198010873-2-26-2024-54-CC-SSAZ-D2TSR9-20240226130557

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198010873
Report Date: 02/26/2024
Date Signed: 02/26/2024 01:06:07 PM

Document Has Been Signed on 02/26/2024 01:06 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:	KEPPEL STATE PRESCHOOL		FACILITY NUMBER:	198010873
ADMINISTRATOR:	ELIDA GARCIA		FACILITY TYPE:	850
ADDRESS:	6630 MARK KEPPEL STREET		TELEPHONE:	(562) 602-6900
CITY:	PARAMOUNT	STATE: CA	ZIP CODE:	90723
CAPACITY: 25	TOTAL ENROLLED CHILDREN: 25	CENSUS: 21	DATE:	02/26/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	10:35 AM
MET WITH:	Imelda Madrigal, Head Teacher		TIME COMPLETED:	01:30 PM

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Licensing Program Analyst (LPA) Susann Sanchez conducted an unannounced 3 - year inspection. LPA met with Imelda Madrigal, Head Teacher. This facility consist of one classroom with an outdoor playground located inside Keppel Elementary School. LPA entered facility through the main entrance of the elementary school and checked in. LPA was escorted to the preschool where Imelda Madrigal, Head Teacher gave LPA a tour of the facility. LPA also met with Elementary School Principal Michael Naruko where LPA explained purpose of visit and the role of the LPA. This is a preschool program and consists of two sessions: Mornings from 7:50am - 10:50am and afternoon from 12:00pm - 3:00pm. There were no children when LPA arrived to the classroom.

All areas identified on the Facility Sketch were inspected. All individuals present have obtained a criminal record clearance or criminal record exemption as a condition of employment with the Paramount Unified School District. The facility was observed to be within the license capacity and limitations. The following was observed during the tour of the facility:

Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Children have their own cubby to store their belongings. Children do not nap at the facility. Age appropriate sinks and toilets were inspected for availability and good repair in all restrooms. General sanitation was observed. Availability of indoor drinking water was observed in the classroom.

Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Head Teacher states there are no poisons stored at the facility. Head Teacher also states there are no weapon in the facility. Carbon monoxide detectors were observed and are operable.

Children arrived at 12:00pm and there was 21 children.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2024

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: KEPPEL STATE PRESCHOOL	FACILITY NUMBER: 198010873
	VISIT DATE: 02/26/2024

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Lunches are provided by the elementary school. 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. Menus are posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request. Preschoolers are provided breakfast for the AM program and lunch, for the PM program. First Aid supplies is located in the classroom. Medication is only administered to a child when accompanied with a doctor's note and is stored in the child’s classroom. The facility was observed to be equipped with an isolation area for any child who becomes ill and is located in the classroom.

Outdoor playground equipment is in a 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 areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard. Availability of outdoor drinking water was observed. LPA advised that no children shall be left without the supervision of a teacher at any time.

All floors were observed to be clean and safe. All materials accessible to children were observed to be toxic-free. There are no firearms stored on the premises. There are no pools or bodies of water at the facility.

There is at least one person trained in CPR and Pediatric First Aid present during this inspection and expires on 12/2025. Children's roster was reviewed and is current. Sign-In and Sign-Out sheets were reviewed. Children present were signed in. Disaster drill log was available, last drill was conducted on 01/25/24. There is a 2A10BC fire extinguisher in the classroom which was last serviced in 07/11/2023.

LPA discuss with the facility water lead test results sampled on 12/15/22. Results show that a water source in the facility had Action Level Exceedance (ALE) of lead. The sink faucet located in the classroom and outside drinking fountain. A result with values of 5.5 parts per billion (ppb) or greater shall be deemed an Action Level Exceedance in accordance with the Lead Testing Written Directives section 101700.3 subsection (b)(1). Facility got retested and is in compliance. Facility retested on 02/24/23. Site Supervisor provided report. LPA informed Site Supervisor that LIC 9275 & LIC 9276 needs to be submitted to the department by 03/26/2024.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2024

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: KEPPEL STATE PRESCHOOL	FACILITY NUMBER: 198010873
	VISIT DATE: 02/26/2024

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Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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 Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California

Site Supervisor arrived at the facility at around 11:45pm.

There were no deficiencies cited during today’s inspection A notice of site visit was given and must remain posted for 30 days. Appeal rights were given and explained. Exit interview conducted and report was reviewed with the Site Supervisor Rita Cruz.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/26/2024 01:06 PM - It Cannot Be Edited

Created By: Susann Sanchez On 02/26/2024 at 12:34 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: KEPPEL STATE PRESCHOOL	FACILITY NUMBER: 198010873
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/26/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above. This requirement was not met as evidence by the record review. Lead test results showed that one water source had an action level exceedance. This poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/27/2024
	Plan of Correction
1 2 3 4	Facility retested for lead exceedance on 02/24/23. Site supervisor provided LPA a copy of the report dated 03/01/23. Per Site Supervisor will provide LIC 9275 & LIC 9276 by 03/26/24.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Susann Sanchez

LICENSING EVALUATOR SIGNATURE:

DATE: 02/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2024

LIC809 (FAS) - (06/04)

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