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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017001
Report Date: 12/03/2024
Date Signed: 12/03/2024 03:20:27 PM

Document Has Been Signed on 12/03/2024 03:20 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:UNION ELEMENTARY SCHOOL CSPPFACILITY NUMBER:
198017001
ADMINISTRATOR/
DIRECTOR:
NARDULLI, GIUSEPPEFACILITY TYPE:
850
ADDRESS:150 S. BURLINGTON AVENUETELEPHONE:
(213) 483-1345
CITY:LOS ANGELESSTATE: CAZIP CODE:
90057
CAPACITY: 22TOTAL ENROLLED CHILDREN: 16CENSUS: 13DATE:
12/03/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:45 PM
MET WITH:Vanessa Rodriguez, Head TeacherTIME VISIT/
INSPECTION COMPLETED:
03:40 PM
NARRATIVE
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On 12/03/2024 at 12:45 p.m., Licensing Program Analyst (LPA) Saul Valenzuela conducted an unannounced required inspection LPA met with Office Technician whom guided LPA to the preschool room. LPA met with Head Teacher Vanessa Rodriguez, who guided the LPA on a tour of the facility. This is an LAUSD state preschool program located in RM 38 on the premises of Union Avenue Elementary School. This program is licensed for 22 children which operates Monday – Friday from 7:50 a.m. – 2:50 p.m..

All areas identified on the Facility Sketch were inspected. The following staff was present during this inspection: Staff # 1 and Staff # 2 with 13 children. Children left at 1:20 p.m. due to early dismissal. Teacher-child ratios were observed to be in accordance with Title 22 Regulations. Staff names were recorded. All children were observed to be under supervision, including visual supervision, of a teacher at all times. The licensed facility is within the conditions, limitations, and capacity specified on the license.

LPA observed the facility to be clean, sanitary and in good repair. Furniture and equipment was inspected for good repair, free of sharp, loose, or pointed parts. Classroom was inspected to ensure that the floors have a surface that is safe and clean. All toilets and washing facilities are in safe and sanitary operating conditions. All materials and surfaces accessible to children are toxic free. At this time, the nurse's office is used as an isolation area. Parents are contacted immediately when children are determined to be ill and staff are ensuring that children with obvious symptoms of illness are not being accepted.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE: DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/03/2024
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 5
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: UNION ELEMENTARY SCHOOL CSPP
FACILITY NUMBER: 198017001
VISIT DATE: 12/03/2024
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The children enrolled in the state preschool program share a restroom with the Special Ed children enrolled in this school. Per Head Teacher, the school renovated the bathroom to meet ADA requirements which reduced from two toilets to one toilet. All toilets, hand washing, and bathing facilities are safe, sanitary and are operating properly. Children use the shelf located near the entrance to store their personal belongings. LPA observed sleeping arrangements in form of mats.

The facility provides breakfast and lunch. Menus were reviewed to ensure that they are being posted at least one week in advance and visible to an authorized representative. Per Teacher meals are dropped of daily by the cafeteria. All food preparation, and storage areas are clean, free of litter, rubbish, and rodents/vermin. All food is protected from contamination, and LPA inspected that any contaminated food is discarded immediately. There is drinking water available in the classroom via individual water bottles- which are taken outside for children to drink. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are stored in an area inaccessible to children. Per Principal that there are no poisons stored at the facility.

LPA observed that there is smoke detector- At 2:00 p.m. LPA did observed a carbon monoxide detector in the facility. The last Disaster and Fire Drill was conducted on 10/17/2024..

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. Toys and play equipment are brought out daily for children to use. There is adequate shade in the play yard. The yard is shared with the Special Ed class.

Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day.

There is at least one person trained in CPR and Pediatric First Aid present during this inspection. All staff have received an active criminal record clearance as a condition of their employment with the Los Angeles Unified School District.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2024
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: UNION ELEMENTARY SCHOOL CSPP
FACILITY NUMBER: 198017001
VISIT DATE: 12/03/2024
NARRATIVE
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At 1:30 p.m. Staff Records and children's records were reviewed. LPA observed that staff present did not have a complete file and children's records reviewed did not have parents or personal rights form on file.

LPA did not review complete staff files during the inspection due to the staff files being stored at the administrative office. LPA will review staff files at a later time and date. If staff files were to be incomplete during the time and date that LPA reviews files, a case management inspection will occur at the facility to reflect the incomplete files.

AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018 any person who works in a child care facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers. AB1207 certificate was on file for staff present.

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.

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

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2024
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: UNION ELEMENTARY SCHOOL CSPP
FACILITY NUMBER: 198017001
VISIT DATE: 12/03/2024
NARRATIVE
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LPA advised the licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

MyChildCarePlan.org – Centers and Family Child Care Homes
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.

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

At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.

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

Exit interview conducted and report was reviewed with the facility representative Vanessa Rodriguez.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2024
LIC809 (FAS) - (06/04)
Page: 4 of 5