198020800-10-8-2021-33-CC-CRES-C7M4HM-20211008190718

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020800
Report Date: 10/07/2021
Date Signed: 10/08/2021 07:07:49 PM

Document Has Been Signed on 10/08/2021 07:07 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:	PUENTE AVE PRESCHOOL		FACILITY NUMBER:	198020800
ADMINISTRATOR:	KIMBERLY NGUYEN		FACILITY TYPE:	850
ADDRESS:	802 VINELANE AVE		TELEPHONE:	(626) 277-9700
CITY:	LA PUENTE	STATE: CA	ZIP CODE:	91746
CAPACITY: 58	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	10/07/2021
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Kimberly Nguyen		TIME COMPLETED:	05:15 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	Licensing Program Analyst (LPA) Cynthia Reyes, conducted an announced pre-licensing site Inspection to inspect and measure the requested Preschool component for capacity determination. LPA met with Kimberly Nguyen, applicant. Due to COVID- 19 precautionary measures were taken during the entire inspection and all individuals present during this inspection wore appropriate personal protective equipment. The applicant is requesting a total capacity of 58 preschool children. Days & hours of the Infant license will be Monday-Friday 6 AM-6 PM At 3:15 PM, LPA began the tour of the facility with Kimberly, beginning at the office. Kimberly states preschool parents will enter and exit the back of the school gate off Amar Street. During Covid parents will sign the child in/out (Clean pins will be available and a container for used pins), outside of each class room door (Rooms 1-5). Temperatures and health checks will be conducted at that same time. Use of hand sanitizer will also be available. Parents will not enter the class rooms at this time unless they request to enter, which at that time all precautionary measures will be taken for that individual entering. Facility staff will walk the child inside the class room and bring the child out at pick up time. LPA observed a parent board placed outside by the sign in/out area during Covid with all licensing forms and Covid-19 posters. LPA observed inside the class room the parent board visible for all to see with all licensing documents and Covid-19 posting as well. Facility was observed to be adhering to local public health guidelines. (According to CDC guidelines, children under the age of (2) are not required to wear masks.) The ill/isolation area is located in the main office and is close to the staff rest room for an ill child to use. The ill/isolation area has a cot for a child to rest if needed. A staff lounge/lunch area is located in the kitchen area that is used just for snack/meal prep and no cooking. Continued on page 2

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 10/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021

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: 198020800
	VISIT DATE: 10/07/2021

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3:35 PM, The tour continued as the LPA was guided to the Infant outdoor play area. The preschool has their own outdoor play yard (Grass, padding & cement), and is self contained by a gate around it for separation from the infant yard to prevent children from commingling. Water jugs with disposable cups or labeled bottles will be used for children while outdoors. LPA observed age appropriate outdoor toys and play equipment to be clean safe and in good repair, as well as adequate shade is available. All areas around play equipment and slides are cushioned with material to absorb a fall. Measurements were taken of the outdoor play yard and the total outside capacity allows for 70 preschool children. LPA advised the owner Kimberly that the children need to be within the direct care and supervision, including visual observation and supervision of the teacher(s) at all times.

3:55 PM Licensing staff was then guided through the new proposed preschool class rooms (#1-5). Toys were observed to be age appropriate clean and safe. Furniture and equipment was inspected for age appropriateness and good repair. Napping equipment (Cots) were also inspected and observed to be in good condition. Appropriate storage and cleanliness was observed. The preschool children will bring their own labeled water bottle. Lunch and AM/PM snack will be provided by the facility. Menus were observed. Containers used to discard food have tight fitting lids. Cleaning compounds are inaccessible to the children. There is a fully equipped first aid kit available on site in the main office. Individual storage space was observed to be available for each child. Parents will bring each child's linen for the week and take home at the end of the week. Facility has extra linen and food available if needed. Measurements for preschool Room #1 (Capacity 12), #2 (Capacity 12), #3 (Capacity 11), #4 (Capacity 9), and room #5 (Capacity 12) for a total capacity of 56 preschool children.

Preschool bathroom was observed to be in good repair, water temperature, paper towels, toilet paper, all area inspected for safety and sanitation. LPA observed in class room #5 a bathroom with 6 toilets (90 preschool children) and 6 sink (90 preschool children) with a changing table in arms reach of 1 of the sinks was observed and inspected.

There is smoke detectors, carbon monoxide detector and a fire extinguisher (Service date 05/19/2021) in each room that meets statutory requirements. Heating, lighting and ventilation were evaluated. Building/Rooms are centrally heated and air conditioned. Overhead lights as well as natural light is used.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 10/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021

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: 198020800
	VISIT DATE: 10/07/2021

NARRATIVE

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Food preparation areas were toured for safety and cleanliness. Smoke and Carbon Monoxide detectors should be checked and batteries replaced as needed. The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Hazardous items including poisonous cleaning compounds and sharp items were observed to be stored inaccessible to children.

4:15 PM Items discussed during this Inspection:

Licensing does not tolerate the following: Refused Entry to a Facility or Any Part of a Facility is a
violation of Section 1596.852, 1596.853 or 1597.09. Regulations 101238 (g) (2), The Presence of an Excluded Individual, Fire Clearance Violations, Accessible Bodies of Water, Accessible Firearms, Ammunition or Both.
Breakfast/Lunch/Snack Menus: Menus are required to be posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days must also be available upon request.
Current Children’s Roster LIC 9040: Each child day care facility shall maintain a current roster of children who are provided care in the facility. The roster shall include the name, address, and daytime telephone number of the child's parent or guardian, and the name and telephone number of the child's physician. This children roster must be updated and available to the licensing agency upon request.
Pediatric First Aid and CPR: At least one person in the facility, along with the Director/Administrator must be trained in Pediatric First Aid and CPR and present in the facility.
Designated Staff: The name of the childcare center director or fully qualified teacher(s) designated to act in the director's absence must be on file.
Qualifications and staff files: Educational background, training, and/or experience and all required documents by the department for each staff present must be available for review.
Children’s Records: All required licensing documents must be available for review; including but not limited to, the following: Name, address and telephone number of the child's authorized representative and of relatives or others who can assume responsibility for the child if the authorized representative cannot be reached when necessary. Director advised to visit www.shotsforschool.org for immunization information.
Immunization Requirements: Commencing September 1, 2016, a person shall not be employed or
volunteer at a day care center if he or she has not been immunized against influenza, pertussis, & measles.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 10/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021

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: 198020800
	VISIT DATE: 10/07/2021

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Continued: Items discussed during this Inspection:

Criminal background clearance: LPA advised Director that all adults 18 years of age and older providing Care & Supervision and/or have continuous presence in the facility shall adhere to a criminal background clearance with the Department of Justice, FBI and Child Abuse Index Check.
Reporting Requirements Section 101212: Changes at the facility must be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your location. The Director was also advised of the requirement to report Unusual Incidents and/or injuries to the parent/guardian and to CCL within the time frame specified by the regulation.

4:40 PM Facility has no transportation policy. Applicant states that any lifesaving medication will be stored in a locked area inaccessible to children in care in the kitchen.

Incidental Medical Services (IMS): This facility does not plan at this time to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A 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.

4:50 PM LPA consulted with applicant regarding COVID-19 health and safety guidelines on this date. Applicant was provided forms to post via email. Licensing staff observed COVID- 19 postings posted in different areas of the day care for parents, as well as for children at eye level in their class rooms and in the bathrooms on this date. During this inspection LPA also discussed PIN 20-06 CCP, Social and Physical Distancing Guidance and Healthy Practices for Child Care Facilities in Response to The Global Corona virus (COVID-19) Pandemic Written in Collaboration with The California Department of Education. LPA handed the applicant the Child Care Covid-19 Self-Assessment guide during this inspection on this date. The applicant filled out and handed the department a copy on 10/07/2021. LPA discuss the Self-Assessment guide with applicant Kimberly. .

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 10/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021

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: 198020800
	VISIT DATE: 10/07/2021

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LPA advised the applicant how to access forms, regulations providers information notices (PINs), regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

Based on LPA measurements taken on this date and observations of the facility, No corrections are needed and the facility will be approved for 56 preschool children indoors and outdoors. The application will be submitted to be licensed. Once licensed, the applicant is required to adhere to the terms and limitations stated on the license. A fire clearance was approved on 10/04/2021 and on file for a capacity of 58.

5:15 PM, Exit interview was conducted in person with Kimberly Nguyen. A copy of this report and Appeal Rights were discussed, signed, given and printed on this date. Consultation regarding the licensing state laws and regulations, were conducted through out this inspection.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 10/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021

LIC809 (FAS) - (06/04)

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