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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191599892
Report Date: 05/01/2024
Date Signed: 05/01/2024 12:34:40 PM

Document Has Been Signed on 05/01/2024 12:34 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:WING LANE ELEMENTARYFACILITY NUMBER:
191599892
ADMINISTRATOR/
DIRECTOR:		M. YOKOYAMA, R. KHANNAFACILITY TYPE:
850
ADDRESS:16605 WING LANETELEPHONE:
(626) 933-5937
CITY:VALINDASTATE: CAZIP CODE:
91744
CAPACITY: 24TOTAL ENROLLED CHILDREN: 20CENSUS: 17DATE:
05/01/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Monica Jarvis, Kathy Jarvey & Delia CastroTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
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On May 1, 2024, at 9:00 am Licensing Program Analyst (LPA), Carolyn Tuba conducted a Case Management inspection due to a temporary classroom move that occurred on 4/15/2024. A Covid Risk assessment was conducted. LPA met with the Principal, Tabitha Blanton of Wing Lane Elementary who guided LPA to classroom #73. LPA took census of 17 children with 3 staff. LPA had called and spoken to Manager Monica Jarvis who arrived at approximately 9:45 am with Child Development Supervisor, Kathy Jarvey. They guided LPA to the outside playground, cafeteria and provided additional information.

The incident was reported to the Department within the required 24 hours of occurrence. The incident consisted with the children who were currently in the licensed portable had been moved to a new classroom located at the Wing Lane Elementary school site for safety reasons.

LPA inspected the classroom (Room 73) due to the temporary move because of construction and demolition of a portable, that is located near the licensed classroom. The construction crew along with school officials informed the management team of Head Start that they felt it was not safe for the children to be in their classroom during this time. Children will resume in their original licensed classroom in the Fall of 2024. The last day of school for the Head Start Program will be May 21, 2024. The enrollment of children are currently 20 students ages 3 to 5 years of age and there are 3 staff members supervising the children. The program has changed their schedule temporarily and operates from 8:15 am – 1:30 pm. Children do nap in their classroom. There is 1 additional staff member who is scheduled from 8:00 – 8:30 am as extra support and supervision for morning drop off. The classroom currently has a sink for handwashing. There is a girl and boys’ bathroom that has 1 toilet and 1 sink in each restroom and are located outside of the classroom. The classroom is located in the same building as the school’s library. A staff member escorts children to the restroom. Water is provided by a Britta Pitcher and the program is using bottled water to fill the pitcher. Children also bring water from home.
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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE: DATE: 05/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/01/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
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: WING LANE ELEMENTARY
FACILITY NUMBER: 191599892
VISIT DATE: 05/01/2024
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The children are currently eating breakfast at 8:25 am and lunch at 10:45 am in the cafeteria and there are no other children found in the cafeteria during that time. According to the manager the reason for children eating meals at the cafeteria is due to there being no fridge for proper food storage. LPA asked if there are any children on medication, but the Manager stated there are currently 2 children on medication, but do not require refrigeration. LPA checked the fire extinguisher that was last serviced on September 19, 2023, and smoke/carbon monoxide detectors are monitored and connected with the main school and tested regularly. First Aid is available. LPA noted that there are toys, children’s furnishings, and found the classroom to be clean, safe, and comfortable for the children in care. Cleaning supplies and Medication are kept in a locked cabinet. Parents have been notified of the temporary move.

The children are currently playing in the TK/Kindergarten playground from 9:00 am – 9:30 am, and LPA inspected the play structure for safety and found it to be age appropriate. During their play time no other children from TK/Kindergarten are scheduled to be outside. LPA observed that the playground has enough space to accommodate the children and is surrounded by a chain link fence. Staff close and latch the gate for extra safety. LPA took photos of play equipment and outside area.

The following measurements were taken:
INDOORS: 705 sq. ft./ 35 sq. ft. = 20

Based on measurements taken today, capacity for the temporary move is approved for 20 students.
Manager and Child Development Supervisor will be updating the facility sketch for indoor and outdoor and sending it to the LPA by Friday, May 3, 2024, for the Department’s records.

No citations are being issued during this inspection visit.

Notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Lead Teacher, Delia Castro.
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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2024
LIC809 (FAS) - (06/04)
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