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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198003333
Report Date: 09/18/2024
Date Signed: 09/18/2024 01:28:49 PM

Document Has Been Signed on 09/18/2024 01:28 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:WASHINGTON ELEM. HEAD START-MADISON AVE.FACILITY NUMBER:
198003333
ADMINISTRATOR/
DIRECTOR:		MARIANA SANCHEZFACILITY TYPE:
850
ADDRESS:1400 W. MADISON AVE.TELEPHONE:
(323) 887-2177
CITY:MONTEBELLOSTATE: CAZIP CODE:
90640
CAPACITY: 42TOTAL ENROLLED CHILDREN: 32CENSUS: 25DATE:
09/18/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:13 AM
MET WITH:Gabriela Burgos and Paz Maria SotoTIME VISIT/
INSPECTION COMPLETED:
01:45 PM
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Licensing Program Analyst (LPA) Veronica Martinez Garza conducted an unannounced Annual/Random inspection at the above facility on 09/18/24 at 11:13 a.m. Upon arrival, LPA observed the door to be locked. LPA called the number on file; however, the number is incorrect. LPA contacted the Montebello Unified School District Head Start office and spoke with Susan. LPA disclosed the purpose of the call and explained that the LPA was outside. Per Susan, she was going to contact the education specialist to allow LPA to enter the site. LPA waited over 30 minutes for the education specialist to arrive. LPA called again the Montebello Unified School District Head Start office and spoke with Susan. LPAs call was transferred to education specialist Paz Maria Soto who was not aware of LPAs inspection. Education specialist contacted their lead teacher Gabriela Burgos to allow LPA entry to the site. At approximately 11:37am, LPA met with Lead Teacher Gabriela Burgos who 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 Washington Elementary School. Entrance to the facility is through Madison Ave Gate 10. The program consists of two classrooms (Room 01 and Room 02). Operation hours are Monday – Friday from 08:15 a.m.– 02:15 p.m. Per lead teacher, there are 32 children enrolled. Education specialist later arrived and assisted LPA with the rest of the inspection.

All areas identified on the facility sketch were inspected. The following staff was present during this inspection: Room 01:14 children with 03 staff and Room 02: 11 children with 02 staff. Teacher-child ratios were observed to be in accordance with Title 22 Regulations. Staff names were recorded on the attached LIC859. All children were observed to be under supervision, including visual supervision, of a teacher at all times.

LPA observed the facility to be clean and sanitary conditions. All indoor classrooms were inspected to ensure that the floors have a surface that is safe and clean. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts.


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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE: DATE: 09/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/18/2024
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: WASHINGTON ELEM. HEAD START-MADISON AVE.
FACILITY NUMBER: 198003333
VISIT DATE: 09/18/2024
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Drinking water was readily available indoors and outdoors. LPA observed classrooms have a water dispenser with disposable cups and facility refills water as needed. LPA observed cots are used as napping equipment. LPA also observed all children have their own cubby. At this time, the "isolation area" is used as an isolation area. A mat is available for an ill child to rest on. Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. 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. The facility was observed to be free of flies, other insects, and rodents.

LPA observed all required forms/publications to be posted in the entrance of both classrooms. Snack menus were reviewed to ensure that they are being posted at least one week in advance and visible to an authorized representative. Facility provides breakfast, snacks, and lunch. Food is provided by the Elementary cafeteria. All food is protected from contamination. Lead teacher states there are no weapons, firearms, or bodies of water on the premises.

First Aid supplies are available. LPA observed a current Emergency disaster drill. Last drill documented was on 08/29/24. LPA observed a functioning carbon monoxide detector.

LPA took a tour of the outdoor play area and inspected the outdoor play equipment for any lose or pointed parts. Outdoor areas around and/or under climbing equipment have cushioning material to absorb a fall. LPA advised the education specialist to check with the American Standard Testing Materials for Playground Guidelines and/or to use the manufactures recommendations for the playground equipment in efforts to be more in line with safety guidelines.

Sign in and out sheets were reviewed on the child plus application to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. LPA observed all children present were signed in. Children’s roster was reviewed and was observed to be current. Children's file were reviewed and were observed complete.

There is at least one person trained in CPR and Pediatric First Aid present during this inspection.



LPA did not review staff as they are 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.
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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2024
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: WASHINGTON ELEM. HEAD START-MADISON AVE.
FACILITY NUMBER: 198003333
VISIT DATE: 09/18/2024
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AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018, any person who works in a child care facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers.

This facility provides Incidental Medical Services – IMS. LPA reviewed child 3 (C3) storage of “medication and equipment/supplies, and reviewed children’s, personnel, and
administrative records.

For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Education specialist was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-proces.

Education specialist was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2024
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: WASHINGTON ELEM. HEAD START-MADISON AVE.
FACILITY NUMBER: 198003333
VISIT DATE: 09/18/2024
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CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES:

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

LPA verified that the lead testing was completed in accordance with the Written Directives outlined in PIN 21-21.1-CCP.

At this time, the facility is in compliance with California Title 22 Regulations. Therefore, there are no deficiencies being issued today.

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



Exit interview conducted and report was reviewed with the education specialist Paz Maria Soto.






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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2024
LIC809 (FAS) - (06/04)
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