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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198014197
Report Date: 06/07/2022
Date Signed: 06/07/2022 06:07:26 PM

Document Has Been Signed on 06/07/2022 06:07 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:CHILDREN'S BUREAU FAMILY CENTER AT MAGNOLIA PLACEFACILITY NUMBER:
198014197
ADMINISTRATOR:MARY HELEN VASQUEZFACILITY TYPE:
850
ADDRESS:1910 MAGNOLIA AVENUETELEPHONE:
2133420101
CITY:LOS ANGELESSTATE: CAZIP CODE:
90007
CAPACITY: 105TOTAL ENROLLED CHILDREN: 105CENSUS: DATE:
06/07/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:03 PM
MET WITH:Hamideh Kia, Lead Teacher6TIME COMPLETED:
06:13 PM
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On Tuesday, June 7, 2022 at 2:15 p.m. Licensing Program Analyst Mayra Rivera conducted an annual inspection and met with Lead Teacher Hamideh Kia who guided LPA Rivera on a tour of the facility. LPA did not observe any children due to early dismissal at 2:00 p.m.

This is a half day preschool program which consists of four classrooms room 307, 308, 309 and 310 and outdoor play yard. This preschool program operates from 8:30 a.m. to 11:30 a.m. and 12:00 p.m to 3:00 p.m. This site also house a head start center. Sign in and out takes place at the main entrance area. All areas identified on the facility sketch were toured both indoors and outdoors.



At approximately 2:25 p.m. LPA entered classroom 307 to conduct an inspection. LPA Rivera observed age appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age appropriate toys accessible to children. LPA observed individual personal bin containers with children names inside their cubbies with their personal items. LPA observed cleaning solutions stored inside the bottom sink cabinet with a child proof lock in place making it inaccessible for children to reach or open the cabinet door. LPA Rivera observed a trash bin with a tight-fitting lid.

At approximately 2:30 p.m. LPA entered classroom 308 to conduct an inspection. LPA Rivera observed age appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age appropriate toys accessible to children. LPA observed individual personal bin containers with children names inside their cubbies with their personal items. LPA observed cleaning solutions stored inside the bottom sink cabinet with a child proof lock in place making it inaccessible for children to reach or open the cabinet door. LPA Rivera observed a trash bin with a tight-fitting lid.

At approximately 2:40 p.m. LPA entered classroom 309 to conduct an inspection. LPA Rivera observed age appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE: DATE: 06/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/07/2022
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: CHILDREN'S BUREAU FAMILY CENTER AT MAGNOLIA PLACE
FACILITY NUMBER: 198014197
VISIT DATE: 06/07/2022
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appropriate toys accessible to children. LPA observed individual personal bin containers with children names inside their cubbies with their personal items. LPA observed cleaning solutions stored inside the bottom sink cabinet with a child proof lock in place making it inaccessible for children to reach or open the cabinet door. LPA Rivera observed a trash bin with a tight-fitting lid.

At approximately 2:45 p.m. LPA entered classroom 310 to conduct an inspection. LPA Rivera observed age appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age appropriate toys accessible to children. LPA observed individual personal bin containers with children names inside their cubbies with their personal items. LPA observed cleaning solutions stored inside the bottom sink cabinet with a child proof lock in place making it inaccessible for children to reach or open the cabinet door. LPA Rivera observed a trash bin with a tight-fitting lid

LPA Rivera observed two toilets and five sinks between classroom 307 and 308 and two toilets and five sinks between classrooms 309 and 310, two in the play yard and three in the hallway (staff). LPA observed the areas to be in good condition with working toilets, sinks, hand soap dispenser, paper towels. LPA observed a total of 9 toilets and 12 sinks. Ill/isolation area children utilize staff restroom located in the hallway.

At approximately 3:00 p.m. LPA Rivera entered the outdoor playground to conduct an inspection. LPA observed the equipment to be age appropriate and in safe condition, free of sharp, no 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 climbing equipment, are cushioned with cushion padding that absorbs a fall. LPA observed the play structure age appropriate. LPA observed outdoor trash bins with tight fitting lids. For outdoor drinking water, the water jugs are available along with disposable water cups. For adequate shade, LPA observed sun sail triangles. A section of the yard belongs to the Head Start program and LPA observed Head Start area fenced. Head Start outdoor play time is at 9:00 a.m. to 9:50 a.m. Classrooms 310 and 307 outdoor play time starts at 10:00 a.m to 10:30 a.m and classrooms 308 and 309 at 8:30 a.m. to 9:00 a.m.

Heating lighting and ventilation were evaluated by LPA Rivera. LPA observed central AC/heater and vents located on the ceiling wall. The thermostat located in director’s office and the temperature is at 73 degrees. LPA observed the fire extinguishers located inside the lobby and the valve on the required 2A10BC fire extinguisher indicating fully charged and serviced on 06/07/2021. LPA Rivera observed the pull-down alarm system. LPA observed the fire and earthquake drill log. Last drill conducted on 5/24/22 and LPA also observed the first aid kits in each classroom and fully stocked.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2022
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: CHILDREN'S BUREAU FAMILY CENTER AT MAGNOLIA PLACE
FACILITY NUMBER: 198014197
VISIT DATE: 06/07/2022
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LPA did not observe napping equipment because the program does not have a nap time schedule due to the preschool program is half day. For ill/isolation area children utilize the front lobby and a cot is available for children to rest if needed. At approximately 3:30 p.m. LPA Rivera reviewed staff, children files, children roster and sign in/sign out sheets. Child #1 missing LIC 627 Consent for Medical Treatment. Staff # 2 missing Health and Safety (8) hour certification, incorrect First Aid/CPR certification, and AB 1207 Child Abuse Mandated Certificate.

This program provides breakfast and lunch. The meals are provided by a vendor. A monthly menu is available and posted in each classroom. For water drinking LPA observed disposable water cups and water pitcher in each classroom. LPA observed the food preparation area to be clean and free of litter, rubbish, rodents, and/or any other vermin and storage containers for solid waste, including moveable bins with tight-fitting covers that are kept on, and in good repair. The facility was observed to be free of flies, other insects and rodents.



Facility administers medication. Before administrating medication, parents sign a medication consent form, provides the medication in original container with Dr's prescription. At this time, facility has no children with medication.

Director has proof of immunization against pertussis, and measles, and influenza declination. Leach teacher has been informed mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com

Incidental Medical Services (IMS)

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: Karen Chambers
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2022
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: CHILDREN'S BUREAU FAMILY CENTER AT MAGNOLIA PLACE
FACILITY NUMBER: 198014197
VISIT DATE: 06/07/2022
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Criminal Record Statement
Lead Teacher Hamideh Kia was informed 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 Rivera provided technical violations for Staff # 2 missing proof of AB 1207 Child Abuse Mandated Certificate, incorrect First Aid/CPR certification, missing Health and Safety certification. Lead teacher been given a due date of 6/24/22 for corrections.

Notice of Site Visit

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

Exit Interview

Exit interview conducted and report was reviewed with Lead Teacher Hamideh Kia.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2022
LIC809 (FAS) - (06/04)
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