198020594-8-11-2020-33-CC-CRES-BSDUEW-20200811153148

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020594
Report Date: 08/11/2020
Date Signed: 08/11/2020 03:31:54 PM

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:	PUENTE AVE PRESCHOOL		FACILITY NUMBER:	198020594
ADMINISTRATOR:	KIMBERLY NGUYEN		FACILITY TYPE:	850
ADDRESS:	14045 DILLERDALE ST		TELEPHONE:	(626) 338-3464
CITY:	LA PUENTE	STATE: CA	ZIP CODE:	91746
CAPACITY:	50	CENSUS: 0	DATE:	08/11/2020
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Kimberly Nguyen		TIME COMPLETED:	03:27 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	This is a second pre licensing Tela- Face Time Inspection (via visual phone application) conducted in English today by Cynthia Reyes, Licensing Program Analyst (LPA), due to COVID-19 and precautionary measures. LPA met with licensee Kimberly Nguyen to go over the correction needed from the first pre licensing inspection dated 07/23/2020. The following items have been corrected and viewed by the LPA on this date. The toddler ill isolation areas is now located in a small opening between two class rooms with a complete door closed on one side and another half door closed and located on the other side. Inside that area is a locked closet where a cot is stored and can easily be removed to place on the floor in that area for the ill child. In the same area is where the staff rest room is located and what the ill child can use and has quick access. A small chair is housed in the staff rest room that can be used by the staff who will be located in the isolation area with the ill child until a parent arrives for pick up. No waiver for an ill isolation area is needed to use the director office located at 14032 Dillerdale Ave. (next door) any more. Director also submitted photos of the Ill Isolation area and LPA placed copies in file. The waiver request needed to use the Play yard with the big apparatus, located at 14032 Dillerdale Ave (next door) will still be submitted, however is not needed at this time as this facility has enough play yard space on these premises per measurements for 82 children. Walkie talkies will be used and the phone number 626-338-3464 will be the main land line phone number for this school at this time due to the school at 14032 Dillerdale Ave (next door) is the main school for both facilities. The fire clearance was received and approved for Preschool children capacity of 50, however per LPA measurements the capacity approved on this date will be for 42 preschool children and an updated fire clearance will be requested. Facility will be licensed for 42 preschool children on this date.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 08/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2020

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: PUENTE AVE PRESCHOOL	FACILITY NUMBER: 198020594
	VISIT DATE: 08/11/2020

NARRATIVE

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Exit interview was conducted with Director Kimberly Nguyen, Including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.

Note: A copy of this report was signed by LPA Cynthia Reyes. This report along with the appeal rights, will be sent via email to Director Kimberly Nguyen who agrees to sign and date each page of the report, and understands that an electronic “Read Receipt” is in lieu of a signature at this time and/or confirmation of receipt of the e-mail confirms receipt of the report and constitutes an electronic signature. Director Kimberly Nguyen also agrees to send the original report by mail. As this is a Face Time Tele-Inspection.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 08/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2020

LIC809 (FAS) - (06/04)

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