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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198007432
Report Date: 10/14/2022
Date Signed: 10/14/2022 03:00:42 PM

Document Has Been Signed on 10/14/2022 03:00 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:BUNDLE OF JOY DAYCARE #3FACILITY NUMBER:
198007432
ADMINISTRATOR:YOLANDA STOWEFACILITY TYPE:
850
ADDRESS:4835 LONG BEACH BLVD.TELEPHONE:
(562) 728-6882
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY: 45TOTAL ENROLLED CHILDREN: 3CENSUS: 3DATE:
10/14/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Director - Yolanda StoweTIME COMPLETED:
03:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Randy Derraco conducted an unannounced required one year inspection on 10/14/22 at 9:30 AM. LPA met with Yolanda Stowe, Director, who guided analyst on a tour of the facility. This is a preschool program which consists of 3 classrooms. There is current one classroom in use. Facility operation hours are Monday to Friday from 7:00 AM to 6:00 PM. Per Director, she has been remodeling the facility for approximately two weeks and is currently using one classroom due to low attendance. LPA observed the remodeled classroom to be inaccessible to children in care.

All areas identified on this report were inspected. Upon arrival, the following staff were present during this inspection: Lucky Charms Class Room: Staff S1 with 3 children. Per Director, S2 started today however she has not obtained criminal background clearance prior to starting employment. LPA advised director that a citation under California Code of Regulation (CCR) section 101170(e)(1) will be issued. Teacher-child ratios were observed to be in accordance with Title 22 Regulations. All children were observed to be under visual supervision of a teacher at all times.

The following was observed during the tour of the facility:

Sign in and out sheets were not available for review. Per Director, the center uses the Brightwheel app to sign children in and out of the facility, however she can only view the sign in / out sheets using a laptop and her laptop was not available. LPA advised that a citation under CCR section 101229.1(d) will be issued. Per Director, disaster drills are conducted at least once every month, however a disaster drill log was not available for review. LPA advised Director that a citation under CCR section 101175(d) will be issued. LPA observed required licensing documents not posted because Director had begun painting the wall where required posting would go. Required posting were observed to still be in their respective frames.

(page 1 of 3)

SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE: DATE: 10/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/14/2022
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 9
Document Has Been Signed on 11/15/2022 02:36 PM - It Cannot Be Edited

Document is an Amendment of Original Document on 11/15/2022 08:11 AM


Created By: Randy Derraco On 10/14/2022 at 01:22 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: BUNDLE OF JOY DAYCARE #3
FACILITY NUMBER: 198007432

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/14/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101170(e)(1)
Criminal Record Clearance
(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department or

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview and record review, the licensee did not obtain California clearance or a criminal record exemption for S2, which poses an immediate Health, safety and/or personal rights risk to persons in care.
POC Due Date: 10/24/2022
Plan of Correction
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Director will have employee fingerprinted and associated to facility by POC date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Randy Derraco
LICENSING EVALUATOR SIGNATURE:
DATE: 10/14/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/14/2022


LIC809 (FAS) - (06/04)
Page: 2 of 9
Document Has Been Signed on 11/15/2022 02:37 PM - It Cannot Be Edited

Document is an Amendment of Original Document on 11/15/2022 08:15 AM


Created By: Randy Derraco On 10/14/2022 at 01:22 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: BUNDLE OF JOY DAYCARE #3
FACILITY NUMBER: 198007432

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/14/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101174(d)(2)
Disaster and Mass Casualty Plan
(d) Disaster drills shall be conducted at least every six months. (2) The drills shall be documented. This documentation shall be kept in the child care center for at least one year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview and record review, the licensee did not document disaster drills conducted at least every 6 months, which poses a potential Health, safety and/or personal rights risk to persons in care.
POC Due Date: 10/24/2022
Plan of Correction
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LPA will conduct case management visit to observe corrections.
Type B
Section Cited
CCR
101238(g)
Buildings and Grounds
(g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview and record review, the licensee did not store paint closed cans where they would be inaccessible to children which poses a potential Health, safety and/or personal rights risk to persons in care.
POC Due Date: 10/14/2022
Plan of Correction
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LPA will conduct case management visit to observe corrections.
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:Randy Derraco
LICENSING EVALUATOR SIGNATURE:
DATE: 10/14/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/14/2022


LIC809 (FAS) - (06/04)
Page: 3 of 9
Document Has Been Signed on 11/15/2022 02:38 PM - It Cannot Be Edited

Document is an Amendment of Original Document on 11/15/2022 08:15 AM


Created By: Randy Derraco On 10/14/2022 at 01:22 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: BUNDLE OF JOY DAYCARE #3
FACILITY NUMBER: 198007432

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/14/2022

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, interview and record review, the licensee did not maintain the outdoor activity space to be free of hazards. Paint buckets, toilets, and other construction materials were observed in the outdoor activity space, which poses a potential Health, safety and/or personal rights risk to persons in care.
POC Due Date: 10/24/2022
Plan of Correction
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LPA will conduct case management visit to observe corrections.
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, interview and record review, the licensee did not provide sign in / sign out sheets with signatures available for review, which poses a potential Health, safety and/or personal rights risk to persons in care.
POC Due Date: 10/24/2022
Plan of Correction
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LPA will conduct case management visit to observe corrections.
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:Randy Derraco
LICENSING EVALUATOR SIGNATURE:
DATE: 10/14/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/14/2022


LIC809 (FAS) - (06/04)
Page: 4 of 9
Document Has Been Signed on 11/15/2022 02:34 PM - It Cannot Be Edited

Document is an Amendment of Original Document on 11/15/2022 08:14 AM


Created By: Randy Derraco On 10/14/2022 at 01:22 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: BUNDLE OF JOY DAYCARE #3
FACILITY NUMBER: 198007432

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/14/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101227(a)(19)
Food Service
(19) All food shall be protected against contamination. Contaminated food shall be discarded immediately.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview and record review, the licensee did not discard contaminated food immediatly. LPA observed expired milk (expiration date: 10/06/22) stored in the refrigerator, which poses a potential Health, safety and/or personal rights risk to persons in care.
POC Due Date: 10/24/2022
Plan of Correction
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LPA observed representative discarding expired milk in the sink.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Randy Derraco
LICENSING EVALUATOR SIGNATURE:
DATE: 10/14/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/14/2022


LIC809 (FAS) - (06/04)
Page: 5 of 9
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: BUNDLE OF JOY DAYCARE #3
FACILITY NUMBER: 198007432
VISIT DATE: 10/14/2022
NARRATIVE
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Furniture and equipment were inspected for age appropriateness and good repair. LPA observed material and equipment are free of sharp, loose, or pointed parts. Telephone service, heating, lighting and ventilation were evaluated and are operable. Children have their own cubby to store their belongings. Linens are taken home every Friday and returned every Monday. Napping equipment (cots) were observed in separate storage areas. Per Director, the isolation area is located in the Bumblebee class room where children will await parent pick up. Age appropriate sinks and toilets were inspected for availability and good repair in all restrooms. General sanitation was observed.

Disinfectants, cleaning solutions, and other items that are dangerous to children, were observed to be locked in a closet. According to the Director, medication is not administered to children in care. LPA observed two small paint cans stored on top of a children's cubby locker. LPA observed the Director removing the paint cans and storing them in a locked closet. LPA advised Director that a citation under CCR section 101238(g) will be issued. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. First Aid supplies were observed in the classroom.

Menus were not available for review. Per Director, food is provided to children Monday through Thursday and the children bring their own lunch on Fridays. LPA advised that a technical violation will be issued with regards to having a menu available and posted at least one week in advance. The facility provides AM snack, lunch and PM snack. LPA observed that water is readily available by water jugs and disposable cups.

All kitchen areas/food preparation areas and food storage areas are kept free of litter, rubbish, rodents, and/or any other vermin. LPA observed that a container of milk in the refrigerator has an expiration date of 10/06/22. LPA advised Director that a citation under CCR section 101227(a)(19) will be issued

Outdoor play equipment was observed to be in good condition, free of sharp, loose or pointed parts. Outdoor activity space was observed to have paint buckets, toilets, and other material accessible to children. Per Director, children don't play in that area and are supervised on the opposite side of the yard during outdoor playtime. LPA advised that a citation under CCR section 101238.2(d)(2) will be issued. Areas around and/or under climbing equipment, swings and slides have cushioning material to absorb a fall. The outdoor area had adequate shade. LPA observed that water is readily available outdoors via water fountains. The Director states that there are no bodies of water on the premises and LPA did not observe any bodies of water during this visit. (page 2 of 3)

SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 10/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2022
LIC809 (FAS) - (06/04)
Page: 8 of 9
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: BUNDLE OF JOY DAYCARE #3
FACILITY NUMBER: 198007432
VISIT DATE: 10/14/2022
NARRATIVE
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There is at least one person trained in CPR and Pediatric First Aid present during this inspection. Children’s and Staff’s Records were reviewed and are complete.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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.html

LPA advised the Director to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.cdss.ca.gov.

The following deficiencies listed on the attached deficiencies page LIC809D are being cited in accordance with California Code of Regulations Title 22. A violation regarding uncleared adult working, residing or volunteering in a licensed facility must obtain criminal record clearance; the violation warrants an immediate civil penalty of $100 and is hereby assessed (see LIC 421IM).

LPA R. Derraco informed Director Yolanda Stowe that this report dated 10/14/22 documents one Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPA R. Derraco informed the Director to provide a copy of this licensing report dated 10/14/22 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted, appeal right provided, and report was reviewed with the Director Yolanda Stowe.

(page 3 of 3)

SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 10/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2022
LIC809 (FAS) - (06/04)
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