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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021466
Report Date: 06/13/2024
Date Signed: 06/13/2024 02:17:24 PM

Document Has Been Signed on 06/13/2024 02:17 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:ST. ANNE'S AT BEVERLYFACILITY NUMBER:
198021466
ADMINISTRATOR/
DIRECTOR:		LOPEZ, ANNAFACILITY TYPE:
860
ADDRESS:1501 BEVERLY BLVDTELEPHONE:
(213) 381-2931
CITY:LOS ANGELESSTATE: CAZIP CODE:
90026
CAPACITY: 36TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
06/13/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Anna Lopez TIME VISIT/
INSPECTION COMPLETED:
02:25 PM
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On 06/13/2024 at 9:30 am, Licensing Program Analysts (LPAs), Crystal Green and Priscilla Ochoa conducted an announced Pre-Licensing inspection to add a new Infant and Toddler Option Program and convert the existing Preschool/ HeadStart Program into a Single License. Upon arrival, LPAs met with Applicant Representatives, Anna Lopez, Ruben Tarango, and Reza Khosrowabadi. This location is currently licensed #198018125 as a HeadStart Program serving (43) children from ages 3 to 5 years old in classrooms 1, 2, and 3.

The Applicant, St. Anne’s Family Services, is requesting to reduce their licensed capacity to (36) children: (20) preschool capacity ages 3 to 5 years old in classroom 3, (8) Toddlers ages 18 to 36 months in classroom 2, and (8) Infants ages 0 to 18 months in classroom 1. Hours of operation will be Monday to Friday from 7:30 am to 2:00 pm.

All indoor and outdoor activity space utilized for the children was inspected today. LPA informed Anna Lopez that staff are required to maintain direct visual supervision of the children at all times during indoor and outdoor activities. When medications are on site, Anna Lopez stated that they will be in Directors Office in the locked drawer. A fully equipped first aid kit is located throughout the facility. There is an operational carbon monoxide detector on site located throughout the facility. All required licensing documents were observed posted in the hallway of the main entrance leading. Children will be signed in and out at each classroom entrance.

LPAs continued to tour the facility and measured all indoor and outdoor activity space. Total indoor activity space measured 1329.65 square footage, which is sufficient to accommodate the requested overall capacity of 36 Children.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE: DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/13/2024
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: ST. ANNE'S AT BEVERLY
FACILITY NUMBER: 198021466
VISIT DATE: 06/13/2024
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LPA observed all indoor activity space to be complete with safe, age-appropriate furniture and equipment, including tables, chairs, cubbies, napping cots, (4) cribs, bookshelves, and other activity supplies for the children. Infant toys are safe with no sharp edges, splinters, or points, nor made of small parts that can present a choking hazard. Drinking water will be available in the classrooms via filtered water pitcher with drinking cups. LPA observed all hazardous items to be inaccessible to children. There are no bodies of water or weapons on the property. Fire clearance was granted on 4/23/2024.

In the infant room feeding tables have broad-based legs, plastic seats are in good repair and trays lock onto chairs. Changing tables have at least 1” padding covered with moisture-resistant, washable material. Sides of the changing table are at least 3” high and the changing table is within arm’s reach of a sink. Diapering sink is not used for meal preparation or dishwashing. Cribs meet regulatory requirements. Crib area is separated from activity space via fixed sound absorbing barrier. The partition wall that separates the activity space from the designated crib area measured to 2 feet and 6 inches which is insufficient for the required height of at least four feet high. Title 22 Section 101438.3(b)(2) Moveable walls or partitions, if used, shall be at least four feet high; shall be constructed of sound-absorbing material; and shall be designed to minimize the risk of injury to infants. Sleep logs will be kept in near the crib area. Needs and Services Plans and Sleep Plans are kept in the infant binder within the classroom.

This facility has one restroom available for the children enrolled which is designated for preschool program. LPAs observed a total of (5) sinks and (5) toilets available. LPAs advised the applicant representative to obtain potty chairs for the Infant and Toddler classroom. The Infant and Toddler room must have at least one potty chair or toilet for every five infants. These are sufficient to accommodate the requested overall capacity of (36) children. There is a separate staff restroom equipped with a toilet and a sink. The isolation area for children who are ill will be the area located behind the preschool/ toddler classroom the doors will remain closed while a child is present with a staff member.

Facility will provide breakfast, lunch and pm snack. The kitchen area currently includes refrigerator, sink, dishwasher, microwave, and prep countertop. The kitchen area and food storage areas were observed to be free of rodents and/or vermin. Food was not observed present during this inspection.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: ST. ANNE'S AT BEVERLY
FACILITY NUMBER: 198021466
VISIT DATE: 06/13/2024
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This facility has (2) designated playground areas: Infant and Preschool play yard. Fencing is at least four feet high and observed to be made of bottom half cement and top half wrought iron. The total square footage for all the outdoor activity space for the preschool is 1989.02 square feet, which is sufficient to accommodate the requested capacity. The total square footage for all the outdoor activity space for the infants is 923.93 square feet, which is sufficient to accommodate the requested capacity. The Toddler Option program does not have its own separate designated outdoor space. Per Facility Representative, the applicant plans to request a waiver to allow the toddlers to share the infant play yard using a staggered schedule. A playground waiver to share the playground at different times in the AM and PM due to limited square footage shall be submitted and approved prior to licensure. Shade was observed provided via a fixed shade structure in the preschool yard. The Infant yard was observed to have a shad canopy. There are sufficient outdoor age-appropriate toys and play equipment available on the playgrounds. There is a climbing structure on the preschool playground for children ages 2- 5 years which is properly anchored. There is a climbing structure on the infant playground for children ages 6- 23 months which is properly anchored.

There is adequate cushioning in fall zones of climber. Drinking water is available via filtered water pitcher with drinking cups. LPA observed all hazardous items on the playgrounds to be inaccessible to children. Applicant was reminded that any changes to the facility must be reported to and approved by Community Care Licensing.
For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP).

Applicant Representative, Anna Lopez was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024
LIC809 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: ST. ANNE'S AT BEVERLY
FACILITY NUMBER: 198021466
VISIT DATE: 06/13/2024
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This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. 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) or (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

LPA discussed the safe sleep regulations with licensee representative 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 [applicant, licensee, or facility representative] 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.

Applicant Representative was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: ST. ANNE'S AT BEVERLY
FACILITY NUMBER: 198021466
VISIT DATE: 06/13/2024
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The following corrections are needed prior to the issuance of the license:
  • Applicant will need to obtain (4) potty chairs for the Infant and Toddler classrooms.
  • Applicant will need to a replace existing partition located in Infant classroom with sound absorbing barrier at least four feet high to surround the designated crib area.
  • Applicant will need to submit waiver request letter to the Regional Office to allow the Toddler to use the designated Infant outdoor space using a staggered play schedule.

Applicant Representative, Anna Lopez, understands that all proof of corrections must be provided to the Department within 30 days, or the application may be denied.

Exit interview conducted and report was reviewed with the Applicant Representative, Anna Lopez.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024
LIC809 (FAS) - (06/04)
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