198014862-3-21-2025-54-CC-ACAR-DEYKUL-20250321081256

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198014862
Report Date: 03/20/2025
Date Signed: 03/21/2025 08:13:04 AM

Document Has Been Signed on 03/21/2025 08:13 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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	CALVARY CHAPEL CHRISTIAN PRESCHOOL		FACILITY NUMBER:	198014862
ADMINISTRATOR/ DIRECTOR:	RUBICELY SAUCEDO		FACILITY TYPE:	850
ADDRESS:	12808 WOODRUFF AVENUE		TELEPHONE:	(562) 299-9100
CITY:	DOWNEY	STATE: CA	ZIP CODE:	90242
CAPACITY: 95	TOTAL ENROLLED CHILDREN: 64	CENSUS: 38	DATE:	03/20/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:35 AM
MET WITH:	Rubicely Saucedo		TIME VISIT/ INSPECTION COMPLETED:	04:40 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 March 20, 2025, at 11:35 am Licensing Program Analyst (LPA) A. Carter conducted an unannounced Annual Required Inspection and met with Facility Representative (FR) Rubicely Saucedo. LPA disclosed the purpose of the inspection and was granted entry into the facility by licensee. LPA was taken on a guided tour of both indoors and outdoors of the facility. LPA observed Teacher-child ratios, and recorded staff names. All present center staff had fingerprint clearance and are associated to the facility during today’s inspection. Parent use QR code to sign children in and out. Sign-in and out sheets and procedures were reviewed. Personal Rights of children were observed by LPA.Care and supervision were evaluated, it is determined that the basic needs and personal rights of children are met and appropriate. The hours of operation are 7:30 am – 5:30 pm, Monday - Friday. Beginning June 2, 2025, summer session will be held from 7:30 am – 5:00 pm Monday – Friday. Facility is currently licensed for a capacity of 95. At the initial start of the site visit, there is a total census of 38 children and a total census of 6 teachers present. The facility is made up of 7 classrooms. Little Koalas (2yr old class) had 7 children and 2 staff, Playful Pandas (3yr old class) had 11 children and 1 staff, Blissful Bears (Pre-K) had 11 children and 1 staff, Fantastic Fox (Pre-K) had 10 children and 1 staff at time of inspection. LPA observed the Napping room, Ministry room, and Loyal Lions (Pre-K) to be empty. Class is held on Monday, Wednesday, and Friday in the Loyal Lions room. LPA observed all posting requirements for operation on the posting board and the following documents were observed LIC 203A-License, LIC 610 A-Emergency Disaster Plan, LIC 9148-Earthquake Preparedness Check List, PUB 394-Notification of parent’s rights poster, LIC 613A- Personal Rights, PUB 269- Child Car Seat Law, Menus, and Activity Schedule. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting, and ventilation were evaluated. Children napping equipment met the requirement regulation at time of inspection. Storage for children's belongings, bathrooms facilities, and isolation areas were inspected.

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Andrea Carter
LICENSING EVALUATOR SIGNATURE:	DATE: 03/20/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025

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: CALVARY CHAPEL CHRISTIAN PRESCHOOL	FACILITY NUMBER: 198014862
	VISIT DATE: 03/20/2025

NARRATIVE

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Age-appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, safety, and sanitation. LPA 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. LPA observed cubbies with wooden toys, puzzles, books, and other appropriate toys to be clean and free of hazards at time of inspection. LPA observed carpets and age-appropriate tables and chairs in each classroom. LPA observed red backpacks for first aid kept in each classroom. Isolation area is the main office supervised and away from other children in care.

Menus were reviewed at time of inspection. This facility provides AM/PM snacks and hot lunch is prepared daily at the school cafeteria for children enrolled in the lunch program. Food and snack items are properly stored. Food preparation area was toured and found in compliance for safety, cleanliness, and proper storage. Children bring their own labeled water bottles from home. Drinking water is also provided by the facility if children forget to bring water bottle. Facility has not conducted the lead testing. A representative from the Water Board inspected the site on 09/25/24.

Carbon monoxide and smoke detectors are present in the facility and observed to be operable. LPA did not test the smoke detectors as they are wired to the fire alarm system. LPA observed carbon monoxide detectors in each classroom. The fire extinguishers located in the hallways were observed by LPA. The valve on the required 2A10BC fire extinguishers indicating fully charged and serviced on 3/19/25. Disaster drill logs observed with last drill conducted on 01/27/25. Hazardous items including poisonous cleaning compounds were stored inaccessible area to children. A review of medication policy, including administering, labeling, storage, and records was made.

At 11:55 am, outdoor equipment was inspected for safety, cushioning material, good repair, and age-appropriateness. LPA observed bikes, a play structure with plastic slides, and other age-appropriate toys around the play yard. Required shade and fencing were inspected. LPA advised Director that the children should always be within the direct care and visual supervision by the teachers. Per Director, the children have access to drinking water via water bottles. Play area was inspected for hazards and inaccessibility to bodies of water; no bodies of water or hazards observed at time of inspection.

A Beginning at 12:15 pm, staff and children’s records were reviewed for completeness. Inspection of required forms was made and documented on the LIC 857 for children and the LIC 859 for staff.

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Andrea Carter
LICENSING EVALUATOR SIGNATURE:	DATE: 03/20/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025

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: CALVARY CHAPEL CHRISTIAN PRESCHOOL	FACILITY NUMBER: 198014862
	VISIT DATE: 03/20/2025

NARRATIVE

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LPA observed current CPR and First Aid Certification for center staff. Directors’ Pediatric CPR / first aid card expires on 08/01/25 and Mandated Reporter training completed on 04/22/23, valid for 2 years. 4 out of 9 staff had expired Mandated Reporter certificates in file, a deficiency will be cited.

The following were discussed with the Director: The fire extinguisher type 2A10BC must be serviced annually or as often as necessary. Smoke and Carbon Monoxide detectors should be checked, and batteries replaced as needed. Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your location. The Director was also advised of the requirement to report Unusual Incidents and/or injuries to the parent/guardian and to CCL within the time frame specified by the regulation.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms.
To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

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.

Facility representative 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.

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Andrea Carter
LICENSING EVALUATOR SIGNATURE:	DATE: 03/20/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025

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: CALVARY CHAPEL CHRISTIAN PRESCHOOL	FACILITY NUMBER: 198014862
	VISIT DATE: 03/20/2025

NARRATIVE

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LPA referred facility representative to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

LPA discussed the safe sleep regulations with FR and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed FR of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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 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 ADA are available at: https://www.ada.gov/resources/child-carecenters/.

Facility representative 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.

Based on this information, the following deficiencies on the attached LIC 809D are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

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

Exit interview was conducted and report was reviewed with the Facility representative, Rubicely Saucedo.

Appeal Rights Given

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Andrea Carter
LICENSING EVALUATOR SIGNATURE:	DATE: 03/20/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/21/2025 08:13 AM - It Cannot Be Edited

Created By: Andrea Carter On 03/20/2025 at 04:21 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: CALVARY CHAPEL CHRISTIAN PRESCHOOL	FACILITY NUMBER: 198014862
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/20/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

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 4 out of 5 staff did not have the required Mandated Reporter training on file. Certificates in files were expired, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/04/2025
	Plan of Correction
1 2 3 4	Facility representative will have staff complete Mandated Reporter Training and submit certificates to LPA via email as proof of correction by the agreed upon date.

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:

Denise Gibbs

LICENSING EVALUATOR NAME:

Andrea Carter

LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025

LIC809 (FAS) - (06/04)

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