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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192004092
Report Date: 10/03/2022
Date Signed: 10/03/2022 05:02:00 PM

Document Has Been Signed on 10/03/2022 05:02 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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:NEW HARVEST CHRISTIAN SCHOOLFACILITY NUMBER:
192004092
ADMINISTRATOR:LISA SALAZARFACILITY TYPE:
850
ADDRESS:11364 E. IMPERIAL HWYTELEPHONE:
(562) 929-6034
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY: 41TOTAL ENROLLED CHILDREN: 23CENSUS: 21DATE:
10/03/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:09 AM
MET WITH:Renee Aguilar-Lead Teacher TIME COMPLETED:
05:10 PM
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On 10/3/22 Licensing Program Analyst (LPA) Jeanette Estrada conducted an unannounced required 1 year inspection. LPA met with Assistant Director Renee Aguilar and informed her of the purpose of the visit. LPA provided Facility Entrance Checklist to Assistant Director. This is a preschool program with a toddler component. The facility was observed to be within the license capacity. Upon arrival there were 20 children with 5 staff in the outdoor playground. Criminal Record Clearances for staff present were reviewed. Present during today's inspection was Staff/Aide,Trinity Zazueta who does not have a completed criminal record clearance. Operating hours are Monday to Friday 6AM to 6PM. The facility provides services to children ages 18 months to 30 months in the toddler component and 30 months to entry into first grade in the preschool component.
Classrooms used in the facility are 11, 12 and 13.
All areas on the facility sketch were inspected. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. There is cental air/heating in the facility. Children have their own cubbies in the hallway to store their belongings.
There is one restroom in room 12 for the preschool and one restroom in room 13 for the toddler component. Each restroom has 2 toilets and 2 sinks. General sanitation was observed in the children's restrooms. The facility offers potty training in the toddler classroom.
Availability of indoor drinking water was observed in classrooms via water containers and disposable cups. . Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Cleaning supplies are stored on high shelves in the classrooms. Medication is stored in a locked storage cabinet. Per Assistant Director there are no poisons in the facility. When LPA toured the facility there was no carbon monoxide detector observed. During the inspection a carbon monoxide detector was purchased and installed. The facility has a central fire alarm installed. Each class contains a first aid kit.
Per Assistant Director there are no firearms stored on the premises. There are no pools or bodies of water at the facility. There is a 2A10BC fire extinguisher in the hall way. Fire extinguisher was last serviced in 12/2021. There is appropriate napping equipment available for children.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE: DATE: 10/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/03/2022
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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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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: NEW HARVEST CHRISTIAN SCHOOL
FACILITY NUMBER: 192004092
VISIT DATE: 10/03/2022
NARRATIVE
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Children’s Records were reviewed for completeness. Child 6 was missing LIC 701-Physician's report.
Staff files: Per Assistant Director updated Mandated Reporter training has not been completed for 6 staff present. Per Assistant Director, she does not have access to the complete staff files. A complete staff file review will be conducted at a later time by LPA.
Children's roster was reviewed and is current. Sign-In and Sign-Out sheets were reviewed. A disaster drill log was available. Last drill documented was held on 10/19/21.
The facility provides two snacks. Children bring lunch from home. Menus are provided to parents/ authorized representatives one month in advance and the menus are also posted. Menus for the past 30 days are available upon request.
All food preparation areas and food storage areas are kept clean and are free of litter, rubbish, rodents, and/or any other vermin. All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids or solid waste bags shall be discarded immediately after each meal. A food allergy list is posted in the classrooms.
The outdoor playground area was evaluated. The outdoor playground is fully fenced. 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-grass There is adequate shade in the play yard. LPA did not observe a separate space for the the toddler component. During the tour of the outdoor playground of the facility, LPA observed children enrolled in the toddler program using the same outdoor space at the same time as the children enrolled in the preschool program. Per Assistant Director, they have a staggered schedule but went out together today due to the heat, they wanted children to use the outdoor area in case it became too hot during the day.
Incidental Medical Services (IMS) policy was discussed. Currently there is one child who has medication stored at the facility. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (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

**continued on page 3**

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2022
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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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: NEW HARVEST CHRISTIAN SCHOOL
FACILITY NUMBER: 192004092
VISIT DATE: 10/03/2022
NARRATIVE
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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.
Present during today's inspection was Trinity Zazueta who does not have a criminal record clearance. LPA reviewed LIC 9163 request for livescan for Trinity Zazueta dated 3/27/22. After verification from Licensing Information System (LIS) and Guardian, it was confirmed that the criminal record clearance was not completed. A $500 civil penalty is being cited today.
LPA advised the licensee/facility representative how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.
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. 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/tion-process.

The deficiencies listed on the following pages were observed by the LPA and are being cited in accordance with California Code of Regulations Title 22. One type A citation was issued today for CCR 101170(e)(1)Criminal Record Clearance . Please see attached LIC 809-Ds for additional citations.



Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

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SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2022
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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: NEW HARVEST CHRISTIAN SCHOOL
FACILITY NUMBER: 192004092
VISIT DATE: 10/03/2022
NARRATIVE
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The notice of site visit shall be posted where the parent/guardian of children enter and exit the facility.
A copy of this report shall also be posted where the parent/guardian of children enter and exit the facility.
Both the notice of site visit and licensing report shall remain posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.
A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon their return.
A copy of this report shall also be provided to the parent/guardian of any newly enrolled child for the next 12 months. A signed Acknowledgement of Receipt (LIC9224) shall be in each child’s file, acknowledging receipt.


A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and Appeal Rights and report were reviewed with Assistant Director Renee Aguilar..

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/03/2022 05:02 PM - It Cannot Be Edited


Created By: Jeanette Estrada On 10/03/2022 at 03:53 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: NEW HARVEST CHRISTIAN SCHOOL
FACILITY NUMBER: 192004092

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/03/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101170(e)(1)
Criminal Record Clearance
(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department or

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
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4
Based on interview and record review, the licensee did not comply with the section cited above. Staff Trinity Zazueta does not have a completed criminal record clearance which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 10/04/2022
Plan of Correction
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Per facility representative, Trinity Zazueta will not be present until criminal record clearance is completed. An updated staff schedule will be submitted not including Trinity Zazueta along with a written statement indicating she will not be present until cleared. POC will be submitted via email.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Valarie Cook
LICENSING EVALUATOR NAME:Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:
DATE: 10/03/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/03/2022


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/03/2022 05:02 PM - It Cannot Be Edited


Created By: Jeanette Estrada On 10/03/2022 at 03:53 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: NEW HARVEST CHRISTIAN SCHOOL
FACILITY NUMBER: 192004092

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/03/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101174(d)
Disaster and Mass Casualty Plan
(d) Disaster drills shall be conducted at least every six months.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review and interview, the licensee did not comply with the section cited above. The last documented disaster drill was conducted on 10/19/2021 which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/14/2022
Plan of Correction
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A disaster drill will be completed. Proof of disaster drill and documentation-such as date of drill will be submitted via picture.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review and interview the licensee did not comply with the section cited above in 6 out of 6 staff records which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/03/2022
Plan of Correction
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mandated reporter training will be completed. Proof will be provided to LPA via picture.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Valarie Cook
LICENSING EVALUATOR NAME:Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:
DATE: 10/03/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/03/2022


LIC809 (FAS) - (06/04)
Page: 5 of 11
Document Has Been Signed on 10/03/2022 05:02 PM - It Cannot Be Edited


Created By: Jeanette Estrada On 10/03/2022 at 03:53 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: NEW HARVEST CHRISTIAN SCHOOL
FACILITY NUMBER: 192004092

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/03/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101170(d)
Criminal Record Clearance
(d) All individuals subject to criminal record review shall, be fingerprinted and sign a Criminal Record Statement (LIC 508 [Rev. 1/03]) under penalty of perjury.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above. After review of Guardian, it was determined that Trinity Zazueta did not submit the requested LIC 508 to the Department to continue the process of the criminal record clearance which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/07/2022
Plan of Correction
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Per Assistant Director, a completed LIC 508 will be available for Trinity Zazueta if requested by the Department to processthe criminal record clearance. Proof of a completed LIC 508 will be submitted via picture.
Type B
Section Cited
CCR
101220(a)
Child's Medical Assessments
(a) Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child. This medical assessment enables the licensee to assess whether the center can provide necessary health-related services to the child.

This requirement is not met as evidenced by:
Deficient Practice Statement
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4
Based on record review, the licensee did not comply with the section cited above in 1 out of 7 files reviewed which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/03/2022
Plan of Correction
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4
LIC 701 physician's report will be completed for child 6. proof will be submitted to LPA via picture.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Valarie Cook
LICENSING EVALUATOR NAME:Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:
DATE: 10/03/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/03/2022


LIC809 (FAS) - (06/04)
Page: 6 of 11
Document Has Been Signed on 10/03/2022 05:02 PM - It Cannot Be Edited


Created By: Jeanette Estrada On 10/03/2022 at 03:53 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: NEW HARVEST CHRISTIAN SCHOOL
FACILITY NUMBER: 192004092

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/03/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216.4(a)(2)
Preschool Program with Toddler Component
(2) The toddler program shall be conducted in areas physically separate from those used by older or younger children. Space planning and usage for the toddler component shall be governed by the provisions of Section 101438.3. Plans to alternate use of outdoor play space must be approved by the Department.

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on observation and interview, the licensee did not comply with the section cited above. LPA observed the toddler class using the outdoor space at the same time as the preschool class which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/14/2022
Plan of Correction
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2
3
4
A staggered schedule will be submitted to LPA. Per assistant director staff will review regulation and will sign acknowledgement that regulation is understood. Proof will be submitted to LPA via picture.
Section Cited
Deficient Practice Statement
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2
3
4
POC Due Date:
Plan of Correction
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2
3
4
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Valarie Cook
LICENSING EVALUATOR NAME:Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:
DATE: 10/03/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/03/2022


LIC809 (FAS) - (06/04)
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