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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198014862
Report Date: 05/31/2023
Date Signed: 05/31/2023 01:42:14 PM

Document Has Been Signed on 05/31/2023 01:42 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:CALVARY CHAPEL CHRISTIAN PRESCHOOLFACILITY NUMBER:
198014862
ADMINISTRATOR:DENISSE CARDENASFACILITY TYPE:
850
ADDRESS:12808 WOODRUFF AVENUETELEPHONE:
(562) 299-9100
CITY:DOWNEYSTATE: CAZIP CODE:
90242
CAPACITY: 95TOTAL ENROLLED CHILDREN: 95CENSUS: 0DATE:
05/31/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:46 AM
MET WITH:Ruby Saucedo, DirectorTIME COMPLETED:
01:43 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
On Wednesday, May 31, 2023, at 10:10 a.m. Licensing Program Analyst (LPA) Mayra Rivera conducted an unannounced annual inspection and met with director Ruby Saucedo who guided LPA Rivera on a tour of the facility.

This is a preschool program that serves children ages 2 through kindergarten. This program operates Monday - Friday 7:30 a.m. - 5:30 p.m. Sign in and out takes place at the main entrance area. All areas identified on the facility sketch were toured and inspected both indoors and outdoors. Teacher and child ratio were not observed because children are on summer break.



At approximately 10:23 a.m. LPA entered classroom 116 and did not observed children. 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 cleaning solution stored inside high-top cabinet making it inaccessible for children to reach. LPA Rivera observed a step trash bin with a tight-fitting lid.

At approximately 10:29 a.m. LPA entered classroom 115 and did not observed children. 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 cleaning solution stored inside high-top cabinet making it inaccessible for children to reach. LPA Rivera observed a step trash bin with a tight-fitting lid.

At approximately 10:35 a.m. LPA entered classroom 114 and did not observed children. 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 cleaning solution stored inside high-top cabinet making it inaccessible for children to reach. LPA Rivera observed a step trash bin with a tight-fitting lid.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE: DATE: 05/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/31/2023
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 6
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: CALVARY CHAPEL CHRISTIAN PRESCHOOL
FACILITY NUMBER: 198014862
VISIT DATE: 05/31/2023
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
At approximately 10:39 a.m. LPA entered classroom 113 and did not observed children. 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 cleaning solution stored inside high-top cabinet making it inaccessible for children to reach. LPA Rivera observed a step trash bin with a tight-fitting lid.

At approximately 10:45 a.m. LPA entered classroom 112 and did not observed children. 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 cleaning solution stored inside high-top cabinet making it inaccessible for children to reach. LPA Rivera observed a step trash bin with a tight-fitting lid.

At approximately 10:49 a.m. LPA entered classroom 118 and did not observed children. 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 cleaning solution stored inside high-top cabinet making it inaccessible for children to reach. LPA Rivera observed a step trash bin with a tight-fitting lid.

At approximately 11: 08 a.m LPA Rivera observed the bathrooms to be in good condition with working toilets, sinks, hand soap dispenser and paper towels. LPA observed a total of 8 toilets and 2 sinks with 4 washing sensors ( 4 on each sink) . Ill/isolation area children utilize one stall which is labeled ill/isolation.

At approximately 11:18 a.m. LPA entered the outdoor playground to conduct and inspection. LPA observed the equipment to be in a safe condition, free of sharp,no lose 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, slides, and similar equipment are cushioned with granulated rubber material that could absorb a fall. For adequate shade, LPA observed shade structure. Availability of outdoor drinking water, facility brings out the water jug and disposable cups. No bodies of water were observed on the premises.

.

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

DATE: 05/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2023
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: CALVARY CHAPEL CHRISTIAN PRESCHOOL
FACILITY NUMBER: 198014862
VISIT DATE: 05/31/2023
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
Heating lighting and ventilation were evaluated by LPA Rivera. LPA observed AC/heater located on the wall. LPA observed the current room temperature to be at 70 degrees. LPA observed the fire extinguishers located in the hallways and the valve on the required 2A10BC fire extinguishers indicating fully charged and serviced on 3/10/23. LPA Rivera observed smoke detectors and fire alarm system. LPA did not test the smoke detector as they are wired to the fire alarm system. LPA observed carbon monoxides in the classroom and tested the alarm in classroom 115. LPA observed the first aid kits to be fully stocked with band aids, gauzes, adhesive bandages and antiseptics and located inside red backpacks located in the classrooms. LPA observed the fire/earthquake log and last drill conducted on 4/26/23. No medications onsite.

LPA Rivera asked if there are any poisons, firearms, weapons or bodies of water. director stated she has no firearms, or weapons nor water bodies of water. LPA did not observe firearms or weapons, poisons, nor bodies of water.



LPA observed napping equipment cots to be in good condition. For ill/isolation area children utilize the main office.

This program provides a.m. snack, lunch, and p.m. snacks. Meals are prepared on site. A monthly menu is available and posted on the parent board and playground app. For water drinking LPA observed a water jug and small water bottles. 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 has not conducted the lead testing.

LPA observed on the bulletin wall the license, Parents Right's, Personal Rights, LIC 610 Emergency Disaster Plan, Facility Sketch, LIC 9148 Earthquake Checklist, PUB 269 Child Passenger System Poster, monthly Menu and Daily Schedule. LPA did not observe sign in or out sheets because no children were present during this visit.

LPA also reviewed the children and staff files and observed the files to be completed.

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

DATE: 05/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2023
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: CALVARY CHAPEL CHRISTIAN PRESCHOOL
FACILITY NUMBER: 198014862
VISIT DATE: 05/31/2023
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
Director Ruby Saucedo missing pediatric First Aid/CPR certification and lead component. Director has proof of preventative health and safety training, child abused mandated certification (AB 1207) dated 4/22/23 and has proof of immunization against pertussis, and measles, and influenza. Director has been informed mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com

Items discussed during this visit:

1. The following items are prohibited by Licensing: Refused Entry to a Facility or Any Part of a Facility is a violation of Section 1596.852, 1596.853 or 1597.09. Regulations 101238 (g) (2), The Presence of an Excluded Individual, Fire Clearance Violations, Accessible Bodies of Water, Accessible Firearms, Ammunition or Both

2. Breakfast/Lunch/Snack Menus: Menus are required to be posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days must also be available upon request.



3. Current Children’s Roster: Each childcare facility shall maintain a current roster of children who are provided care in the facility. The roster shall include the name, address, and daytime telephone number of the child's parent or guardian, and the name and telephone number of the child's physician. This roster shall be available to the licensing agency upon request.

4.LIC 311A - Records to be Maintained at the Facility: LPAs advised that forms, regulations and quarterly updates can be accessed on the Child Care Licensing website at: www.ccld.ca.gov.

5.Pediatric First Aid and CPR: At least one person trained in Pediatric First Aid and CPR must be present.
6.Designated Staff: The name of the childcare center director or fully qualified teacher(s) designated to act in the director's absence must be on file.
7.Qualifications: Educational background, training, and/or experience for each staff present must be available for review

8. Immunization Requirements: Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles

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

DATE: 05/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2023
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: CALVARY CHAPEL CHRISTIAN PRESCHOOL
FACILITY NUMBER: 198014862
VISIT DATE: 05/31/2023
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
9.Children’s Records: must be available for review; including but not limited to, the following: Name, address and telephone number of the child's authorized representative and of relatives or others who can assume responsibility for the child if the authorized representative cannot be reached when necessary.
10.Incidental Medical Services (IMS): This facility provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A Plan of Operation that includes IMS must be submitted to the Department. (An IMS Plan was provided with the application and will be reviewed).
11.Liability insurance was also discussed.
12.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

Master teacher Ruth Munoz 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 1 technical violation. Technical violation given due to not having the kitchen sink tested for lead.

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 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

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Master Teacher Ruth Munoz.

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

DATE: 05/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2023
LIC809 (FAS) - (06/04)
Page: 6 of 6