Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198009297
Report Date: 05/11/2016
Date Signed 05/11/2016 10:23:45 AM

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:HACIENDA LA PUENTE USD - SUNSETFACILITY NUMBER:
198009297
ADMINISTRATOR:MELISSA GARAYFACILITY TYPE:
850
ADDRESS:800 N. TONOPAHTELEPHONE:
(626) 933-6544
CITY:LA PUENTESTATE: CAZIP CODE:
91744
CAPACITY:18CENSUS: 16DATE:
05/11/2016
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Mayumi Yokoyama, Lead TeacherTIME COMPLETED:
10:30 AM
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Licensing Program Analyst (LPA) Ann Dumolt met with Ms. Yokoyama for the purpose of a Health and Safety inspection. Head Start Program meets on the campus of Sunset Elementary School in Room #2 from 8 to 11:30 a.m. only. Per school district policy, there are no weapons or firearms stored on the premises. LPA signed in at the elementary school office at 8:55 a.m. and was met by staff and guided to class room.

Classroom is equipped with age appropriate furniture, fixtures, equipment, and supplies. There are areas offering a variety of activities for the children to develop and master educational skills and activities of daily living. Restroom is off the classroom. It is clean, odor free, and well supplied with toilet paper, paper towel, and dispensable soap. Staff visually supervise and are available to children who may require assistance with toileting. Handwashing is emphasized after use of restroom as when transitioning from outdoor play back into the classroom and before & after meals. Water fountain in classroom is available to children to drink freely. Staff observed interacting with children in their classroom activities and are mindful of children's personal rights: Speaking to children in a calm voice at eye level and readily available to assist the children. Teacher child ratios are met using Title 5: 1 teacher for 24 children with 1 adult for 8 children. On this visit the teacher, a teacher assistant, and parent volunteer were supervising 16 children. Sign in /out sheets reflect the number of children in care and census is within the licensed capacity of 18 children. . Parents use full signature when signing children in or out. Disinfectants (bleach water solution) are stored out of reach of children in overhead cabinets. First Aid kit inventoried and appears to meet the needs of children in care for minor injuries. Medications are stored in a locked filing cabinet outside the classroom and across the restroom used by children. Medications have paperwork for protocol in administering medication (allergy and / or asthma). Medications are within expiration dates. A carbon monoxide detector is in place near class
SUPERVISOR'S NAME: Joan HayesTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: EAnn DumoltTELEPHONE: (323) 388-6283
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2016
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: HACIENDA LA PUENTE USD - SUNSET
FACILITY NUMBER: 198009297
VISIT DATE: 05/11/2016
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room sink.

Breakfast and lunch are prepared at the elementary school and brought in from the school's cafeteria in containers that prevent food and milk from perishing. Meals are eaten family style. Food waste and trash are place in a trash can with a tight fitting lid and trash can moved outside. Tables are cleaned and flooring swept immediately after children have finished eating.

Yard is fenced and gated. It is used exclusively by the Head Start's morning session. There is a special education preschool but they do not use the yard when Head Start is in session--at least rarely. Yard offers an age appropriate play structure that uses tot turf under high impact areas. Wood chips are also used but will be replaced with tot turf. Per. Ms Yokoyama, children do not use the play structure (which appears new) as the wood chips are to be replaced with tot turf.. There is a paved area for trikes and a play fire truck that has tot turf under the truck and beyond fall zones. A sensory table is in place (at least 18 above ground) and it is empty except for leaves and twigs. Water dispenser with paper cups is available to children for drinking water.

Staff have copy of records demonstrating qualifications for positions served as well as current certification in pediatric CPR and First Aid. Children have emergency cards with parent/guardian information, who may pick up the child, and consent for emergency medical treatment. Required forms are posted: License, Personal rights, Parents Rights poster for Centers, Car Seat Law, and Emergency Disaster Plan are posted.

No deficiencies given. LPA noted the Head Start Program is preparing to close down for the summer (last day for children May 20, 2016) and will resume in August 2016.

Exit interview conducted with Ms. Yokoyama. Copy of report and appeal rights given. Notice of site visit posted on door used by parents/guardians entering the classroom for sign in or sign out.
SUPERVISOR'S NAME: Joan HayesTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: EAnn DumoltTELEPHONE: (323) 388-6283
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2016
LIC809 (FAS) - (06/04)
Page: 2 of 2