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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020175
Report Date: 03/20/2023
Date Signed: 03/20/2023 03:19:55 PM

Document Has Been Signed on 03/20/2023 03:19 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:KIDSZONE PRESCHOOL ACADEMYFACILITY NUMBER:
198020175
ADMINISTRATOR:LIZETTE PIZARROFACILITY TYPE:
830
ADDRESS:1206 LINCOLN AVETELEPHONE:
(626) 345-5922
CITY:PASADENASTATE: CAZIP CODE:
91103
CAPACITY: 18TOTAL ENROLLED CHILDREN: 18CENSUS: 11DATE:
03/20/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Yvonne WithersTIME COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) Crystal Green conducted an unannounced required 1 year inspection. Licensing Staff met with Director, Yvonne Withers. Facility operation hours are from Monday to Friday from 7:00 AM to 6:00 PM. There is also preschool program on the same premises with facility number 198020176. There are no shared areas between the programs. LPA observed the programs to be physical separate from both indoors and outdoors.

This infant program also has a toddler option program. This facility has 2 classrooms: Infant Room and Red Room (Toddler’s). During this inspection, LPA observed 4 infants with 2 staff in the Infant room and 7 toddlers with 2 staff in the Red Room. All infants were observed by LPA to be under visual supervision of a teacher at all times. The Licensee is within the conditions, limitations, and capacity specified on the license. Sign in and out sheets was 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.

LPA observed the changing table and feeding chairs to be operational condition. There is a sink located within arm’s reach of the changing table. LPA observed the designated napping area to contain 6 cribs, however there are cots available for the older infants to nap. Storage for children's belongings were inspected. LPA observed each child to have their own cubbies. Food is provided by the parents. LPA observed that all food brought from home contains the child’s name on the outside and is protected from contamination.

Licensing staff observed the facility to be clean, safe, sanitary and in good repair. Furniture and equipment were inspected for good repair, free of sharp, loose, or pointed parts. Napping equipment was observed in form of cribs and cots. There are age appropriate toys and supplies for children in the classroom, in good repair. There is a changing table within arm's reach of a sink located in both classrooms. LPA observed it to be clean.
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE: DATE: 03/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/20/2023
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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: KIDSZONE PRESCHOOL ACADEMY
FACILITY NUMBER: 198020175
VISIT DATE: 03/20/2023
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The facility was observed to have diapers and wipes available in each classroom near the changing table. Drinking water is available in form of personal water bottles that are also taken outside when needed. At this time, the Director'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.

The parents provide formula and snacks for the younger infants. All kitchen, food preparation, and storage areas are clean, free of litter, rubbish, and rodents/vermin. All storage containers for solid waste, including moveable bins, have tight fitting covers on and are in good repair. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are stored in an area inaccessible to children. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. The facility takes measures to keep the facility free of flies, other insects and rodents. Per Director, facility does not use water from the faucets to prepare food or to provide water to the children in care. Facility utilizes bottled water from local stores.

The Infant program has their own outdoor play yard, LPA observed it to be physically separated from the preschool outdoor play yard. Outdoor play equipment is in good condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe and is free of hazards.

Staff Records were reviewed to ensure that a health screening report is on file. Children’s Records were reviewed to ensure that Identification and Emergency form and a medical assessment are on file. Criminal Records Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed.
LPA discussed the safe sleep regulations with Director 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 Director 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.
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2023
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: KIDSZONE PRESCHOOL ACADEMY
FACILITY NUMBER: 198020175
VISIT DATE: 03/20/2023
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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 Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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
At this time, the licensee is in compliance with California Title 22 Regulations. 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.

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.

Exit interview conducted and report was reviewed with the Director.
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2023
LIC809 (FAS) - (06/04)
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