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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197408336
Report Date: 01/12/2023
Date Signed: 01/12/2023 01:33:37 PM

Document Has Been Signed on 01/12/2023 01:33 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:ELLEN OCHOA LEARNING CENTER STATE PRESCHOOLFACILITY NUMBER:
197408336
ADMINISTRATOR:MARCOS HERNANDEZFACILITY TYPE:
850
ADDRESS:5027 LIVE OAK STREET RM 1-3TELEPHONE:
(323) 869-1300
CITY:CUDAHYSTATE: CAZIP CODE:
90201
CAPACITY: 42TOTAL ENROLLED CHILDREN: 42CENSUS: 0DATE:
01/12/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Veronica Garcia, Facility RepresentativeTIME COMPLETED:
01:35 PM
NARRATIVE
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Licensing Program Analysts (LPA) Denise Gibbs conducted an unannounced annual required inspection at the above facility on 1/12/23 at 10:30 AM. LPA met with Veronica Garcia Facility Representative (FR) who guided analysts on a tour of the facility.

This is a preschool program that operates an AM and PM program, Monday - Friday from 7:30AM-10:30PM and 11:20AM.- 2:20PM.

There were no children and three staff present when LPA arrived. Facility is in transition from the AM to the PM program. All individuals present have obtained a criminal record clearance or criminal record exemption as a condition of employment with the Los Angeles Unified School District.

Facility shares a campus with Kindergarten and Transitional Kindergarten. Licensed classrooms are located in Room #1 and Room #3. State preschool does not commingle with the programs on campus. Both classrooms had furniture in good condition, free of loose, sharp and/or pointed parts. The floors and surfaces in the classrooms were clean and safe. Rugs were observed to be flat on the ground to avoid tripping hazards. Water is made readily available via labeled bottles provided by facility. Facility does have extra water bottles on hand. Facility also has operable water fountains in each classroom. LPA observed solid waste in trash cans without lids. Trash cans were discussed with FR. There are currently no children with medication. Per staff, when a child does have medication it is stored in the classroom with required authorization forms, inaccessible to children. Children have cubbies to store personal belongings separate from each other. Children do not nap at facility because they are part time. LPA toured the children’s restrooms. Restrooms are located in each classroom for preschool use only. Restrooms were observed to be safe and sanitary with operable sinks and toilets.

LPA toured outdoor play area. Outdoor space is only used by preschool children. Outdoor areas were ---------------------PAGE 1
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE: DATE: 01/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/12/2023
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: ELLEN OCHOA LEARNING CENTER STATE PRESCHOOL
FACILITY NUMBER: 197408336
VISIT DATE: 01/12/2023
NARRATIVE
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observed to have age appropriate equipment, toys and material for children. LPA observed required cushioning under climbing structure to absorb fall. Shade was observed throughout the outdoor area. LPA observed shade material falling down, touching the ground. Per FR this is due to the rain and wind we just experienced and shade will be fixed. LPA observed three operable water fountains available for children to drink freely. LPA observed children's play house and picnic bench is cracked with sharp plastic edges.

LPA observed required posted documentation in each classroom, which included, Facility License, Publication (PUB) 393- Notification of Parent Rights, Licensing Form (LIC) 610- Facility Disaster Plan, PUB 269- Child Passenger Restraint System, LIC 613A- Notification of Personal Rights and Lunch/Snack Menu. Disaster plan was discussed with FR.

Facility records were reviewed for LIC 9040- Facility Roster, 9148- Earthquake Preparedness form, Daily schedules and Disaster drill log, last drill conducted on 12/16/22. All items observed.

LPA toured kitchen at facility. Facility provides breakfast and lunch. Food is not cooked at the facility. Prepackaged food is brought from the neighboring elementary school. Extra food is discarded. Food Storage area was observed to be clean, free of litter, insects and rodents. Cleaning supplies are stored separate from the food. Carbon monoxide detector is wired with facility smoke and fire alarm.

LPA reviewed Sign In/Out sheets are located inside each classroom. All children were signed in and out with date, time and full signature of child's guardian.

Children’s records were reviewed for Emergency Card with consent for medical treatment, Immunization Records, LIC 995 Notification of Parents’ Rights, LIC 701- Physician’s Report, LIC 613A- Personal Rights, Request for medication documentation, medication expiration dates and signed Admissions Agreement. All documents were observed.

Staff records were not available for review. All staff are missing proof of immunization, Mandated Reporter Training, and current CRP and First aid certificates. LIC 9052- Employee Rights, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse and Teachers permit were discussed. --------------------PAGE 2
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2023
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: ELLEN OCHOA LEARNING CENTER STATE PRESCHOOL
FACILITY NUMBER: 197408336
VISIT DATE: 01/12/2023
NARRATIVE
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LPA observed that facility still is implementing COVID-19 precautions and procedures as required by Los Angeles Unified School District and the Department of Public Health.

Incidental Medical Services (IMS):
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a plan for providing 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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm

Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

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/process.

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

Exit interview conducted and report was reviewed with the Facility Representative Veronica Garcia.


--------------------------PAGE 3
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2023
LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 01/12/2023 01:33 PM - It Cannot Be Edited


Created By: Denise Gibbs On 01/12/2023 at 12:36 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: ELLEN OCHOA LEARNING CENTER STATE PRESCHOOL
FACILITY NUMBER: 197408336

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/12/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238.2(d)(2)
Outdoor Activity Space
(d) The surface of the outdoor activity space shall be maintained: (2) Free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard.

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. LPA observed cracked plastic doll house and picnic bench with sharp edges and fallen shade material, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/10/2023
Plan of Correction
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Per FR, by tomorrow playhouse will be removed, the bench will be taped so plastic is not sharp and the shade will be put back up by custodian. FR will email LPA pictures of corrections by POC date 2/10/23.
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

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 out of 3 staff files which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/10/2023
Plan of Correction
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FR states she will send staff an email asking to submit immunization with a deadline of two weeks. FR will be creating a binder to keep all documents together. FR will email immunization records to LPA by POC date 2/10/23.
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:Trevino Cochran
LICENSING EVALUATOR NAME:Denise Gibbs
LICENSING EVALUATOR SIGNATURE:
DATE: 01/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/12/2023


LIC809 (FAS) - (06/04)
Page: 4 of 5
Document Has Been Signed on 01/12/2023 01:33 PM - It Cannot Be Edited


Created By: Denise Gibbs On 01/12/2023 at 12:36 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: ELLEN OCHOA LEARNING CENTER STATE PRESCHOOL
FACILITY NUMBER: 197408336

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/12/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
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, the licensee did not comply with the section cited above in 2 out of 3 staff files which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/10/2023
Plan of Correction
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FR states she will send staff an email asking to submit mandated reporter training with a deadline of two weeks. FR will be creating a binder to keep all documents together. FR will email certificates to LPA by POC date 2/10/23.
Type B
Section Cited
CCR
101216(f)
Personnel Requirements
(f) At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities.

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. At least one staff member does not have a current CRP/1st aid certification, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/10/2023
Plan of Correction
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FR states she will send staff an email requiring staff to update their CPR certification. FR will be creating a binder to keep all documents together. FR will email certification to LPA by POC date 2/10/23.
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:Trevino Cochran
LICENSING EVALUATOR NAME:Denise Gibbs
LICENSING EVALUATOR SIGNATURE:
DATE: 01/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/12/2023


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