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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198005445
Report Date: 10/14/2021
Date Signed: 10/15/2021 08:11:16 AM

Document Has Been Signed on 10/15/2021 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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:ST. LINUS PRE-KINDERGARTENFACILITY NUMBER:
198005445
ADMINISTRATOR:AMANDA STEVERFACILITY TYPE:
850
ADDRESS:13913 SHOEMAKER AVENUETELEPHONE:
(562) 921-0336
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY: 19TOTAL ENROLLED CHILDREN: 19CENSUS: 4DATE:
10/14/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Aimee Parker, Director &
Thu Do, Principal		TIME COMPLETED:
03:30 PM
NARRATIVE
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An unannounced Required Inspection was conducted on this day by Licensing Program Analyst (LPA) Lucero. Facility is currently licensed for a capacity of 19 preschool children. Licensing staff met with Principal Thu Do and with Director Aimee Parker. Licensing staff was taken on a guided tour of the facility of both indoors and outdoors.

At the initial start of the site visit, there is a total census of four napping children and a total census of one teacher present. Furniture and equipment was inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Storage for children's belongings was observed. Mat/cot was inspected. Availability of drinking water was reviewed. Age appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, area safety and sanitation. Toys observed to be clean.

A first aid kit is kept in the classroom. Carbon monoxide and smoke detectors is a dual device and is present in the facility, but was not tested as children were napping. Hazardous items including poisonous cleaning compounds were stored inaccessible to children. Per Director, facility provides a morning and an afternoon snack. Lunch is provided by the family and is warmed up by the facility.

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. During records review, it was determined that Principal Thu Do is not finger printed with the department; however, she is fingerprinted with the Archdiocese of Los Angeles. Principal provided proof of Live Scan taken with the Archdiocese of Los Angeles with a date of 11/14/2019. A conversation was held with Director and principal regarding the need of having Principal Do fingerprinted with the Department. LIC 9163 was provided on this date and Principal stated she will get fingerprinted with the Department by Close of Business on 10/15/2021 and provide proof of prints taken to LPA via email by 10/18/2021. Personal Rights of children were observed by LPA.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Armando J Lucero
LICENSING EVALUATOR SIGNATURE: DATE: 10/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/14/2021
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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Document Has Been Signed on 10/15/2021 08:11 AM - It Cannot Be Edited


Created By: Armando J Lucero On 10/14/2021 at 02:33 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: ST. LINUS PRE-KINDERGARTEN
FACILITY NUMBER: 198005445

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/14/2021

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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 During records review, it was determined that Director's CPR/First Aid was issued by the American Safety & Health Institute. LPA determined that the course is not EMSA Certified as it does not have the EMSA Pediatric First Aid/CPR stickers. Discussion was held with Director regarding the importance of having a valid Pediatric CPR/First Aid.
POC Due Date: 11/15/2021
Plan of Correction
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Director stated she will obtain the EMSA certified stickers or enroll in a new course and will provide proof to LPA via email by POC date of 11/15/2021
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:Valarie Cook
LICENSING EVALUATOR NAME:Armando J Lucero
LICENSING EVALUATOR SIGNATURE:
DATE: 10/14/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/14/2021


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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: ST. LINUS PRE-KINDERGARTEN
FACILITY NUMBER: 198005445
VISIT DATE: 10/14/2021
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Outdoor equipment was inspected for safety, cushioning material, good repair and appropriateness. Required shade, drinking water and fencing were inspected. LPA Lucero advised that the children need to be within the direct care and supervision, including visual supervision of the teacher(s) at all times. The children have access to drinking fountains during outside play. Play area was inspected for hazards and inaccessibility to bodies of water; no bodies of water or hazards observed.

Staff and Children’s Records were reviewed. Inspection of required forms made. CPR/First Aid for the Director was issued by the American Safety & Health Institute. LPA determined that the course is not EMSA Certified as it does not have the EMSA Pediatric First Aid/CPR stickers. Discussion was held with Director regarding the importance of having a valid Pediatric CPR/First Aid.

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

LPA advised Director that all adults 18 years of age and older providing Care & Supervision and/or have continuous presence in the facility shall adhere to a criminal background clearance with the Department of Justice, FBI and Child Abuse Index Check.

See deficiencies page for deficiencies cited during today's visit in accordance to the California Code of Regulations Title 22, Division 12, Chapter 1

Exit interview, copy of report was given. Appeal rights were issued and discussed.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Armando J Lucero
LICENSING EVALUATOR SIGNATURE:

DATE: 10/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2021
LIC809 (FAS) - (06/04)
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