<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198014169
Report Date: 11/28/2023
Date Signed: 11/29/2023 08:28:40 AM


Document Has Been Signed on 11/29/2023 08:28 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:KIDS KLUB SAN GABRIEL / ROSEMEADFACILITY NUMBER:
198014169
ADMINISTRATOR:MARIA RENNARDFACILITY TYPE:
840
ADDRESS:4930 EARLE AVENUETELEPHONE:
(626) 288-4400
CITY:ROSEMEADSTATE: CAZIP CODE:
91770
CAPACITY:40CENSUS: 6DATE:
11/28/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
02:08 PM
MET WITH:Maria Rennard, DirectorTIME COMPLETED:
04:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Thelma Razo conducted an unannounced Required - 3 year inspection. LPA met with Director Maria Rennard and stated the purpose of the visit. LPA provided Director with a copy of the Entrance Checklist for Child Care Centers form (LIC 125). A COVID 19 risk assessment was conducted prior to entering the facility. This is a school age program which consists of 2 classrooms. There are 2 other licenses under this facility: Preschool Program #198014168 & Infant Program #198014170. Hours of Operation: Monday through Friday, 7am to 7pm.

Director guided LPA on a tour of the facility which consists of 2 rooms and outdoor play area. There were 6 children with one teacher during inspection.

Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. All toilets, hand washing, and bathing facilities are safe, sanitary and are operating properly. All floors are clean and safe. All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish and 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. Drinking water is readily available both indoors and outdoors. The facility was observed to be free of flies, other insects and rodents.



Outdoor playground equipment is in 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 play structure, swings, slides, and similar equipment are cushioned with material that absorbs a fall. The school age children use the same outside space with the preschoolers on staggered basis. Outdoor waiver is on file.
Page 1 of 3
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Thelma RazoTELEPHONE: (323) 981-3387
LICENSING EVALUATOR SIGNATURE:
DATE: 11/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/28/2023
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 3


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: KIDS KLUB SAN GABRIEL / ROSEMEAD
FACILITY NUMBER: 198014169
VISIT DATE: 11/28/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Individuals present have obtained a criminal record clearance or criminal record exemption. There is at least one person trained in CPR and Pediatric First Aid was present during this visit. The name of the child care center director or fully qualified teacher designated to act in the director's absence is on file. Educational background, training, and/or experience for each staff present are on file and were reviewed.

Snack 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. Snacks were reviewed for availability, quantity and appropriateness to children in care. This facility provides breakfast, AM snack, lunch, and PM snack. However, since the school age children typically arrive after school they are served PM snacks on most occasions.

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 the licensee to access forms, regulations, and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

Analyst reviewed new Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, which requires the testing of water for lead in Child Care Centers (CCCs) with facility director during the inspection. Per AB 2370, all CCCs that are in buildings constructed before January 1, 2010, must have their water tested and post the results by January 1, 2023, and every 5 years after the date of the first testing. Per Director, facility passed the lead testing which was done on December 19, 2022.

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



Page 2 of 3
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Thelma RazoTELEPHONE: (323) 981-3387
LICENSING EVALUATOR SIGNATURE:

DATE: 11/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: KIDS KLUB SAN GABRIEL / ROSEMEAD
FACILITY NUMBER: 198014169
VISIT DATE: 11/28/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Notice of Site Visit (LIC 9213) must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

No deficiencies were cited under Title 22 at this time.

Exit interview was conducted with Director Maria Rennard. Appeal Rights and copy of report provided.

Page 3 of 3
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Thelma RazoTELEPHONE: (323) 981-3387
LICENSING EVALUATOR SIGNATURE:

DATE: 11/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2023
LIC809 (FAS) - (06/04)
Page: 3 of 3