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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198000822
Report Date: 04/06/2022
Date Signed: 04/06/2022 11:59:25 AM

Document Has Been Signed on 04/06/2022 11:59 AM - 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:GREENWOOD ELEMENTARY SCHOOLFACILITY NUMBER:
198000822
ADMINISTRATOR:MARIANA SANCHEZFACILITY TYPE:
850
ADDRESS:900 S. GREENWOOD AVE.TELEPHONE:
(323) 887-7900
CITY:MONTEBELLOSTATE: CAZIP CODE:
90640
CAPACITY: 42TOTAL ENROLLED CHILDREN: 36CENSUS: 32DATE:
04/06/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Julia MojarroTIME COMPLETED:
12:14 PM
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Licensing Program Analyst (LPA) Lissete Gonzalez conducted an unannounced annual inspection on 4/06/2022 at 9:00AM. LPA met with Julia Mojarro, Lead Teacher. LPA provided Maria Valenzuela, Principal, with a copy of the Entrance Checklist for Child Care Centers form (LIC 125). Lead Teacher then guided LPA on a tour of the facility. This is a Head Start preschool program which is operated by Montebello Unified School District and is located on the premises of Greenwood Elementary School. Entrance to the facility is through Jacmar Dr. The program consists of two classrooms (Room 01 and Room 02/03). The full day program is in Room 01 and operates from 8:00am to 2:00pm. The partial day programs include an AM Session that operate in Room 02 from 8:00am to 11:45am and the PM Session operates in Room 03 from 12:00am to 3:45pm, Monday through Friday.

All areas identified on the Facility Sketch were inspected. Upon arrival, the following staff were present during this inspection; Room #01: Staff #1 and Staff #2 with 14 preschoolers; Room #02: Staff #3 and Staff #4 with 18 preschoolers. The facility was observed to be within the license capacity and limitations. The following was observed during the tour of the facility:

PHYSICAL PLANT
Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Children have their own cubby to store their belongings. Linens are washed weekly every Friday or as needed. Napping equipment (cots) were observed to be stored in a the classroom and are labeled. Age appropriate sinks and toilets were inspected for availability and good repair in all restrooms. General sanitation was observed. Availability of indoor drinking water was observed in the classrooms.

Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible
REPORT CONTINUES ON NEXT PAGE: 1 OF 4
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Lissete Gonzalez
LICENSING EVALUATOR SIGNATURE: DATE: 04/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/06/2022
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 4
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: GREENWOOD ELEMENTARY SCHOOL
FACILITY NUMBER: 198000822
VISIT DATE: 04/06/2022
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to children. Lead Teacher states there are no poisons stored at the facility. Carbon monoxide detectors were observed and are operable.

All kitchen, food preparation and food storage areas are kept clean and are free of litter, rubbish, rodents, 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.

Outdoor playground equipment is in a safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard. Availability of outdoor drinking water was observed. LPA advised that no children shall be left without the supervision of a teacher at any time.

All floors were observed to be clean and safe. All materials accessible to children were observed to be toxic-free There are no firearms stored on the premises. There are no pools or bodies of water at the facility.

FACILITY RECORDS
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.

There is at least one person trained in CPR and Pediatric First Aid present during this inspection.
Children’s Records were partially reviewed for completeness. Children’s health records are stored in the administrative office.

LPA did not review staff files during the inspection due to the staff files being stored at the administrative office. LPA will review staff files at a later time and date. If staff files are found to be incomplete during the time and date that LPA reviews files, a case management inspection will occur at the facility to reflect incomplete files.

REPORT CONTINUES ON NEXT PAGE: 2 OF 4
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Lissete Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2022
LIC809 (FAS) - (06/04)
Page: 2 of 4
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: GREENWOOD ELEMENTARY SCHOOL
FACILITY NUMBER: 198000822
VISIT DATE: 04/06/2022
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Children's roster was reviewed and is current. LPA observed children and signed in and out via Child Plus. Children present were signed in. Disaster drill log was available, last drill was conducted on 03/22/2022.

Menus are posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request. Food is provided by the School District Cafeteria. The facility provides, breakfast, lunch and a PM snack to the full day program. The facility provides breakfast and lunch to the AM Session and lunch and a PM snack to the PM Session.

First Aid supplies were observed in the classroom in a cabinet. According to the Lead Teacher, medication is only administered to a child when accompanied with a doctor's note and is stored in the child’s classroom. The facility was observed to be equipped with an isolation area for any child who becomes ill and it is located within the classroom. Ill children use the staff restroom located in the bungalow between Room 01 and Room 02/03.

Medication: This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication, 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
LPA advised the licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

UPDATE: LPA provided the Licensee/Director/Principal with a copy of the Effects of Lead Exposure form during the inspection and discussed the following Provider Information Notices (PINs) Required Lead Testing: PIN 20-01 CCP Effects of Lead Exposure, and Guardian User Account Access - PIN 20-20-CCLD.

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.
REPORT CONTINUES ON NEXT PAGE: 3 OF 4
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Lissete Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2022
LIC809 (FAS) - (06/04)
Page: 3 of 4
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: GREENWOOD ELEMENTARY SCHOOL
FACILITY NUMBER: 198000822
VISIT DATE: 04/06/2022
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There were no deficiencies cited during today’s inspection.

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, Julia Mojarro.

END OF REPORT PAGE: 4 OF 4
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Lissete Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2022
LIC809 (FAS) - (06/04)
Page: 4 of 4