced annual required inspection at the above facility on 3/17/22 at 10:30 AM. LPA met with Chong Ahn, Facility Representative (FR) who guided analysts on a tour of the facility. There were 42 children and 11 staff present when LPA arrived. Facility capacity is in compliance License capacity and Title 22 ratio guidelines. All individuals present have obtained a criminal record clearance. Facility currently has four classrooms in use, Panda, Rabbit, Bear, and Elephant. Panda, Rabbit and Bear are located in the main building. The Elephant room is located in detached building in front of the big outdoor play area. Both Rabbit and Elephant have napping areas in a separate rooms next to their classrooms. Due to COVID-19 and low enrolment this provides more activity space in the main classrooms. Panda classroom is part time AM schedule 7:50am-12pm. Full time schedule is 7:50-4pm. LPA toured All classrooms. 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. LPA did not observe any tripping hazards. Water is made readily available by via water bottles brought by children and pitcher of water for refills provided by the facility. Per FR, there are currently no children taking medication and there is no medication stored at the facility. Children have cubbies to store personal belongings separate from each other. LPA observed napping cots stored separate storage areas. LPA toured the children’s restrooms. Restrooms were observed to be safe and sanitary with operable sinks and toilets. LPA observed two separate outdoor spaces. Outdoor area was observed to have age appropriate toys and ---------------------PAGE 1

SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022

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: LOS ANGELES FIRST PRESCHOOL EDUCATION CENTER	FACILITY NUMBER: 197403009
	VISIT DATE: 03/17/2022

NARRATIVE

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material for children, free of loose, sharp, and/or pointed parts. LPA observed required cushioning under
climbing structures to absorb fall. Shade was observed throughout the outdoor area. Water bottles and water pitchers are brought outside for children.

LPA observed required posted documentation 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 were observed.

Facility records were reviewed for LIC 9040- Facility Roster, 9148- Earthquake Preparedness form, Daily schedule and Disaster drill log, last drill conducted on 11/29/21. All documents were observed.

LPA reviewed Sign In/Out sheets located outdoors next to the parent check in stations. All children present were signed in with date, time and full signature of the child's representative.

LPA toured the kitchen located adjacent to the administration offices. Facility provides AM snack, PM snack and lunch. Food is prepared at facility. Kitchen was observed to be clean, free of litter, insects and rodents. LPA discussed trash cans in kitchen with FR. Cleaning supplies are stored separate from the food. Carbon monoxide detector was observed and operable.

Children’s records were reviewed for Licensing Form (LIC) 700 Emergency Card, Immunization Records, LIC 627- Consent for Medical Treatment, LIC 995 Notification of Parents’ Rights, LIC 701- Physician’s Report, LIC 613A- Personal Rights, and signed Admissions Agreement. All documents complete.

Staff records were reviewed for approved Pediatric First Aid and CPR certification for at least one staff member on site, LIC 9052- Employee Rights, LIC 501- Personnel Record, LIC 503- Health Screening Report, LIC 508- Criminal Record Statement, 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 and current Mandated Reporter Training Certificate. LPA observed that eight staff need to renew Mandated Reporter training and three staff are missing proof of immunization.

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SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022

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: LOS ANGELES FIRST PRESCHOOL EDUCATION CENTER	FACILITY NUMBER: 197403009
	VISIT DATE: 03/17/2022

NARRATIVE

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AMENDED REPORT
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.

LPA observed that facility is implementing COVID-19 precautions and procedures as recommended by the Department of Public Health.

Incidental Medical Services (IMS):
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a plan for providing IMS must be submitted to the Department. 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 (REPORT AMENDING TO CHANGE LANGUAGE)

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.

Facility representative was reminded that all adults 18 and over living or working in the home, 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 Family Child Care Home. 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.

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 Chong Ahn,.------PAGE 3

SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/17/2022 02:21 PM - It Cannot Be Edited

Created By: Denise Gibbs On 03/17/2022 at 01:25 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: LOS ANGELES FIRST PRESCHOOL EDUCATION CENTER	FACILITY NUMBER: 197403009
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/17/2022

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
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 3 out of 11 staff files which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/15/2022
	Plan of Correction
1 2 3 4	Per FR, he will talk to the staff that need immunizations and have them obtain proof. FR will email proof to LPA by POC date.

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
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 8 out of 11 staff files which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/15/2022
	Plan of Correction
1 2 3 4	Per FR they will begin their trainings in April and email certificated to LPA by POC date.

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:

Trevino Cochran

LICENSING EVALUATOR NAME:

Denise Gibbs

LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022

LIC809 (FAS) - (06/04)

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