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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020251
Report Date: 07/14/2021
Date Signed: 07/14/2021 12:34:38 PM

Document Has Been Signed on 07/14/2021 12:34 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:HAPPY BIRCH PRESCHOOLFACILITY NUMBER:
198020251
ADMINISTRATOR:MALI RANDFACILITY TYPE:
850
ADDRESS:1423 TAMARIND AVETELEPHONE:
(323) 469-3706
CITY:LOS ANGELESSTATE: CAZIP CODE:
90028
CAPACITY: 46TOTAL ENROLLED CHILDREN: 0CENSUS: 10DATE:
07/14/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Director, Mali Rand TIME COMPLETED:
12:45 PM
NARRATIVE
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On 07/14/2021 at 9:00 am, Licensing Program Analysts (LPA) Roxana Lopez conducted an unannounced required inspection. A risk assessment was conducted prior to entering the facility- the appropriate PPE was used. LPA met with Director, Mali Rand , who guided the LPA on a tour of the facility. This is a preschool age program licensed for 46 children which operates Monday – Friday from 8:00 AM – 5:00 PM. Per the Director there are 18 children enrolled.

All areas identified on the Facility Sketch were inspected. Upon arrival, the preschool room was emptied- children were being dropped off in the yard. The following staff was present during this inspection: Staff #1, Staff #2 and Staff # 3 with 9 children. 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. All adults present have been fingerprint cleared.

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. All indoor classrooms were 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 art room is used as an isolation area, there are mats available. 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.

Per Director, During COVID no meals are being provided, therefore they are no menus posted. Children bring their own lunch- in the event children drop or forget their lunch parents are called to provide food. There is drinking water available in all indoor classrooms and individual water bottles brought from home that are taken outdoors. -----------------------------------------------------------Pg.1 of 3------------------------------------------------------------

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE: DATE: 07/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/14/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: HAPPY BIRCH PRESCHOOL
FACILITY NUMBER: 198020251
VISIT DATE: 07/14/2021
NARRATIVE
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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. Director states that there are no poisons stored at the facility. At 9:25 am LPA observed that there is smoke an carbon detectors in the facility and were found operable.

Outdoor play equipment was observed- Outdoor activity space surface is maintained in a safe condition and is free of hazards. The director states that there are no bodies of water on the premises and LPA did not observe any bodies of water during this visit. Director states there are no weapons or firearms on the premises.

Per Director, during COVID parents are using the Pro Care app to sign in and out. LPA reviewed the app to ensure all children present were signed in. 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. At 11:00 am LPA observed that Staff #1, Staff # 2, Staff # 3 and Staff #4 did not have current CPR/Pediatric and First Aid training. LPA also observed that Staff # 1, Staff # 2 and Staff # 4 did not have a current AB1207 Mandated Child Abuse Reporting Certificate on file.

SB792 (Immunization Requirements for Staff and Employees) was discussed with the director. The director and her staff do have immunization documentation.

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.



LPA issued the Review of Staff records (LIC 859) and the Confidential names (LIC 811) to the licensee during this inspection. The LIC 811 and the LIC 859 documents the staff and children’s files that were reviewed during this inspection.

Medication: Per Director, there is no children currently enrolled in need of medication, Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - --------------------------------------------------- Pg.2 of 3 ----------------------------------------------------------------------------
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2021
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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: HAPPY BIRCH PRESCHOOL
FACILITY NUMBER: 198020251
VISIT DATE: 07/14/2021
NARRATIVE
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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 (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

The following was discussed:


· Reporting Requirements.
· The facility shall ensure that each child is accorded the following personal rights: to be accorded safe, healthful and comfortable accommodations.
· All personnel shall be in good health and shall be physically and mentally capable of performing assigned tasks; personnel that pose a threat to the health and safety of children shall be relieved of their duties.
· All personnel shall be given on the job training in housekeeping, sanitation principles and universal health precautions.

LPA advised the licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

The deficiencies listed on the following pages were observed by the LPA and are being cited in accordance with California Code of Regulations Title 22 and/or the Health and Safety Code. Please see attached LIC 809d.

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 visit by a licensing reprehensive. Failure to maintain posting as required will result in a civil penalty of $100.00.



Exit interview was conducted with Director, Mali Rand. The Director was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of the report.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2021
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/14/2021 12:34 PM - It Cannot Be Edited


Created By: Roxana Lopez On 07/14/2021 at 11:49 AM
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: HAPPY BIRCH PRESCHOOL
FACILITY NUMBER: 198020251

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/14/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/04/2021
Section Cited
CCR
101216(f)

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At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities. This requirement was not met as evidence by:
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Per Director, staff will renew their CPR certificate and will email proof to LPA via email by POC due date of 8/4/2021
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During file review LPA observed that Staff #1-4 did not have a current or valid CPR-Pediatric first aid card on file. This poses a potential risk for the health and safety of children in care.
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Type B
08/04/2021
Section Cited
HSC1596.8662(4)(b)(1)

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 On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training... and shall complete renewal mandated reporter
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Per Director, staff will take the Mandated Reporter Tranining and will email proof to LPA via email by POC due date of 8/4/2021
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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: During file review LPA observed that Staff # 1,2 and 4 did not have a current AB1207 certificate on file. This poses a potential risk for the health and safety of children in care.
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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:Brandi VanOosten
LICENSING EVALUATOR NAME:Roxana Lopez
LICENSING EVALUATOR SIGNATURE:
DATE: 07/14/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/14/2021


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