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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198005445
Report Date: 10/25/2022
Date Signed: 10/25/2022 01:46:23 PM

Document Has Been Signed on 10/25/2022 01:46 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: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: 6CENSUS: 5DATE:
10/25/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Director Yvette Rodriguez TIME COMPLETED:
01:50 PM
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On 10/25/22 Licensing Program Analyst (LPA) Jeanette Estrada conducted an unannounced required 1 year inspection. LPA initially met with School Principal Ms. Thu Do who guided LPA to Director Yvette Rodriguez and informed her of the purpose of the visit. LPA provided Facility Entrance Checklist to Director. This is a preschool program which consists of one classroom. The facility was observed to be within the licensed capacity. Upon arrival there were 5 children with 2 staff present. Criminal Record Clearances for staff present were reviewed. Operating hours are Monday to Friday 7:40 AM to 2:30PM. The facility provides services to children ages 2.5 to entry into first grade.
All areas accessible to children were inspected. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. There is cental air/heating in the facility. Children have their own cubbies in the classroom to store their belongings.
Children use the restroom in the hallway. LPA observed 6 toilets and 4 sinks. General sanitation was observed in the children's restrooms.
Availability of indoor drinking water was observed in classrooms via water a dispenser. Per Director, children bring their own water bottles and can refill in the classroom if needed. Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Cleaning supplies are stored in a locked cabinet and Per the Director, medication would also be stored in a separate locked cabinet but at the moment, none of the children enrolled require medication. Per Director there are no poisons in the facility. LPA observed a combination smoke and carbon monoxide detector in the classroom. The detector is operable and there is also a central fire alarm in the facility. There is a first aid kit available in the classroom.
Per Director there are no firearms stored on the premises. There are no pools or bodies of water at the facility. There is a 2A10BC fire extinguisher in the facility. Fire extinguisher was last serviced in 1/2022. LPA reviewed a current facility roster. The last documented emergency drill was conducted on 10/20/22. There is appropriate napping equipment available for children in the classroom. Bedding is sent home to be laundered weekly or as needed. Sign in -sign out sheets were reviewed. All children present were signed in. Isolation area for ill children is in the computer lab and there is an isolation bathroom available in the front office if needed.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE: DATE: 10/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/25/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: 10/25/2022
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Children’s Records were reviewed for completeness. Child 6 was missing LIC 701-Physician's report.
Staff files were reviewed. Director and Teacher present have pediatric cpr/first aid on file completed on 11/12/21. Director did not have the Mandated Reporter for Child Care Providers completed. Director did have the General course completed on 9/7/22. Teacher present did not have a current Mandated Reporter training - General and for child care providers-completed. Last certification on file completed in 2018. Director did not have proof of immunization for Measles. Teacher present had proof of immunization for Measles, pertussis and flu.
The facility provides two snacks. Children bring lunch from home. Menus are provided to parents/ authorized representatives one week in advance and the menus are also posted. Menus for the past 30 days are available upon request.
All food preparation areas and food storage areas are kept clean and are free of litter, rubbish, rodents, and/or any other vermin. All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids or solid waste bags shall be discarded immediately after each meal. At the moment there are no children with food allergies.
The outdoor playground area was evaluated. The facility has a waiver on file for use of the outdoor playground. The outdoor playground is shared with the rest of the school (TK-8) but the preschool program follows a certain schedule for use of the playground. The outdoor playground is fully fenced. Outdoor equipment is in a safe condition, free of sharp, loose or pointed parts. All areas around or under high climbing equipment and similar equipment are cushioned with material that absorbs a fall-grass. There is adequate shade in the play yard. Per Director, children bring their water bottles out when using the play ground.
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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 Centers and the ADA, available at: http://www.ada.gov/childqanda.htm
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2022
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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: 10/25/2022
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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 advised the licensee/facility representative how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.
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/tion-process.

The deficiencies listed on the following pages were observed by the LPA and 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.
A notice of site visit was given and must remain posted for 30 days. Exit interview conducted with Director Yvette Rodriguez.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/25/2022 01:46 PM - It Cannot Be Edited


Created By: Jeanette Estrada On 10/25/2022 at 12:42 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: 10/25/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
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 interview and record review, the licensee did not comply with the section cited above in 2 out of 2 staff files which did not contain the completed mandated reporter training. The Director did not have the child care provider section completed and the Teacher present had not completed the training since 2018 which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/25/2022
Plan of Correction
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Director will complete the child care provider section of the training and Teacher present will complete the general and child care provider training. proof of certificates will be submitted to LPA via email by due date.
Type B
Section Cited
CCR
101220(a)
Child's Medical Assessments
(a) Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child. This medical assessment enables the licensee to assess whether the center can provide necessary health-related services to the child.

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 1 out of 6 children present which did not have a completed physician's report. Child was enrolled in April 2022 which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/25/2022
Plan of Correction
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Physician's report will be obtained for child and proof will be provided to LPA via email via due 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:Valarie Cook
LICENSING EVALUATOR NAME:Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:
DATE: 10/25/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/25/2022


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