198012841-11-14-2024-54-CC-KDUP-DAZVGV-20241114152610

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198012841
Report Date: 11/14/2024
Date Signed: 11/14/2024 03:26:30 PM

Document Has Been Signed on 11/14/2024 03:26 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	LINDBERGH PRESCHOOL		FACILITY NUMBER:	198012841
ADMINISTRATOR/ DIRECTOR:	MARIANA COVARRUBIAS		FACILITY TYPE:	850
ADDRESS:	3300 CEDAR AVE		TELEPHONE:	(310) 603-2082
CITY:	LYNWOOD	STATE: CA	ZIP CODE:	90262
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 18	DATE:	11/14/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:30 AM
MET WITH:	Giselle Ochoa, Education Specialist		TIME VISIT/ INSPECTION COMPLETED:	01:20 PM

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On November 15, 2024 at 11:30a.m., Licensing Program Analysts (LPAs) Keneisha Dunlap and Jeanette Estrada arrived at the above facility for the purpose of an unannounced Annual Inspection. LPA Estrada announced the purpose of the visit and was granted entry into the facility by Education Specialist Giselle Ochoa, and guided LPA’s on tour of facility by Lead Teacher Angela Porter. There were 24 children enrolled, 18 children present, and 5 staff present at the time of inspection. The hours of operation are Monday-Friday from 8:00a.m.-11:00a.m. & 11:45AM.- 2:45p.m. All adults at the facility were discussed and background and fingerprinted cleared. License, facility sketch, disaster plan, parent rights, and PUB 393 posted. Facility does have a current disaster log drill with date of 10/17/24. Facility does have current LIC9040 (facility roster). The school district off site facility provides all meals for children at center. The center has menus posted in classrooms along with allergy list in the classrooms and kitchen. Daily schedule are posted in each classroom. LIC 500 was available for review. There is a working landline in classroom. LPA's observed a first aid kit with all required components. The facility did not have Lead Testing certificate. This poses/posed an immediate health, safety or personal rights risk to persons in care. A Type A citation will be issued.

The facility has 1 classroom that includes cabinet space for material and supplies with a sink for hand washing and drinking fountain spout. LPA's observed cleaning solutions inaccessible for children to reach inside of teachers workroom with inaccessible locked cabinet. The classrooms have age appropriate tables, cubbies for personal belongings, dramatic play area, library, and age appropriate toys. All electrical outlets in the classroom were covered. There are sinks in the classroom that are accessible to children during indoor play. The parents sign in and out daily through QR Scan Code. LPA’s observed all furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts.

There are 2 bathrooms in classroom with each bathroom having with 1 toilet, 1 sink, and 1 soap dispenser. Both bathrooms sinks and toilets are in good working good condition.

All trash cans in classrooms, and outside have lids. The outdoor area has rubber mat area where the slide structure. There are age appropriate toys, and bikes. Page 1 of 3

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Keneisha Dunlap
LICENSING EVALUATOR SIGNATURE:	DATE: 11/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2024

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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LINDBERGH PRESCHOOL	FACILITY NUMBER: 198012841
	VISIT DATE: 11/14/2024

NARRATIVE

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Water bottles with children names and/or water fountain inside are accessible to children during outdoor play. There is a shade structure. There are picnic tables are. LPA’s observed all furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts.

At 11:45a.m. LPA's observed a storage area where outside play materials are stored the gate that is wide enough for making the area accessible to children. This poses/posed a potential health, safety or personal rights risk to persons in care. A Technical Violation will be cited.

At 11:50a.m., LPA's observed a thorned tree on playground area. This poses/posed a potential health, safety or personal rights risk to persons in care. A Technical Violation will be cited.

There are no napping cots because this is a part day program.

LPA's observed a fire extinguisher with 10/25/24.

LPA's observed a operable carbon monoxide and smoke detector.

There are no pets in the classroom.

Children who need medication are administered medication by the nurses office. The nurse office was closed at time if inspection. LPA's are recommending that when the office is closed for lunch that an authorized representative have access to medication to ensure that all children are administered medication in an emergency.

Staff # 1- All required licensing forms, immunization's, and CTC Permit in file.

Mandated reporter- 9/18/26

Expired CPR & First Aid 8/12/24, LIC 9052 not filled out correctly.

Staff # 2- Immunization Record in file.

Mandated reporter- 9/29/25

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SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Keneisha Dunlap
LICENSING EVALUATOR SIGNATURE:	DATE: 11/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2024

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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LINDBERGH PRESCHOOL	FACILITY NUMBER: 198012841
	VISIT DATE: 11/14/2024

NARRATIVE

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CPR & First Aid 9/29/25

All licensing forms not filled out correctly, and no transcripts,

Staff # 3-Staff file missing all required licensing forms, immunization record, CPR & First Aid, Mandated Reporter Certificate, and transcripts.
Staff 2 & 3 missing all required licensing documents, and transcripts- This poses/posed a potential health, safety or personal rights risk to persons in care. A Type B Violation will be cited.

Staff # 4-LIC 501 not filled out correctly, LIC 9108 not filled out correctly, and no transcripts.

Mandated reporter- 8/22/25

CPR & First Aid- 3/18/25

Staff 3 & Staff 4- fingerprints are not associated with facility This poses/posed a potential health, safety or personal rights risk to persons in care. A Type B Violation will be cited.

Children Files-

Child #1 - all required licensing forms are in file. Immunization records are in file. No admission agreement.

Child #2- all required licensing forms are in file. Immunization records are in file. No admission agreement.

Child # 3- all required licensing forms are in file. Immunization records are in file. No admission agreement. Child # 4- all required licensing forms are in file. Immunization records are in file. No admission agreement.

Child #5- all required licensing forms are in file. Immunization records are in file. No admission agreement.

5 out 5 children files did not have an admission agreement. This poses/posed a potential health, safety or personal rights risk to persons in care. Technical assistance will be cited.

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. Page 3 of 5

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Keneisha Dunlap
LICENSING EVALUATOR SIGNATURE:	DATE: 11/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2024

LIC809 (FAS) - (06/04)

Page: 3 of 10

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LINDBERGH PRESCHOOL	FACILITY NUMBER: 198012841
	VISIT DATE: 11/14/2024

NARRATIVE

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Criminal Record Clearance - Child Care Centers Education Specialist Giselle Ochoa 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.

Lead Testing

CCC DID NOT COMPLETE TESTING PRIOR TO THEIR DEADLINE

LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the

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SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Keneisha Dunlap
LICENSING EVALUATOR SIGNATURE:	DATE: 11/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2024

LIC809 (FAS) - (06/04)

Page: 4 of 10

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LINDBERGH PRESCHOOL	FACILITY NUMBER: 198012841
	VISIT DATE: 11/14/2024

NARRATIVE

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MyChildCarePlan.org

Education Specialist Giselle Ochoa 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.

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

Appeal rights reviewed and given to the Education Specialist Giselle Ochoa.

1 Type A Violation, 2 Technical Violations, 1 Technical Assistance, 2 Type B Violations cited during todays inspection.

Exit interview conducted and report was reviewed with Education Specialist Giselle Ochoa.

Based on this information the following deficiencies on the LIC 809 D are being cited today 11/14/24.

LPA's Keneisha Dunlap and Jeanette Estrada informed Education Specialist Giselle Ochoa that this report date 11/14/24 document(s) 1 Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA's LPA's Keneisha Dunlap and Jeanette Estrada informed the Education Specialist Giselle Ochoa to provide a copy of this licensing report dated 11/14/24 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.
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SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Keneisha Dunlap
LICENSING EVALUATOR SIGNATURE:	DATE: 11/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2024

LIC809 (FAS) - (06/04)

Page: 5 of 10

Document Has Been Signed on 11/14/2024 03:26 PM - It Cannot Be Edited

Created By: Keneisha Dunlap On 11/14/2024 at 02:36 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: LINDBERGH PRESCHOOL	FACILITY NUMBER: 198012841
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/14/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

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, the licensee did not comply with the section cited above in the facility did not have Lead Test which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 12/13/2024
	Plan of Correction
1 2 3 4	LPA gave PIN and instructions on how to complete Lead Test Lead Test must be completed by POC date. Provide proof of lead testing to LPA on or before the POC date my means of email.

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:

Karen Chambers

LICENSING EVALUATOR NAME:

Keneisha Dunlap

LICENSING EVALUATOR SIGNATURE:

DATE: 11/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2024

LIC809 (FAS) - (06/04)

Page: 6 of 10

Document Has Been Signed on 11/14/2024 03:26 PM - It Cannot Be Edited

Created By: Keneisha Dunlap On 11/14/2024 at 02:36 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: LINDBERGH PRESCHOOL	FACILITY NUMBER: 198012841
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/14/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.871(c)(1)(A)

Administration of Child Day Care Licensing

Subsequent to initial licensure, a person specified in subdivision (b) who is not exempt from fingerprinting shall obtain either a criminal record clearance or an exemption from disqualification, pursuant to subdivision(f) of this section or Section 1522.7, from the State Department of Social Services prior to employment, residence, or initial presence in the facility. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 2 out 4 staff did not have fingerprints associated with the facility, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/21/2024
	Plan of Correction
1 2 3 4	The adminstration must associate all staff with facility. The amisntration must show proof that all staff have been associated with facility on or before POC date via email to LPA.

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
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 2 out of 4 staff records did not have all required licensing documents, and transcripts which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/06/2024
	Plan of Correction
1 2 3 4	Staff must obtain mandated reporter, complete all licensing files, obtain immunization records, and transcripts by POC date. All proof of documents must be submited to LPA via email by POC 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:

Karen Chambers

LICENSING EVALUATOR NAME:

Keneisha Dunlap

LICENSING EVALUATOR SIGNATURE:

DATE: 11/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2024

LIC809 (FAS) - (06/04)

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