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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198012202
Report Date: 11/03/2022
Date Signed: 11/03/2022 11:30:08 AM

Document Has Been Signed on 11/03/2022 11:30 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:COLLINS STATE PRESCHOOLFACILITY NUMBER:
198012202
ADMINISTRATOR:GARCIA, ELIDAFACILITY TYPE:
850
ADDRESS:6125 COKE STREETTELEPHONE:
(562) 602-6909
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY: 25TOTAL ENROLLED CHILDREN: 14CENSUS: 13DATE:
11/03/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Lead Teacher - Diana AmezcuaTIME COMPLETED:
11:45 AM
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Licensing Program Analyst (LPA) Randy Derraco conducted an unannounced required on year inspection to the above facility on 11/03/22 at 9:30 AM. LPA met with Diana Amezcul, Lead Teacher, who guided analyst on a tour of the facility. LPA continued the tour with Program Director, Rita Cruz, at 10:15 AM.

This is a half day preschool program that operates Monday-Friday from 7:50 AM to 10:50 AM.

There were 13 children and 3 staff present when LPA arrived. Facility is in compliance with license capacity and ratio guidelines. All individuals present have obtained a criminal record clearance or criminal record exemption as a condition of employment with the Paramount Unified School District.

LPA toured room 5. Room 5 had furniture in good condition, free of loose, sharp and/or pointed parts. The floors and surfaces in the classrooms were clean and safe. Rugs were observed to be flat on the ground to avoid tripping hazards. Water is made readily available via water bottles that are brought from home. A water filter connected to a water fountain was observed in the play ground area. Per teacher, water jugs are filled with filtered water and distributed to children in care. Lead teacher states that children's medication is stored in a locked closet along with first aid supplies Per lead teacher, no child currently enrolled requires prescription medication. Children have cubbies to store personal belongings separate from each other. LPA toured the children’s restrooms. Restrooms were observed to be safe and sanitary with operable sinks and toilets.

LPA toured outdoor play area. Outdoor area were observed to have age appropriate toys and material for children, free of loose, sharp, and/or pointed parts. LPA observed required cushioning under climbing structure to absorb fall. Shade was observed throughout the outdoor area. Water bottles are taken outdoors for children and water fountains are available.
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE: DATE: 11/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/03/2022
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 2
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: COLLINS STATE PRESCHOOL
FACILITY NUMBER: 198012202
VISIT DATE: 11/03/2022
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LPA observed required posted documentation at the entrance to the classroom, which included, Facility License, Publication (PUB) 393- Notification of Parent Rights, Licensing Form (LIC) 610- Facility Disaster Plan, PUB 269- Child Passenger Restraint System, LIC 613A- Notification of Personal Rights and Lunch/Snack Menu. All items were observed. Facility records were reviewed for Daily schedules and Disaster drill log, last drill conducted on 10/20/22. All items were observed. Pre-school program only provides breakfast. Food is prepared at the cafeteria on campus and is brought to children in care. Cleaning supplies are stored separate from the food. LPA reviewed Sign In/Out sheets located at the room entrance. All children present were signed in with date, time and full signature of the teacher who receives the child.

Children’s records were reviewed for Emergency Card, Immunization Records, Licensing Form (LIC) 627- Consent for Medical Treatment, LIC 995 Notification of Parents’ Rights, LIC 701- Physician’s Report, LIC 613A- Personal Rights, and signed Admissions Agreement. All documents were complete. Per Program Director, staff records are kept at the Paramount Unified School District central office. Staff records were not available for review.

During inspection all children were observed to be treated with dignity and respect, they were observed to be receiving safe, healthful and comfortable accommodations, furnishings and equipment, and free from corporal and/or unusual punishment.

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


Based on the LPA's observations and records review no deficiencies will be cited today 11/03/22

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Lead Teacher Diana Amezcua. .
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2022
LIC809 (FAS) - (06/04)
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