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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191670515
Report Date: 11/21/2024
Date Signed: 11/21/2024 12:06:51 PM

Document Has Been Signed on 11/21/2024 12:06 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:LBUSD ADDAMS CHILD DEVELOPMENT CENTERFACILITY NUMBER:
191670515
ADMINISTRATOR/
DIRECTOR:		SYBIL BALDWIN PERRYFACILITY TYPE:
850
ADDRESS:256 E. PLYMOUTH ST.TELEPHONE:
(562) 422-3579
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY: 68TOTAL ENROLLED CHILDREN: 68CENSUS: 21DATE:
11/21/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Coordinating Teacher-Mom Khit TIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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Licensing Program Analysts (LPAs) Jeanette Estrada and Keneisha Dunlap conducted an unannounced annual inspection. LPAs initially met with Substitute Lead Teacher Pamela Quintana an informed her of the reason for the visit. Program Coordinator, Cristabel Rodriguez and Coordinating Teacher, Mom Khit joined at a later time.
This is a preschool program which consists of three classrooms. This facility is located on the premises of Jane Addams Elementary school. Currently the program has two classrooms in operation and one classroom is closed due to enrollment. There is an operating full day classroom in room 6. This classroom operates Monday through Friday 6:30 AM to 5:30 PM. The second classroom that is open (room 5) operates two half day sessions Monday through Friday: AM Session is from 8:00 AM to 11:00 AM and the PM session is from 12:00 PM to 3:00 PM. The closed classroom (room 28) is also a half day program. The program offers care to children 2 to entrance into kindergarten.
Upon arrival there were 14 children with 3 staff present in Room 6 and 5 children with 4 staff present in Room 5. A total census of children 21 children were present during the inspection.
All areas used by children were inspected. Furniture and equipment were inspected for age appropriateness and good repair in each classroom. Telephone service, heating, lighting and ventilation were evaluated and are operable. The facility has air conditioning and heating units available in the classrooms. Lighting was observed to be in operable condition. Children have access to personal individual cubbies in each classroom.
Children are provided with a napping cot and bedding by the program in the full day classroom (room 6). Per Facility Representative, the bedding is sent home to be laundered with the families at the end of each week or as needed. Room 5 does not take a nap due to being half day. LPAs observed all documents required to be posted in each classroom.
Per Facility Representative, the isolation area is located in the staff office. LPAs inspected the restrooms available to children. In room 5 there is one toilet and one sink.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE: DATE: 11/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/21/2024
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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: LBUSD ADDAMS CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191670515
VISIT DATE: 11/21/2024
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In room 6 there are two toilets and two sinks and room 28 uses the elementary school restroom in the hallway closest to the classroom. Per Facility Representative, children are escorted to this restroom and staff ensure there are no elementary school students inside-this restroom has 9 toilets and 6 sinks. General sanitation was observed in each restroom.
Availability of indoor drinking water was observed. Children have access to a water container in the classrooms and they also have personal water bottles to use. The facility initially tested for lead contamination in the water sources used for children on 7/12/23 and no lead exceedances were found. Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Cleaning solutions are stored in locked cabinets medication for each classroom is stored in a locked box in each classroom. There are currently three child enrolled who require medication. Medication was inspected and was observed to be in the original prescribed container. Per Facility Representative, all staff present are trained in administering the medication.
Per Facility Representative, there are no poisons stored at the facility. LPA observed an operable carbon monoxide detector in each classroom. The facility is equipped with a centralized fire alarm system throughout the school.
The outdoor playground areas were evaluated. There are three outdoor areas available for children to use. One area is shared with the TK and kindergarten classrooms. Per Facility Representative, this area is used when not in use by other classrooms only. The outdoor areas are fully enclosed. Outdoor equipment is in a safe condition, free of sharp, loose or pointed parts. All areas around or under high climbing equipment and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard. Availability of outdoor drinking water is provided via the water bottles in the classroom which are taken out when children play outside and water fountains.
Per facility representative there are no firearms stored on the premises. There are no pools or bodies of water at the facility.
Children’s Records were reviewed for completeness. Children's records contained all required documents and information.
Staff records were reviewed. Files reviewed contained the required documents. At least one staff's pediatric first aid/cpr was current ( expires 6/3/25). Facility Representative was reminded Mandated Reporter training and pediatric first aid/cpr shall be completed every two years.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2024
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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: LBUSD ADDAMS CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191670515
VISIT DATE: 11/21/2024
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Children's roster was reviewed. The program uses a QR code or ipad for sign in/ sign out procedures. A paper copy sign in/out sheet is available as a back up.
Disaster drills are conducted every month and are documented. The last documented drill was conducted on 10/2/24 (Fire Drill). The program provides breakfast, lunch and an afternoon snack for the full day class and lunch for both AM and PM sessions. Menus are posted once a month in the classroom where it is visible by the child's authorized representative. Menus are also provided to parents.
Menus for the past 30 days are available upon request. Per Facility Representative breakfast and lunch are provided by the elementary school cafeteria and snack is provided by LBUSD CDC nutrition services and delivered as needed. Per facility representative, children with allergies are provided alternatives and allergy lists are maintained in the classroom and individuals who prepare the meals are also aware of allergies. .
Facility Representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.
Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for
drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).
LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.
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 PIN 22-02-CCP. 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/.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2024
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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: LBUSD ADDAMS CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191670515
VISIT DATE: 11/21/2024
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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.
No citations were issued during today's inspection. A notice of site visit was given to Facility Representative and must remain posted for 30 days.
Exit interview conducted and report was reviewed with Coordinating Teacher Mom Khit.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2024
LIC809 (FAS) - (06/04)
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