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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191607802
Report Date: 09/24/2024
Date Signed: 09/24/2024 11:40:21 AM

Document Has Been Signed on 09/24/2024 11:40 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:FURGESON ELEMENTARY SCHOOL--STATE PRESCHOOLFACILITY NUMBER:
191607802
ADMINISTRATOR/
DIRECTOR:		LAURA HERNANDEZFACILITY TYPE:
850
ADDRESS:22215 ELAINE AVENUETELEPHONE:
(562) 421-8285
CITY:HAWAIIAN GARDENSSTATE: CAZIP CODE:
90716
CAPACITY: 24TOTAL ENROLLED CHILDREN: 16CENSUS: 14DATE:
09/24/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Lead Teacher - Connie GuzmanTIME VISIT/
INSPECTION COMPLETED:
11:55 AM
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Licensing Program Analysts (LPAs) Randy Derraco and Peter Bishop conducted an unannounced annual inspection on 09/24/24 at 9:15 AM. LPA met with Connie Guzman, Lead Teacher, who guided analyst on a tour of the facility. This is a preschool program which consists of 1 classroom. Facility operation hours are Monday to Friday from 8:30 AM - 11:30 AM.

All areas identified on this report were inspected. Upon arrival, the following staff were present during this inspection: Room A6: Staff: S1 and S2 with 14 children. Teacher-child ratios were observed to be in accordance with Title 22 Regulations. All children were observed to be under visual supervision of a teacher at all times. LPA observed Dr. Rebecca Lynch arriving to the classroom at 11:10 AM and continued the inspection with LPAs.

The following was observed during the tour of the facility:

Children's roster was reviewed and is current. 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. Children present were signed in. Disaster drill log was available, last drill was conducted on 08/12/24. LPA observed required licensing documents posted on the classroom wall and on the door leading to the outdoor play area.
Furniture and equipment were inspected for age appropriateness and good repair. LPA observed material and equipment are free of sharp, loose, or pointed parts. Telephone service, heating, lighting and ventilation were evaluated and are operable. Children have their own cubby to store their belongings. Linens and Napping equipment are not available due to the program only lasting 3 hours. Per Lead Teacher, the isolation area is located in the "comfy corner" of the classroom. LPAs observed a padded rubber mat inside a Lakeshore Jr. classroom nook . Age appropriate sinks and toilets were inspected for availability and good repair in all restrooms. General sanitation was observed.

Disinfectants, cleaning solutions, medication and other items that are dangerous to children, are inaccessible (page 1 of 3)
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE: DATE: 09/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/24/2024
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: FURGESON ELEMENTARY SCHOOL--STATE PRESCHOOL
FACILITY NUMBER: 191607802
VISIT DATE: 09/24/2024
NARRATIVE
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to children. Per Lead Teacher, the school janitor cleans bathrooms designated for children after school hours. Per Lead Teacher, no children enrolled require the use of medication Lead Teacher states that there are no poisons stored at the facility and understands that storage areas for poisons must be locked with a key or combination lock. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. First Aid supplies were observed in the classroom.

Menus were reviewed to ensure that they are being posted at least one week in advance and visible to an authorized representative. The facility provides breakfast. LPA observed that water is readily available indoors via water fountain, however Lead Teacher states that children bring their own water bottles from home. Food is prepared by the elementary school and transported to the classroom for meal time
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. Areas around and/or under climbing equipment, swings and slides have cushioning material to absorb a fall. The outdoor area has adequate shade. LPA observed that water is readily available outdoors via water bottles brought from home. LPAs observed a water fountain, and a stationary sink and faucet located in the outdoor play area. The Lead Teacher states that there are no bodies of water on the premises and LPA did not observe any bodies of water during this visit. Lead Teacher states there are no weapons or firearms on the premises.

All individuals present have obtained a criminal record clearance through the school district. Staff files were not reviewed as staff files are kept at the off site at Main Office and will be reviewed at a later date. If there are any deficiencies during that review, this report may be amended. There is at least one person trained in CPR and Pediatric First Aid present during this inspection.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

At this time, the center is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.
(page 2 of 3)
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: FURGESON ELEMENTARY SCHOOL--STATE PRESCHOOL
FACILITY NUMBER: 191607802
VISIT DATE: 09/24/2024
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Notice of site visit was given and must remain posted for 30 days

Exit interview conducted and report reviewed with Supervisor of Child Development and Special Programs, Dr. Rebecca Lynch.

(page 3 of 3)
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2024
LIC809 (FAS) - (06/04)
Page: 3 of 3