198018207-10-5-2023-33-CC-MSIA-CWBRL4-20231005130631

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198018207
Report Date: 10/05/2023
Date Signed: 10/05/2023 01:06:38 PM

Document Has Been Signed on 10/05/2023 01:06 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	GRACE LUTHERAN CHURCH INFANT CARE CENTER		FACILITY NUMBER:	198018207
ADMINISTRATOR:	CHRISTY ARREGUIN		FACILITY TYPE:	830
ADDRESS:	17880 E. COVINA BLVD		TELEPHONE:	(626) 967-5855
CITY:	COVINA	STATE: CA	ZIP CODE:	91722
CAPACITY: 16	TOTAL ENROLLED CHILDREN: 16	CENSUS: 3	DATE:	10/05/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:25 AM
MET WITH:	Director, Christy Arreguin		TIME COMPLETED:	01:30 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 10/5/2023 at 10:25 AM, Licensing Program Analyst (LPA) Mary Silva arrived at the facility to conduct an unannounced Required – 1 year inspection. LPA met with Director Christy Arreguin and stated the purpose of the visit. LPA provided Director with a copy of the LIC 126 Entrance Checklist to facilitate the inspection. This is an infant program which consists of one classroom and one crib room. Facility hours of operation is from Monday to Friday, 6:30 AM to 5:30 PM. This facility has an infant component license #198018207. LPA inspected all areas identified on the Facility Sketch were inspected. The infant program is located adjacent to the center's pre-school program. The following staff were present during this inspection: Staff #1 with 3 infants. The facility was observed to be within the license capacity and limitations. The following was observed during the tour of the facility: Furniture and equipment were inspected for age appropriateness and good repair. The facility has enough napping equipment, feeding chairs, and changing tables. Infants sleep on the cribs. No infants were observed to be swaddled. Telephone service (land line), heating, lighting and ventilation were evaluated. Infants have their own cubby to store their belongings. Bedding is provided by the parents and is washed at the end of the day, or as needed. Per Director, the isolation area is located in the hallway next to the staff restroom. Age-appropriate sinks and toilets were inspected for availability and good repair in all restrooms. General sanitation was observed. Availability of indoor drinking water was observed in the classroom. LPA observed children's bottles labeled with their names. First Aid supplies were in a cabinet inside the classroom. Page 1 of 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:	DATE: 10/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2023

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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GRACE LUTHERAN CHURCH INFANT CARE CENTER	FACILITY NUMBER: 198018207
	VISIT DATE: 10/05/2023

NARRATIVE

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Disinfectants, cleaning solutions, and other items that are dangerous to infants, were inaccessible to infants. All floors were observed to be clean and safe. All materials accessible to infants were observed to be toxic free.

Per Director, there are no firearms stored on the premises. There are no pools or bodies of water at the facility. Staff stated that there were no poisons stored at the facility. Carbon monoxide and smoke detectors were tested and were working. All food preparation areas and food storage areas are kept clean and are free of litter, rubbish, 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. Infants are on formula and soft foods. LPA observed snack menus posted in the classroom. Food in refrigerator was labeled. Sink counter tops were clean and free of clutter.

At 10:40am, licensing staff reviewed the outdoor play area. 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 high climbing equipment, swings, slides, and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard. Drinking water is readily available outdoors.

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. Disaster drills have been conducted at least every six months.

There is at least one person trained in CPR and Pediatric First Aid present during this inspection. Licensing staff also reviewed staff records. The review of Staff records was documented on the LIC 859. Staff present had proof of the AB 1207 Mandated Reporter Training certificate on file.

Children’s Records were reviewed for completeness; Inspection of required forms was made and documented on the LIC 857.
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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:	DATE: 10/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2023

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GRACE LUTHERAN CHURCH INFANT CARE CENTER	FACILITY NUMBER: 198018207
	VISIT DATE: 10/05/2023

NARRATIVE

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Director 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.

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.

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

Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:	DATE: 10/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2023

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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GRACE LUTHERAN CHURCH INFANT CARE CENTER	FACILITY NUMBER: 198018207
	VISIT DATE: 10/05/2023

NARRATIVE

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Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For childcare center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). Licensing staff verified that the lead testing was completed in June 2022. Director submitted to Regional Office, LIC 999, LIC 9275 & LIC 9276 in August of 2022.

At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview was conducted with the director Christy Arreguin, and appeal rights were given.

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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:	DATE: 10/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2023

LIC809 (FAS) - (06/04)

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