198020176-6-5-2023-33-CC-CGRN-CSHPQD-20230605113058

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020176
Report Date: 06/05/2023
Date Signed: 06/05/2023 11:31:09 AM

Document Has Been Signed on 06/05/2023 11:31 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	KIDSZONE PRESCHOOL ACADEMY		FACILITY NUMBER:	198020176
ADMINISTRATOR:	YVONNE WITHERS		FACILITY TYPE:	850
ADDRESS:	1206 LINCOLN AVE		TELEPHONE:	(626) 345-5922
CITY:	PASADENA	STATE: CA	ZIP CODE:	91103
CAPACITY: 33	TOTAL ENROLLED CHILDREN: 33	CENSUS:	DATE:	06/05/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Jessica Vance		TIME COMPLETED:	10:55 AM

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	Licensing Program Analyst (LPA) Crystal Green conducted an unannounced required 1 year inspection. Licensing Staff met with Compliance Manager, Jessica Vance. Facility operation hours are from Monday to Friday from 7:00 AM to 6:00 PM. There is also infant program on the same premises with facility number 198020175. There are no shared areas between the programs. LPA observed the programs to be physical separate from both indoors and outdoors. This is a facility located on the same premises as Lincoln Avenue Christian Church. The following was observed during this visit. At 9:45 AM, LPA was provided a tour of the facility. This facility is currently licensed to operate out of (2) classrooms which are the Blue Room and Great Room. Licensing staff observed a total of 9 children with 2 staff members in the Blue Room. Licensing staff observed 11 children in the hallway transitioning to the bathroom with 2 staff members. Teacher-child ratios were observed. All children were observed by licensing staff to be under visual supervision of a teacher at all times. Licensing staff observed the facility to be clean, safe, sanitary and in good repair. Individual storage space is available for each child; there are cubbies in each classroom. LPA observed cots located within each classroom. Toys were observed to be clean and safe. Furniture and equipment were inspected for good repair, free of sharp, loose, or pointed parts. All indoor classrooms were inspected to ensure that the floors have a surface that is safe and clean. All toilets and hand washing facilities are in safe and sanitary operating conditions. There are smoke detectors and fire extinguishers located throughout the facility. This facility main entrance uses a keypad entry and is also equipped with security cameras located in each classroom and throughout the facility. There is drinking water accessible to the children in care via filter water bottles and their personal sippy cups. 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. Children are signed in by parents using the Brightwheel app which is located throughout the facility

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2023

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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: KIDSZONE PRESCHOOL ACADEMY	FACILITY NUMBER: 198020176
	VISIT DATE: 06/05/2023

NARRATIVE

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This facility provides AM and PM snacks, and parents provide their child lunch. 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.
Licensing staff was guided through the outdoor activity space. The outdoor area was observed to have a secured fence surrounding the property. All areas around or under high climbing equipment, and slides were observed to have cushion material to absorb a fall. LPA observed sufficient shaded area outdoors. Outdoor play equipment was observed to be in good condition, free of sharp, loose or pointed parts.
Staff Records were reviewed during this inspection. Children’s Records were reviewed to ensure that Identification and Emergency form and a medical assessment are on file.

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

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.

At this time, the licensee is in compliance with California Title 22 Regulations. Exit interview was conducted with Facility Representative. A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2023

LIC809 (FAS) - (06/04)

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