Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019499
Report Date: 01/30/2019
Date Signed: 01/30/2019 02:40:07 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:PLAY PRESCHOOLFACILITY NUMBER:
198019499
ADMINISTRATOR:GABRIEL ROSSFACILITY TYPE:
830
ADDRESS:2828 GLENDALE BLVDTELEPHONE:
(323) 664-8494
CITY:LOS ANGELESSTATE: CAZIP CODE:
90039
CAPACITY:50CENSUS: 25DATE:
01/30/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:01 PM
MET WITH:GABRIEL ROSSTIME COMPLETED:
03:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Judy Mora conducted an unannounced Annual/random inspection. LPA met with designated facility Director, Gabriel Ross, who guided LPA on a tour of the facility. This is an infant program licensed for 50 infants ages birth through 2 years of age. The facility operates Monday – Friday from 8:00 AM – 6:00 PM. Per the Director there are 32 children enrolled. There is a preschool license on site, license #198019498. The infant program is physically separate from the other components at this facility both indoors and outdoors.

All areas identified on the facility sketch were inspected. Upon arrival, LPA observed 05 infants from the Lime Classroom on the outdoor play yard with 02 staff and 20 children with 06 staff in the Lemons Classroom. Teacher-infant ratios were observed to be in accordance with Title 22 regulations. The Licensee is within the conditions, limitations, and capacity specified on the license. Staff names were recorded. All children were observed to be under visual supervision of a teacher at all times. Classrooms were observed to ensure that infants are never left unattended and under the direct visual supervision of a staff person at all times.



Furniture and equipment was inspected for age appropriateness, good repair, free of sharp, loose, or pointed parts. LPA observed cribs, cots/mats, changing tables and feeding chairs to be in accordance with Title 22 Regulations section 101439.1 (a) – (m). LPA observed sufficient napping equipment that meets the requirements of Title 22 regulations. All indoor classrooms were inspected to ensure that the floors have a surface that is safe and clean. All toilets and hand washing facilities are in safe and sanitary operating conditions. All materials and surfaces accessible to children are toxic free. At this time, the office is used as an isolation area. Parents are contacted immediately when children are determined to be ill.

Parents of infants enrolled provide all items which include food, milk, breast milk, snacks, and diapering materials. LPA observed that not all items are labeled; this is a potential risk to the health and safety of children in care.

*REPORT CONTINUES ON NEXT PAGE

SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Judy MoraTELEPHONE: (323) 981-3371
LICENSING EVALUATOR SIGNATURE:

DATE: 01/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2019
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: PLAY PRESCHOOL
FACILITY NUMBER: 198019499
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/30/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/08/2019
Section Cited
CCR
101427(J)
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Infant Care Food Service
Bottles, dishes and containers of food brought by the infant's authorized representative shall be labeled with the infant's name and the current date.
This requirement was not as evidenced by LPA observed that not all items are labeled; this is a potential risk to the health and safety of children in care.
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Director states all items will be labeled. LIC 9054 will be sent to LPA by POC due date of 02/08/19.
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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: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Judy MoraTELEPHONE: (323) 981-3371
LICENSING EVALUATOR SIGNATURE:

DATE: 01/30/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2019
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: PLAY PRESCHOOL
FACILITY NUMBER: 198019499
VISIT DATE: 01/30/2019
NARRATIVE
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There is uncontaminated drinking water available in all indoor classrooms and drinking containers are taken outdoors. 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 infants. Storage areas for poisons are locked. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. The licensee takes measures to keep the facility free of flies, other insects and rodents.

Outdoor play equipment was observed to be in good condition, free of sharp, loose or pointed parts. Outdoor activity space surface is maintained in a safe condition as 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. Per Director there are no weapons or firearms on the premises. Areas around and/or under climbing equipment, swings and slides have tot turf as a cushioning material to absorb a fall; climbing apparatuses are single level only.

Staff Records were reviewed to ensure that a health screening report is on file. Infant Teachers files were reviewed to ensure that teachers present are qualified. Children’s Records were reviewed to ensure that Identification and Emergency form and a Needs and Services Plan are on file. Criminal Records Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed.


SB792 Immunization Requirements for Staff and Employees was discussed with the Licensee. The Licensee and her assistants do not currently have immunization documentation. This is a potential risk to the health and safety of children in care.

AB1207 Mandated Child Abuse Reporting – Implementation was discussed with Licensee. Website provided: https://www.mandatedreporterca.com/training/child-care-providers

*REPORT CONTINUES ON NEXT PAGE

SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Judy MoraTELEPHONE: (323) 981-3371
LICENSING EVALUATOR SIGNATURE:

DATE: 01/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2019
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: PLAY PRESCHOOL
FACILITY NUMBER: 198019499
VISIT DATE: 01/30/2019
NARRATIVE
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - 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 (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

REMINDER: Failure to obtain a criminal record background check clearances prior to initial presence in the facility will result in an immediate $100.00 dollar or more per day Civil Penalty.



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

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. Please see attached LIC 809D for deficiencies that are being cited and 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 representative. Failure to maintain posting as required will result in a civil penalty of $100.00.



Exit interview was conducted with Director, Gabriel Ross. Appeal Rights and Procedures explained and provided.

*END OF REPORT

SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Judy MoraTELEPHONE: (323) 981-3371
LICENSING EVALUATOR SIGNATURE:

DATE: 01/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2019
LIC809 (FAS) - (06/04)
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