<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197416279
Report Date: 05/18/2023
Date Signed: 05/18/2023 04:08:34 PM

Document Has Been Signed on 05/18/2023 04:08 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:NU BUILDING BLOCKS DAY CARE CENTERFACILITY NUMBER:
197416279
ADMINISTRATOR:PAIGE SOLOMONFACILITY TYPE:
850
ADDRESS:2313 WEST JEFFERSON BOULEVARDTELEPHONE:
(323) 732-5439
CITY:LOS ANGELESSTATE: CAZIP CODE:
90018
CAPACITY: 58TOTAL ENROLLED CHILDREN: 58CENSUS: DATE:
05/18/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Paige Solomon, Facility RepresentativeTIME COMPLETED:
04:15 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 5/18/23 at 12:00PM. LPA met with Paige Solomon, Facility Representative (FR).

This is a preschool program which consists of three classrooms (Pre-K 4/5, Pre-K 2 and Pre-K 3). Children also use the open area central to all classrooms as a shared play area. There is also a nap room for the children. Facility operation hours are Monday-Friday, 6:00AM-7:00PM. Additional care is provided on evening on weekends when needed. There were 37 children and six staff present with children when LPA arrived.

Facility is in compliance with license capacity and Title 22 ratio guidelines. All individuals present have obtained a criminal record clearance.

LPA reviewed required posted documentation on the parent board in the main entry, which included, Facility License, Publication (PUB) 393- Notification of Parent Rights, Licensing Form (LIC) 610- Facility Disaster Plan, 9148- Earthquake Preparedness form, PUB 269- Child Passenger Restraint System, and LIC 613A- Notification of Personal Rights and AM/PM snack and Lunch Menu. All documents were observed.

Facility records were reviewed for LIC 9040- Facility Roster and Disaster drill log. Last drill conducted on 9/2022. All documents were observed. LPA reminded FR that disaster drills are required every six months. Daily schedules are located in each classroom. Carbon monoxide detector is wired with facility smoke detector and alarm system.

Parents sign in and out via Bright Wheel an application that can be viewed and printed as needed. All children present were signed in with date, time and full signature of guardian.
LPA toured all classrooms, nap room and shared room. Classrooms had furniture in good condition, free of loose, sharp and/or pointed parts. ------------PAGE 1
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE: DATE: 05/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/18/2023
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 6
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: NU BUILDING BLOCKS DAY CARE CENTER
FACILITY NUMBER: 197416279
VISIT DATE: 05/18/2023
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
26
27
28
29
30
31
32
The floors and surfaces in the classrooms were clean and safe. LPA observed that rugs are clean and lay flat on the ground to avoid tripping hazards. There are age appropriate toys and material for children to play with in each classroom. Water is made readily available via water jugs and cups in each classroom. Pre-K 4/5 also has water bottles on hand for children. Children have cubbies to store personal belongings in each classroom. During inspection LPA observed children napping on cots with required bedding. Bedding is provided by facility and washed twice a week, Wednesday and Friday. Nap room was observed to have two changing tables. LPA advised FR to remove the cloth padding covering the vinyl pads on the changing tables for sanitary reasons. Medication is not administered at the facility. First aid kits were observed in each classroom. Facility has completed required water lead test with no Action Level Exceedance (ALE). Lead results are posted on the parent board in the main entrance. LPA reminded FR that staff's personal belongings needs to be inaccessible to children.

LPA toured the children’s restrooms. Facility has two restrooms. LPA observed three toilets and three sinks in restroom #1; one toilet and one sink are inoperable, FR turned water on and plunged toilet making them operable during inspection. In Restroom #2 there are three toilets and three sinks; two toilets and two sinks are in operable. Facility has to maintain four toilets and four sinks in working order to meet regulation. Restrooms were observed to be safe and sanitary.

LPA observed the outdoor play area split into three sections. Outdoor area was observed to have age appropriate toys and material for children. Toys and equipment were observed to be in good condition. Picnic tables were observed for activities and meal times. Shade was observed throughout the outdoor area. LPA observed a water jugs and cups for children to drink freely. LPA observed trash cans for solid have tight fitting lids. Per FR they are going to get rid of trash cans that have slits in the lids that cannot be completely covered.

LPA toured the kitchen. Storage containers in the kitchen for solid waste, including moveable bins have tight-fitting covers that are kept on, and in good repair. All foods/beverages are stored in covered containers at 45˚ (F) or less. Cleaning supplies are stored separate fro the food.

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, LIC9224- Acknowledgment of Receipt of Licensing Report, and signed Admissions Agreement. All documents complete.----------------PAGE 2
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2023
LIC809 (FAS) - (06/04)
Page: 2 of 6
Document Has Been Signed on 05/18/2023 04:08 PM - It Cannot Be Edited


Created By: Denise Gibbs On 05/18/2023 at 03:12 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: NU BUILDING BLOCKS DAY CARE CENTER
FACILITY NUMBER: 197416279

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/18/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(g)(1)
Personnel Requirements
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

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 2 out 5 files which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/16/2023
Plan of Correction
1
2
3
4
Per FR, they will send staff to get health screenings complete and email proof to LPA by POC date 6/16/23
Type B
Section Cited
CCR
101239(e)(4
101239(e)(4) Fixtures, Furniture, Equipment and Supplies
(4)All toilets, handwashing and bathing facilities shall be maintained in safe and sanitary operating condition. Additional equipment, aids and/or conveniences shall be provided as needed in centers that serve children with physical disabilities.


This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above. 3 sinks and 3 toilets are not operable, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/16/2023
Plan of Correction
1
2
3
4
One sink was turned back on during inspection and one toilet was plunged and operable making facility in compliance for capacity.
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: 05/18/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/18/2023


LIC809 (FAS) - (06/04)
Page: 5 of 6
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: NU BUILDING BLOCKS DAY CARE CENTER
FACILITY NUMBER: 197416279
VISIT DATE: 05/18/2023
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
26
27
28
29
30
31
32
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. Mandated Reporter missing for four out of five staff, immunization's missing for three out of five staff and Health Screenings missing for two out of five staff.

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

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.

Licensee 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 Paige Solomon, Licensee .---------------PAGE 3

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

DATE: 05/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2023
LIC809 (FAS) - (06/04)
Page: 3 of 6
Document Has Been Signed on 05/18/2023 04:08 PM - It Cannot Be Edited


Created By: Denise Gibbs On 05/18/2023 at 03:12 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: NU BUILDING BLOCKS DAY CARE CENTER
FACILITY NUMBER: 197416279

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/18/2023

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
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in 3 out 5 files, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/16/2023
Plan of Correction
1
2
3
4
Per FR, they will send staff to get proof of immunization's and email LPA a copy by POC date 6/16/23
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
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in 4 out 5 files, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/16/2023
Plan of Correction
1
2
3
4
Per FR, all staff will take the training and they will send a copy to LPA by POC date 6/16/23
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: 05/18/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/18/2023


LIC809 (FAS) - (06/04)
Page: 4 of 6