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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494018
Report Date: 05/19/2023
Date Signed: 05/19/2023 01:24:33 PM

Document Has Been Signed on 05/19/2023 01:24 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:MARTIN LUTHER KING JR. LEARNING CENTER PRESCHOOLFACILITY NUMBER:
197494018
ADMINISTRATOR:CAMARENA,E & LUNA,RFACILITY TYPE:
850
ADDRESS:12029 S WILMINGTON AVETELEPHONE:
(424) 338-1980
CITY:LOS ANGELESSTATE: CAZIP CODE:
90059
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 38DATE:
05/19/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Ana Martinez, Assistant DirectorTIME COMPLETED:
01:45 PM
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Licensing Program Analyst (LPA) Alicia Mooberry conducted an unannounced Required 1 year inspection. LPA met with Facility Representative (FR) Ana Martinez, Assistant Director, who provided tour of the facility. This is a preschool program located adjacent to the Martin Luther King Jr. Community Hospital, with a capacity of up to 60 children. An Infant Program Lic # 197494017 is located on separate area of the same premises.

Days and hours of operation are Monday – Friday from 6:30 AM – 6:00 PM. The entrance to the facility is locked and parents enter using a call/buzzer system.

LPA observed the following classroom ratios: Room 120 (3 Teachers and 13 children); Room 121 (2 Teachers and 12 children); Room 123 (2 Teachers and 13 children). LPA observed teacher-child ratios in compliance and staff fingerprints have the required clearances at this time.

LPA observed telephone service, heating, lighting and ventilation to be satisfactory. Children have adequate cubby storage for their belongings. Napping mats are stored appropriately with bedding removed. The facility provides sheets and blankets and weekly laundering. LPA observed drinking water with drinking cups readily available in the classrooms. Age appropriate restrooms, sinks and toilets were inspected for good repair, water temperature, toilet paper, safety and sanitation. All available toilets and sinks are in operable condition. LPA reminded As to always store items such as hand sanitizer, cleaners and similar items in inaccessible areas or locked cabinets. The indoor classrooms have surfaces that appear to be clean and safe and there are age appropriate toys and reading material for children to use.

There are first aid supplies in each classroom. Carbon monoxide detectors and smoke detectors are present in the facility. Hazardous items including including medicine and cleaning compounds are stored in inaccessible areas such as high cabinets and inaccessible office cabinets. The office is used as an isolation area for ill children, the staff restroom is available for child use. Page 1 --- Report Continues

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE: DATE: 05/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/19/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: MARTIN LUTHER KING JR. LEARNING CENTER PRESCHOOL
FACILITY NUMBER: 197494018
VISIT DATE: 05/19/2023
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The outdoor play area is enclosed, exit gates are at least five feet high. Areas around and under climbing equipment have mats and grass to cushion a fall. All play equipment, toys, materials and surfaces accessible to children appear to be age appropriate and toxic free.

Snack menus are posted at least one week in advance and are visible to an authorized representative. The facility provides AM and PM snacks and lunch is provided by parents. LPA reminded Facility Representative to constantly assess expiration dates on food items that are removed from original packaging and document. LPA observed drinking water available (indoors and outdoors) and trash receptacles have tight fitting covers.

Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are locked and/or inaccessible. The facility has one or more functioning smoke detectors and carbon monoxide detectors that meet statutory requirements. LPA observed a fire extinguishers in the hallway due for service June 24, 2023.

LPA observed sign in books in the office area. A review of the sign in books shows that 8 out of 38 children present were not signed in on this date, this poses a potential risk to the health and safety of children care. The facility representative stated a staff will be stationed by sign in station to ensure children are being properly signed in and signed out by the authorized representative. LPA conducted a Children's Records Review for completeness and to ensure children have proper forms such as Identification and Emergency forms, Immunization records, Health History, Personal Rights, Parents Rights etc.on file. The children's roster was available and current.

Staff Records were reviewed to ensure the following: Criminal record clearance or criminal record exemption, education credits, current CPR/First Aid and health preventative practices, proof of immunization against pertussis and measles and influenza and/or flu declination, Mandated Reporter training, LPA observed at least one staff member to have current CPR (Expiration January, 2024) .

Incidental Medical Services (IMS) policy was discussed. For IMS information , see PIN 22-02-CCP. 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 Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

---------------Page 2 Report Continues

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 05/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2023
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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: MARTIN LUTHER KING JR. LEARNING CENTER PRESCHOOL
FACILITY NUMBER: 197494018
VISIT DATE: 05/19/2023
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Mandatory forms for the children’s files and staff files, requirements for fire drills, earthquake drills (last drill 5/18/23) and documentation were discussed. Role and responsibilities of being a Mandated Reporter were reviewed. The Director was advised how to access forms and Regulations online at www.ccld.ca.gov. LPA advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Staff has completing Mandated Reporter training.

The facility has completed the required Lead Testing on 11/4/22. A copy of the report was provided on this date.

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.

Records for all children and staff must be maintained for three (3) years after separation from the facility. Report Unusual Incidents and/or injuries to the parent/guardian immediately and to Child Care Licensing within 24 hours and/or the next business day. All care for children require supervision at all times.



The facility is cited one (1) "B" deficiency according to California Code of Regulation Title 22

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.

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, Ana Martinez

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 05/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2023
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Document Has Been Signed on 05/19/2023 01:24 PM - It Cannot Be Edited


Created By: Alicia Mooberry On 05/19/2023 at 12:14 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: MARTIN LUTHER KING JR. LEARNING CENTER PRESCHOOL
FACILITY NUMBER: 197494018

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/19/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Section Cited
Administration of Child Day Care Licensing
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Type B
Section Cited
CCR
101229.1(d)
Sign In and Sign Out
(d) The sign-in and sign-out sheets with the signatures required by this section and by Section 101226.1 shall be kept for one month and shall be available at the center for review by the Department.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in that 9 out of 38 children present were not signed into the sign in books by parents on this date which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/26/2023
Plan of Correction
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Per Facility Representative, A staff will be present at sign in station to ensure all parents sign in consistetly, a written plan wil be sent to LPA vial e-mail by POC due date.
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:Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:
DATE: 05/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/19/2023


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