198010922-3-16-2023-54-CC-AMOY-CPZ65A-20230316203002

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198010922
Report Date: 03/16/2023
Date Signed: 03/16/2023 08:30:31 PM

Document Has Been Signed on 03/16/2023 08:30 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:	CUDAHY PRESCHOOL ACADEMY		FACILITY NUMBER:	198010922
ADMINISTRATOR:	ADOL VERGARA		FACILITY TYPE:	850
ADDRESS:	4912 CLARA ST		TELEPHONE:	(323) 771-8700
CITY:	CUDAHY	STATE: CA	ZIP CODE:	90201
CAPACITY: 60	TOTAL ENROLLED CHILDREN: 60	CENSUS: 11	DATE:	03/16/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:27 PM
MET WITH:	Adol Vergara		TIME COMPLETED:	04:30 PM

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Licensing Program Analyst (LPA) Alicia Mooberry conducted an unannounced required 1 year inspection to the above facility on 03/21/22. Upon arrival LPA met with Adol Vergara, Director, who provided a tour of the facility. LPA provided the LIC 125 Entrance Checklist upon arrival to help facilitate the inspection. This facility is located in the campus of a church building. LPA observed four (4) napping children supervised by one (1) staff in room C-2 and seven (7) napping children and 1 staff in room B-7 and no children in room B-6. All staff present have obtained criminal record clearance. Sign-in sheet were reviewed, all children present were signed in. Upon arrival LPA observed that the alarm system located in Room C-2 was beeping loudly every 2-5 minutes while children were napping, this is a potential risk to the personal rights of children in care.

This is a preschool program that has 3 classroom. Classroom C-2 is used for AM/PM sessions. Classrooms B-6 and B-7 are used for full day program. The facility operates from Monday through Friday and is open from 8:00AM to 4:00 PM.

Per Director there are 34 children currently enrolled. Per Director the staff bathroom is located on the church building out inaccessible to children in care. The Isolation area for children who are ill is in room B7, since the enrollment is low. Should the facility reach maximum capacity, the facility will have to make arrangements to provide an isolation area with access to separate bathroom.

During inspection the facility was inspected for cleanliness and good repair. LPA observed age appropriate toys and equipment. Lighting was in operable condition. Children's individual storage space was inspected. There is accessible filtered drinking water in each classroom by a dispenser and disposable cups.

Appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, paper towels, and general sanitation. The restrooms located in the classrooms were observed to be clean and in operable condition.

---- Page 1 Report Continues

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:	DATE: 03/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2023

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: CUDAHY PRESCHOOL ACADEMY	FACILITY NUMBER: 198010922
	VISIT DATE: 03/16/2023

NARRATIVE

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LPA inspected the food preparation area located next to the office. The refrigerator was observed it to be clean and in operable condition. There cleaning agents are located in locked cabinets.

The required posting were observed in a prominent location in the classrooms including facility license, current menus, PUB 269, PUB 393, LIC 610.

First Aid supplies were observed. Disinfectants, cleaning solutions, and other dangerous items to children, were inaccessible. There are no poisons stored at the facility. Carbon monoxide detectors were observed and tested to ensure that they are operable.

The outdoor play area was inspected for hazards and inaccessibility to bodies of water. LPA observed a round metal table with chipping paint that poses a potential risk to the health and safety of children in care. LPA observed appropriate shading equipment, benches and toys. Drinking water is available by a dispenser and disposable cups.

Per Director, there are currently no children on medication. 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

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

LPA reviewed Children and Staff records. The review was documented on the LIC 857 and LIC 859.

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.

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SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:	DATE: 03/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2023

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: CUDAHY PRESCHOOL ACADEMY	FACILITY NUMBER: 198010922
	VISIT DATE: 03/16/2023

NARRATIVE

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Children's roster was reviewed and is current. Disaster drill log was available, last drill was conducted on 02/24/22.

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

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.

Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22.

Deficiencies that are being cited need to be cleared to protect the children’s health & safety

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

Exit interview conducted and report was reviewed with Director, Adol Vergara. Appeal rights were discussed and a copy provided.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:	DATE: 03/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/16/2023 08:30 PM - It Cannot Be Edited

Created By: Alicia Mooberry On 03/16/2023 at 03:07 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: CUDAHY PRESCHOOL ACADEMY	FACILITY NUMBER: 198010922
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/16/2023

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
1 2 3 4	Based on observation, the licensee did not comply with the section cited above due to round metal table with chipping paint and the grass in the play area is over grown which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/24/2023
	Plan of Correction
1 2 3 4	Per licensee, the faciltiy will be notified to fix the metal table with the chipping paint and to cut the overgrown grass, proof of correction will be sent to LPA's email by POC due date.

Type B

Section Cited

CCR

101230(b)

Activities/Napping

(b) All children shall be given an opportunity to nap or rest without distraction or disturbance from other activities at the center. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in that the security alarm by the office next to Room C2 was beeping loudly while children were napping every 2-5 minutes which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/24/2023
	Plan of Correction
1 2 3 4	Per licensee, they will have the alarm company service the alarm, proof correction will be sent to LPA via email by POC due date.

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:

Valarie Cook

LICENSING EVALUATOR NAME:

Alicia Mooberry

LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2023

LIC809 (FAS) - (06/04)

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