198010585-8-19-2022-54-CC-RNAO-CHFTJJ-20220819144625

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198010585
Report Date: 08/19/2022
Date Signed: 08/19/2022 02:46:41 PM

Document Has Been Signed on 08/19/2022 02:46 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:	LONG BEACH COMMUNITY IMPROVEMENT LEAGUE		FACILITY NUMBER:	198010585
ADMINISTRATOR:	LAURA SIDNEY		FACILITY TYPE:	840
ADDRESS:	2399 CALIFORNIA AVENUE,SUITE A		TELEPHONE:	(562) 951-3500
CITY:	SIGNAL HILL	STATE: CA	ZIP CODE:	90755
CAPACITY: 29	TOTAL ENROLLED CHILDREN: 10	CENSUS: 9	DATE:	08/19/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:31 PM
MET WITH:	Laura Sidney		TIME COMPLETED:	03:10 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	An unannounced Required Inspection was conducted on 08/19/2022 at 1:30 PM by Licensing Program Analysts (LPAs) Raul Navarro and Austin Estrada. Facility is currently licensed for a capacity of 29. Director states there are currently 10 children enrolled. Licensing staff met with Director Laura Sidney. The program currently operates Monday thru Friday from 7:00am to 6:00pm. LPAs was taken on a guided tour of the facility of both indoors and outdoors. At the initial start of the site visit, there is a total census of 9 children and a total census of one teacher present. The facility is made up of one classroom. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. There were cubbies observed as storage for children's belongings. Availability of drinking water was reviewed. LPAs observed water fountain and cups in the classroom. Age appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, area safety and sanitation. LPAs observed individual toilets (2) and sinks(2) in School Age room. Toys observed to be clean and free of loose and sharp parts. A first aid kit is kept in high cabinet upon entry. Carbon monoxide detectors and smoke detectors are present in the facility. Hazardous items including poisonous cleaning compounds were stored and inaccessible to children. Snack/lunch menus were reviewed. Food and snacks were reviewed for availability, quantity and appropriateness to children in care. Food preparation areas were toured for safety, cleanliness and proper equipment.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Raul Navarro
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2022

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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LONG BEACH COMMUNITY IMPROVEMENT LEAGUE	FACILITY NUMBER: 198010585
	VISIT DATE: 08/19/2022

NARRATIVE

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Outdoor equipment was inspected for safety, cushioning material, good repair and age appropriateness. LPA's observed the playground to have sufficient shaded are, large play structure with steps and multiple slides with cushioning material to observe a fall. Director understands that the children need to be within the direct care and supervision, including visual supervision of a teacher at all times.

LPAs observed water fountains and cups located in the outdoor play area. Play area was inspected for hazards and inaccessibility to bodies of water; no bodies of water or hazards observed.

Teacher child ratios were observed and staff names recorded. Care and supervision was evaluated to determine if the basic needs of children are met and appropriate. Sign-in and out sheets and procedures were reviewed.

Children’s Records were reviewed to ensure that Immunization Records are on file , LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, and LIC 613A-Personal Rights.

Staff Records were reviewed. Criminal Record Clearances were reviewed for adults. CPR certification. Inspection of required forms made. LPA reminded Director, that records for all children and staff must be maintained for three (3) years after separation from the facility.

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.htm

Licensee 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.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Raul Navarro
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2022

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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LONG BEACH COMMUNITY IMPROVEMENT LEAGUE	FACILITY NUMBER: 198010585
	VISIT DATE: 08/19/2022

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Requirements for fire drills, earthquake drills 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.

At this time, the facility is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today. Exit interview was conducted with Director, Laura Sidney

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

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

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Raul Navarro
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2022

LIC809 (FAS) - (06/04)

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