197417494-5-10-2023-30-CC-JLAO-CRPKSZ-20230510081022

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197417494
Report Date: 05/09/2023
Date Signed: 05/10/2023 08:11:10 AM

Document Has Been Signed on 05/10/2023 08:11 AM - 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	JEFFERSON STATE PRESCHOOL		FACILITY NUMBER:	197417494
ADMINISTRATOR:	RIOS-PARRA NELLIE		FACILITY TYPE:	850
ADDRESS:	10203 FIRMONA AVENUE		TELEPHONE:	(310) 680-3500
CITY:	LENNOX	STATE: CA	ZIP CODE:	90304
CAPACITY: 80	TOTAL ENROLLED CHILDREN: 80	CENSUS: 54	DATE:	05/09/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Nellie Parra-Rios		TIME COMPLETED:	04:00 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 5/9/2023 Licensing Program Analyst (LPA) Judy Laureano conducted an unannounced Annual Required Inspection at 10203 Firmona Avenue, Lennox, CA 90304 and was greeted by facility director, Nellie Rios-Parra. LPA toured the facility both indoors and outdoors and observed 54 children and 9 staff members and director providing care and supervision. Classroom 21: 17 children and 3 staff member Classroom 22: 18 children and 3 staff member Classroom 23: 19 children and 3 staff member. Classroom 24: Classroom has been closed for the school year; no children were observed in the space. Facility operates on a school district campus. Days and hours of operation are Monday through Friday 7:50 a.m .to 10:50 a.m. and 12:00 p.m. to 3:00 p.m. Program offer an AM and PM session. Facility is licensed to serve 72 preschool children ages 3 years through 5 years of age, no more than 8 non-ambulatory children ages 3 to 5 years old- total maximum capacity of 80. There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition allowed or stored on the premises. Medications are made inaccessible and stored in a locked classroom cabinet. If medication needs to be refrigerated, medication will be stored in the kitchen area near the Health Specialist Office. All necessary paperwork that needs to be included with medication is stored in the classroom with medication and health office.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2023

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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: JEFFERSON STATE PRESCHOOL	FACILITY NUMBER: 197417494
	VISIT DATE: 05/09/2023

NARRATIVE

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Teachers do the day to day cleaning in the classroom. Disinfectants, cleaning solutions and other hazardous items are made inaccessible in locked classroom cabinets. Cabinets were observed to have safety latches making the content inaccessible to the children in care. School district maintenance comes daily after school and mid-day to disinfect classrooms.

Furniture and equipment are in good condition, free of sharp, loose or pointed parts. Playground equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards.

All toilets and hand washing facilities are in safe and sanitary operating condition. Floors in the facility are clean and safe. All kitchen, food preparation and storage areas are clean, free of litter/rubbish and free of rodents/vermin.

Facility provides meals through the school district. Menu is posted on classroom parent board, parents receive it via Class Dojo online application and school district website. All food is protected against contamination and any contaminated food is discarded immediately. Preschool program coordinates with school cafeteria staff to ensure that all dietary restriction are being adhere too. LPA observed all classrooms have a “Medically fragile list” to ensure all staff is aware of the allergies. Solid waste storage containers have tight-fitting covers and are in good repair.

Drinking water is available both indoors and outdoors. Children bring in their own refillable water container and school will provide water bottles when children forget to bring in their water or run out of water.

Areas around high climbing equipment have cushioning material to absorb falls. The facility is free of flies, insects and rodents. Facility contracts with a Pest control vendor to ensure that facility stays pest free. LPA observed working fire extinguishers and working carbon and smoke detector in each classroom. First Aid kits were observed in each classroom.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2023

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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: JEFFERSON STATE PRESCHOOL	FACILITY NUMBER: 197417494
	VISIT DATE: 05/09/2023

NARRATIVE

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Prior to working or volunteering in a licensed childcare facility, all individuals subject to a criminal record review have received a criminal record clearance or exemption. Upon notification from the Department, the licensee will comply and act immediately to terminate the employment of, remove from the facility or bar from entering the facility for any person it is deemed necessary while the Department considers granting or denying an exemption. Capacity and limitations as specified on the license are being maintained.

At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at offsite activities. LPA observed 10 staff’s files and 9 files had a valid certification. LPA reminded facility to ensure all vendors are EMSA approved. LPA reviewed Mandated Reporter Training and staff has current proof of completion. All staff files were complete with health screening, immunization records for influenza, pertussis and measles and educational requirements.

LPA reviewed a sample of children’s files and observed 6 files were complete. LPA provided facility with a copy of the LIC 311A and LIC 125 via email to use as a reference to ensure all files have current documents.

The name of the child care center director or fully-qualified teacher(s) designated to act in the director’s absence has been reported to the Department. The person who signs the child in/out of the facility shall use their full legal signature and record the time of day. Facility currently using Care Connect as an electronic sign in/out and hard copy is available for LPA’s review. All children are under supervision, including visual supervision, of a teacher at all times. Facility maintains a ratio of one teacher supervising no more than 12 children in care.

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/inspection-process.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2023

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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: JEFFERSON STATE PRESCHOOL	FACILITY NUMBER: 197417494
	VISIT DATE: 05/09/2023

NARRATIVE

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Facility representative was reminded that all adults 18 and over, 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 Child Care Center. 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.

LPA and facility director discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the director Nellie Parra-Rios

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2023

LIC809 (FAS) - (06/04)

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