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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198007432
Report Date: 02/29/2024
Date Signed: 02/29/2024 04:55:55 PM

Document Has Been Signed on 02/29/2024 04:55 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 SW RO, 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: 17CENSUS: 12DATE:
02/29/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Teacher - Destiny StoweTIME COMPLETED:
05:10 PM
NARRATIVE
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Licensing Program Analysts (LPA) Randy Derraco and Anthony Padilla conducted an unannounced required 3 year inspection on 02/29/24 at 12:30 pm. LPA met with S1, who guided analyst on a tour of the facility. This is a preschool program which consists of 1 classroom. Facility operation hours are Monday to Friday from 7:00 AM to 6:00 PM. LPAs observed S4 arriving at 1:10 PM, whom continued the tour with LPAs.

All areas identified on this report were inspected. Upon arrival, the following staff were present during this inspection: Room 1: S1, S2, S3, S4 with 12 napping children children; 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:

Children's roster was reviewed and is current. Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. LPAs observe the center to use the Brightwheel application as an alternative to signing in / out the child. Children present were signed in. Disaster drill log was available, last drill was conducted on 02/07/24. LPA observed required licensing documents posted on bulletin board at the entrance to the classroom.

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 each Friday to be washed. Per S4, the isolation area is located in the office while the child awaits parent pick up. Age appropriate sinks and toilets were inspected for availability and good repair


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SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE: DATE: 02/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/29/2024
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 8
Document Has Been Signed on 02/29/2024 04:55 PM - It Cannot Be Edited


Created By: Randy Derraco On 02/29/2024 at 03:53 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: BUNDLE OF JOY DAYCARE #3
FACILITY NUMBER: 198007432

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/29/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.16(a)(1)
Lead Testing
(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview, the Director did not did not have drinking water tested for lead which poses an potential Health, safety and/or personal rights risk to persons in care.
POC Due Date: 03/09/2024
Plan of Correction
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Director will have lead testing scheduled as indicated on PIN 21-21-CCP. Director will email LPA date that lead testing has been scheduled by the POC date
Type B
Section Cited
CCR
101238(a)
Buildings and Grounds
(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation facility staff did not keep outdoor play area safe by allowing children to play on top of green turf cover which poses a potential Health, safety and/or personal rights risk to persons in care.
POC Due Date: 03/09/2024
Plan of Correction
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LPA will conduct a POC visit
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:Denise Gibbs
LICENSING EVALUATOR NAME:Randy Derraco
LICENSING EVALUATOR SIGNATURE:
DATE: 02/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/29/2024


LIC809 (FAS) - (06/04)
Page: 2 of 8
Document Has Been Signed on 02/29/2024 04:55 PM - It Cannot Be Edited


Created By: Randy Derraco On 02/29/2024 at 03:53 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: BUNDLE OF JOY DAYCARE #3
FACILITY NUMBER: 198007432

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/29/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
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 facility staff did not making cleaning solutions inaccessible to children by storing Clorox wipes on a wooden cabinet in the children's classroom, which poses a potential Health, safety and/or personal rights risk to persons in care.
POC Due Date: 03/09/2024
Plan of Correction
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LPA observed S3 removing Clorox wipes from cabinet and putting it in storage.
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 facility staff did not maintain the outdoor activity space to be free of hazards. LPAs observed exposed nails, sharp and pointy edges on plastice equipment, and a loose pole on the chain link fence. This poses a did potential Health, safety and/or personal rights risk to persons in care.
POC Due Date: 03/09/2024
Plan of Correction
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POC visit will be conducted to review 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:Denise Gibbs
LICENSING EVALUATOR NAME:Randy Derraco
LICENSING EVALUATOR SIGNATURE:
DATE: 02/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/29/2024


LIC809 (FAS) - (06/04)
Page: 3 of 8
Document Has Been Signed on 02/29/2024 04:55 PM - It Cannot Be Edited


Created By: Randy Derraco On 02/29/2024 at 03:53 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: BUNDLE OF JOY DAYCARE #3
FACILITY NUMBER: 198007432

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/29/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(g)(2)
Personnel Requirements
(2) Each person specified in (g) above shall have a health-screening report signed by the person performing the screening. This report shall indicate the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation licensing staff did not have health screening report in personnel file which poses a potential Health, safety and/or personal rights risk to persons in care.
POC Due Date: 03/09/2024
Plan of Correction
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POC visit
Type B
Section Cited
CCR
101216(l)(1)(B)
Personnel Requirements
(B) A copy of the signed LIC 9052 (11/94) shall be kept in the employee's personnel record.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, facility staff did not have LIC 9052 - Notice of Employee Rights on file, which poses a potential Health, safety and/or personal rights risk to persons in care.
POC Due Date: 03/09/2024
Plan of Correction
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POC visit
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:Denise Gibbs
LICENSING EVALUATOR NAME:Randy Derraco
LICENSING EVALUATOR SIGNATURE:
DATE: 02/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/29/2024


LIC809 (FAS) - (06/04)
Page: 4 of 8
Document Has Been Signed on 02/29/2024 04:55 PM - It Cannot Be Edited


Created By: Randy Derraco On 02/29/2024 at 03:53 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: BUNDLE OF JOY DAYCARE #3
FACILITY NUMBER: 198007432

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/29/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101227(a)(16)
Food Service
(16) Pesticides and other similar toxic substances shall not be stored in food storerooms, kitchen areas, food-preparation areas, or areas where kitchen equipment or utensils are stored.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation the facility staff stored disinfectant wipes on the counter in the kitchen area next to the water filter jug. This poses a potential Health, safety and/or personal rights risk to persons in care.
POC Due Date: 03/09/2024
Plan of Correction
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POC visit
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:Denise Gibbs
LICENSING EVALUATOR NAME:Randy Derraco
LICENSING EVALUATOR SIGNATURE:
DATE: 02/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/29/2024


LIC809 (FAS) - (06/04)
Page: 5 of 8
Document Has Been Signed on 02/29/2024 04:55 PM - It Cannot Be Edited


Created By: Randy Derraco On 02/29/2024 at 04:18 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: BUNDLE OF JOY DAYCARE #3
FACILITY NUMBER: 198007432

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/29/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216.1(g)
Teacher Qualifications and Duties
(g) A photocopy of the teacher's Child Development Permit as specified in (c)(3) above, or a photocopy of the teacher's transcript(s) documenting successful completion of required course work, shall be maintained at the center.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview Director did not provide a photocopy of teacher's transcripts which poses and potential Health, safety and/or personal rights risk to persons in care.
POC Due Date: 03/09/2024
Plan of Correction
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POC Visit
Type B
Section Cited
CCR
101217(a)(12)
Personnel Records
(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: (12) Tuberculosis test documents as specified in Section 101216(g).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation Director did not have Tuberculosis test documents on file for employees which poses a potential Health, safety and/or personal rights risk to persons in care.
POC Due Date: 03/09/2024
Plan of Correction
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POC Visit
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:Denise Gibbs
LICENSING EVALUATOR NAME:Randy Derraco
LICENSING EVALUATOR SIGNATURE:
DATE: 02/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/29/2024


LIC809 (FAS) - (06/04)
Page: 6 of 8
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: BUNDLE OF JOY DAYCARE #3
FACILITY NUMBER: 198007432
VISIT DATE: 02/29/2024
NARRATIVE
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in all restrooms. General sanitation was observed.

LPAs observed Clorox wipes on top of a wooden cabinet located in classroom. LPAs advised that a citation under California Code of Regualtion (CCR) section 101238(g) will be issued. According to S4, no medication is administered to children in care. Poisons and other cleaning supplies are kept in a locked cabinet in the bathroom designated for children in care. LPA observed the cabinet to have a lock that requires a key to open. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. First Aid supplies were observed in the classroom.

Menus were reviewed to ensure that they are being posted at least one week in advance and visible to an authorized representative. The facility provides breakfast, AM snack, lunch, PM snack, and dinner. LPA observed that water is readily available indoors via a filtration system. Per S4, water is filled from faucet into the filter and then distributed via water bottles. Water bottles are provided by the center, and individually labeled. Per S4, lead testing has not yet been scheduled. LPA advised that a citation under Health and Safety Code (HSC) Section 1597.16(a)(1) will be issued.

All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish, rodents, and/or any other vermin. LPAs observed disinfectant wipes stored on the counter next to the water filtration jug. LPA advised that a citation under CCR section 101227(a)(16) will be issued. All storage containers for solid waste, including moveable bins have tight-fitting covers that are kept on, and in good repair. All foods/beverages are stored in covered containers at 45˚ (F) or less.

Outdoor play equipment was not observed to be in good condition. LPAs observed a wooden bench to have exposed nails; a sandbox lid was observed to have been cracked exposing sharp and pointy edges; chain link fence was observed to have a loose cross pole. LPA advised that a citation under CCR section 101238.2(d)(2) will be issued. Outdoor activity space surface was not maintained in a safe condition. A green turf cover was observed to be weathered, exposing multiple tripping hazards in the outdoor play area. 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 a water fountain. Per S4, water bottles are also taken outside during outdoor play time. S4 states that there are no bodies of water on the premises and LPA did not observe any bodies of water during this visit. S4 states there are no weapons or


(page 2 of 3)
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 02/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/29/2024
LIC809 (FAS) - (06/04)
Page: 7 of 8
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: BUNDLE OF JOY DAYCARE #3
FACILITY NUMBER: 198007432
VISIT DATE: 02/29/2024
NARRATIVE
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firearms on the premises.

All individuals present have obtained a criminal record clearance or criminal record exemption. There is at least one person trained in CPR and Pediatric First Aid present during this inspection.

Children’s records were reviewed and are complete. Staff record review shows that S1 and S4 are missing LIC 503 - health screening report. LPA advised that a citation under CCR section 101216(g)(2) will be issued. LPAs observed that S4 did not have LIC 9052 - Notice of Employee Rights on file. LPA advised that a citation under CCR section 101216(l)(1)(B) will be issued. LPA observed that S1 and S2 do not have a photo copy of teacher's transcripts. LPA advised that a citation under CCR section 101216.1(g) will be issued. LPA observed that S1,and S2 did not have Tuberculosis test documents on file. LPA advised that a citation under CCR section 101217(a)(12) will be issued.



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 S4 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 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 rights provided and report was reviewed with Olivia Belger.

(page 3 of 3)

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 02/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/29/2024
LIC809 (FAS) - (06/04)
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