191593623-2-1-2023-33-CC-RLOZ-CNMVWG-20230201154755

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191593623
Report Date: 02/01/2023
Date Signed: 02/01/2023 03:48:04 PM

Document Has Been Signed on 02/01/2023 03:48 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:	MAXSON HEAD START/STATE PRESCHOOL		FACILITY NUMBER:	191593623
ADMINISTRATOR:	ALMA GONZALES		FACILITY TYPE:	850
ADDRESS:	12380 FELIPE		TELEPHONE:	(626) 652-4250
CITY:	EL MONTE	STATE: CA	ZIP CODE:	91732
CAPACITY: 75	TOTAL ENROLLED CHILDREN: 80	CENSUS: 35	DATE:	02/01/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:	Samarah Baker, Program Facilitator		TIME COMPLETED:	02:15 PM

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2023

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: MAXSON HEAD START/STATE PRESCHOOL	FACILITY NUMBER: 191593623
	VISIT DATE: 02/01/2023

NARRATIVE

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Classroom was inspected to ensure that the floors have a surface that is safe and clean. All toilets and washing facilities are in safe and sanitary operating conditions. All materials and surfaces accessible to children are toxic free. At this time, each classroom has a office/ room available for isolation. Per Program Facilitator if child needs to isolate there’s always a teacher with them. Parents are contacted immediately when children are determined to be ill and staff are ensuring that children with obvious symptoms of illness are not being accepted.

The facility provides breakfast, lunch and snack for the full day program. Breakfast and lunch for the AM programs and lunch and snack for the PM programs. Menus were reviewed to ensure that they are being posted at least one week in advance and visible to an authorized representative. Per Program Facilitator meals are picked up daily by staff and it’s stored in an insulated cart. All food preparation, and storage areas are clean, free of litter, rubbish, and rodents/vermin. All food is protected from contamination, and LPA inspected that any contaminated food is discarded immediately.

There is drinking water available in the classroom via water bottles and water jug. Water bottles and water jugs are taken outside for children to drink. 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 children.

LPA observed that there are smoke and carbon detectors in the facility and were found to be operable. The last Disaster and Fire Drill was conducted on 1/24//2023.

Per Program Facilitator, nap is offered only in the full day program. Sheets are taken home weekly to be washed.

Room K1 and K2 share a yard by their bungalow and Room 27 has their own playground. Outdoor playground equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards.--------------------------------------- pg. 2 of 5------------------------------------------------------

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2023

LIC809 (FAS) - (06/04)

Page: 2 of 5

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: MAXSON HEAD START/STATE PRESCHOOL	FACILITY NUMBER: 191593623
	VISIT DATE: 02/01/2023

NARRATIVE

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All areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard.

Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day.

There is at least one person trained in CPR and Pediatric First Aid present during this inspection.
All staff is fingerprint cleared as a condition of employment through the Mountain View School District.

LPA did not review staff files during the inspection due to the staff files being stored at the administrative office located at Mountain View School District.

LPA will review staff files at a later time and date. Children's emergency records were reviewed; children's health records are kept in the administrative office and will be reviewed at a later time and date. If files were to be incomplete during the time and date that LPA reviews files, a case management inspection will occur at the facility to reflect the incomplete files.

LPA issued the Review of Children's Records (LIC 857 & LIC 859) to the facility representative during this inspection. The LIC 857 documents the children’s files that were reviewed during this inspection. At 2:00 pm Program Facilitator Claudia Casillas took over the inspection.

AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018 any person who works in a child care facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers. AB1207 certificate was on file for staff present.

LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at ---------------------------------------- pg 3 of 5 -----------------------

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2023

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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MAXSON HEAD START/STATE PRESCHOOL	FACILITY NUMBER: 191593623
	VISIT DATE: 02/01/2023

NARRATIVE

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https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed 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.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

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

Facility representative was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov.m
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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2023

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: MAXSON HEAD START/STATE PRESCHOOL	FACILITY NUMBER: 191593623
	VISIT DATE: 02/01/2023

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For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process

At this time, the facility is in compliance with California Code of Regulations Title 22. No deficiencies cited.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with Program Facilitator Claudia Casillas.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2023

LIC809 (FAS) - (06/04)

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