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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191603461
Report Date: 03/11/2022
Date Signed: 03/14/2022 05:19:16 PM

Document Has Been Signed on 03/14/2022 05:19 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:GARDENA BUDDHIST CHURCHFACILITY NUMBER:
191603461
ADMINISTRATOR:KEIKO DAMIATAFACILITY TYPE:
850
ADDRESS:1517 W. 166TH STREETTELEPHONE:
(310) 327-4627
CITY:GARDENASTATE: CAZIP CODE:
90247
CAPACITY: 94TOTAL ENROLLED CHILDREN: 94CENSUS: 43DATE:
03/11/2022
TYPE OF VISIT:Case Management - COVID-19UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Keiko DamiataTIME COMPLETED:
02:30 PM
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On 3/11/2022, at 1:00PM, Licensing Program Analyst (LPA) Veronica Wheatley conducted an unannounced Case Management and met with director Keiko Damiata after conducting a risk assessment. The purpose of inspection is to follow up on an Unusual Incident Report which was submitted on 2/25/2022. LPA Wheatley toured the inside and outdoors of the facility. LPA observed 43 children napping on the premises.

According to the UIR, there were two positive cases of Covid-19.

The directors states all of the children who were reported to Los Angeles County Public County Health Department isolated at that time and since then have returned back to the facility. LPA observed the children in attendance today.

During the inspection, LPA observed all staff wearing masks and students mask were on their desks as they were napping during the inspection.

LPA observed cleaning supplies and hand sanitizer inside the classrooms and outside on the playground.
LPA observed the restrooms fully stocked with soap and paper towels. LPA observed the required PPE supplies in the school office including masks for children and adults.

LPA observed Covid-19 signs posted at the entrance and throughout the facility.
LPA discuss with the director current Covid-19 resources and guidance.

No deficiencies were cited, per Title 22 Division 12, Chaper 3, of the California Code of Regulations.

An exit interview was conducted and a copy of this report will be provided to the director, Keiko Damiata at damiatapreschool@gmail.com
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Veronica Wheatley
LICENSING EVALUATOR SIGNATURE: DATE: 03/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/11/2022
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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