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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192004092
Report Date: 10/11/2022
Date Signed: 10/11/2022 04:47:43 PM

Document Has Been Signed on 10/11/2022 04:47 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: 41CENSUS: 19DATE:
10/11/2022
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Renee Aguilar-Lead Teacher TIME COMPLETED:
05:00 PM
NARRATIVE
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On 10/11/22 Licensing Program Analysts (LPAs) Jeanette Estrada and Austin Estrada conducted an unannounced visit to the above facility. This is a continuation of an annual inspection conducted on 10/3/22. LPAs met with Facility Representative Renee Aguilar and informed her of the reason for the visit. Director Lisa Salazar joined LPAs at a later time.

Upon arrival at the facility, LPAs did not observe the Notice Of Site Visit and the LIC 809 issued on 10/3/22 posted in a prominent area. Per Assistant Director, it fell off of the wall it had originally been posted on. An immediate Civil Penalty of $100 is being issued today for this citation.


The purpose of today's visit was to review staff records for completeness as well as teacher and director qualifications. LPA reviewed staff files for five staff present during the visit on 10/3/22.

Based on the LPAs record review and observations the following deficiencies listed on the attached LIC 809D is being cited in accordance with California Code of Regulations Title 22.
Two type B citations were issued today for 101216(g)(1) Personnel Requirements-3 staff files did not contain LIC 503 Health Screening Report and for 1596.817(b)(1)(2)(1) for not having the Notice of site visit posted.


Exit interview was conducted with Director Lisa Salazar
Notice of Site Visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE: DATE: 10/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/11/2022
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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Document Has Been Signed on 10/11/2022 04:47 PM - It Cannot Be Edited


Created By: Jeanette Estrada On 10/11/2022 at 03:46 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: 10/11/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(g)(1)
Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

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 in 3 staff files which did not contain LIC 503 Health Screening Report which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/18/2022
Plan of Correction
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Per Director, Staff have a due date of 10/14/22 to complete the LIC 503. Director will send LPA a picture of the completed LIC 503 for each staff by the POC due date.
Type B
Section Cited
HSC
1596.817(b)(1)(2)(1)
(b)(1) The notice posted pursuant to subdivision (a) shall remain posted for 30 consecutive days...
(2) Failure by a licensed child day care facility... to comply with paragraph (1) shall result in an immediate civil penalty of one hundred dollars ($100).


This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above. LPAs observed that the notice of site visit issued on 10/3/22 was not posted in a prominent area which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/11/2022
Plan of Correction
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Assistant Director Renee Aguilar obtained the notice of site visit from the classroom and posted it on the wall at the entrance to the facilty. Per Assistant Director, it must have fallen off the wall.
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: 10/11/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/11/2022


LIC809 (FAS) - (06/04)
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