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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192005044
Report Date: 11/09/2022
Date Signed: 11/09/2022 01:42:31 PM

Document Has Been Signed on 11/09/2022 01:42 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:ELM STREET HEAD STARTFACILITY NUMBER:
192005044
ADMINISTRATOR:MARSHA BULLOCKFACILITY TYPE:
850
ADDRESS:1425 & 1429 ELM AVENUETELEPHONE:
(562) 218-6220
CITY:LONG BEACHSTATE: CAZIP CODE:
90806
CAPACITY: 85TOTAL ENROLLED CHILDREN: 56CENSUS: 30DATE:
11/09/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:35 AM
MET WITH:Marsha Bullock, Head TeacherTIME COMPLETED:
02:30 PM
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An unannounced Required – 1 Year Inspection was conducted on 11/09/2022 at 11:35 AM by Licensing Program Analyst (LPA) Katrina Chicote. Facility is currently licensed for a capacity of 85 but have 56 enrolled at this time. Licensing staff initially met with Marsha Bullock, Head Teacher (S9). The program currently operates a Full Day Program from 7:45 AM to 2:45 PM, Monday thru Friday. LPA was taken on a guided tour of the facility of both indoors and outdoors. LPA arrived as children were going down for nap time. Early Learning Center Managers (ELCMs), Jenny Acosta and Judy Long, arrived during inspection at 12:18 PM.

Facility is made up of four classrooms (RM2, RM 3, RM 1A, and RM 1B). At the initial start of the site visit, there is a total census of 30 children and a total census of nine staff present. LPA observed RM 2 (2 year olds) to have five children with two staff (S1 and S2), RM 3 (2 year olds) to have six children and two staff (S3 and S4), RM 1A to have eight children with two staff (S5 and S6) and RM1B to have 11 children with two staff (S7 and S8).

Beginning at 11: 45 AM, furniture and equipment were inspected for age appropriateness and good repair in all classrooms. Telephone service, heating, lighting and ventilation were evaluated. There were cubbies observed as storage for children's belongings. LPA observed child size tables and chairs well maintained and floors to be free of hazards at time of inspection. LPA observed learning stations in each classroom for dramatic play, math, and art with toys and materials available for children that is well maintained free of loose and sharp parts in each classroom. LPA observed a library area with seating available for quiet play option. Mats/cots were inspected. Per S9, linens are provided by the facility and washed weekly. Availability of drinking water was reviewed. LPA observed water pitchers with paper cups available in each classroom. Age appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, area safety and sanitation. LPA observed bathrooms from RM 2 and RM 3 available in each classroom each with two toilets and two sinks, bathrooms in these classrooms also contain diaper changing tables that meet Title 22 Regulation Requirements. LPA observed RM 1A and RM1B share the bathroom in the middle that contains three sinks and three toilets.
Report Continues - Page 1 of 3
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE: DATE: 11/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/09/2022
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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: ELM STREET HEAD START
FACILITY NUMBER: 192005044
VISIT DATE: 11/09/2022
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A first aid kit is kept in each classroom and LPA inventoried for necessary supplies. LPA observed sick/isolation area is in Family Service's Liaison's (FSL) office. LPA observed C1 and C2 to require medications and stored per Title 22 Regulation requirements. Disaster drill log was available and last drill conducted on 11/2022. LPA observed carbon monoxide detectors were operable and smoke detectors are present in the facility at time of inspection. Fire extinguishers have been serviced on 07/02/2022. Hazardous items such as cleaning compounds were stored inaccessible to children in a shed in outdoor play ground. Per S9, there are no poisonous items stored at the facility.

Snack/lunch menus were reviewed and posted for the month. Per S9, facility serves breakfast, lunch, and snack. There is no kitchen at the facility. All meals and snacks are delivered from Head Start Kitchen. Trash cans used to discard food have tight fitting lids.

Beginning at 12:00 PM, outdoor equipment was inspected for safety, cushioning material, good repair and age-appropriateness. LPA observed a play structure with stairs, slide, and balancing equipment with cushioning material below to absorb fall all well maintained. Required shade and fencing were inspected, LPA observed tables and benches available under covered shade. LPA advised that the children need to be within the direct care and supervision, including visual supervision of the teacher(s) at all times. LPA observed drinking fountains outside available for children as well as water pitchers. Play area was inspected for hazards and inaccessibility to bodies of water; no bodies of water or hazards observed.

Teacher-child ratios were observed and staff names recorded. Care and supervision was evaluated to determine if the basic needs of children are met and appropriate. Sign-in and out sheets and procedures were reviewed. LPA observed all children present signed in with full legal signatures. Personal Rights of children were observed by LPA.

Beginning at 12:45 PM, Staff and Children’s Records were reviewed. All staff and employees have obtained a criminal record clearance or criminal record exemption as a condition of employment with the Long Beach Unified School District. CPR card expires in 05/2024 for S2. Staff present have proof of the AB 1207 Mandated Reporter Training certificate on file. All staff have been given on the-job training sanitation principles, housekeeping, including universal health precautions. LPA did not review confidential forms and information due to the files being stored at the administrative office.

Report Continues - Page 2 of 3
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2022
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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: ELM STREET HEAD START
FACILITY NUMBER: 192005044
VISIT DATE: 11/09/2022
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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 Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and Carbon Monoxide detectors should be checked and batteries replaced as needed.

Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your location.

LPA advised of the requirement to report Unusual Incidents and/or injuries to the parent/guardian and to CCL within the time frame specified by the regulation.

The facility was found in compliance per Title 22 regulations, there will be no deficiencies cited today, 11/09/2022.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.



Exit interview was conducted and report was reviewed with the Licensee (or facility representative), Jenny Acosta and Judy Long.
Report Ends - Page 3 of 3
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2022
LIC809 (FAS) - (06/04)
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