<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198014168
Report Date: 11/02/2023
Date Signed: 11/02/2023 05:03:35 PM

Document Has Been Signed on 11/02/2023 05:03 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:KIDS KLUB SAN GABRIEL / ROSEMEADFACILITY NUMBER:
198014168
ADMINISTRATOR:MARY PERALTAFACILITY TYPE:
850
ADDRESS:4930 EARLE AVENUETELEPHONE:
(626) 288-4400
CITY:ROSEMEADSTATE: CAZIP CODE:
91770
CAPACITY: 149TOTAL ENROLLED CHILDREN: 149CENSUS: 130DATE:
11/02/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
01:01 PM
MET WITH:Maria Rennard, DirectorTIME COMPLETED:
03:30 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
Licensing Program Analyst (LPA) Thelma Razo conducted an unannounced Required 3-year inspection. Licensing Staff met with Director Maria Rennard and stated the purpose of the visit. LPA provided Director with a copy of the Entrance Checklist for Child Care Centers form (LIC 125). A COVID 19 risk assessment was conducted prior to entering the facility. This is a preschool program with 2 other components: Infant Program #198014170 & School age #198014169. Hours of Operation: Monday through Friday, 7AM to 6PM. There are no shared areas between the programs. LPA observed the programs to be physically separated both indoors and outdoors.

LPA toured the areas of the facility to include classrooms and outdoor play area. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Children have their own cubby to store their belongings. Linens are washed weekly by the facility. Any personal bedding brought by children are taken home to be washed. Napping equipment (mats) were observed in cabinets in the classrooms. Per director, the isolation area is located in the office. Age appropriate sinks and toilets were inspected for availability and good repair in all restrooms. LPA observed smoke and carbon monoxide detectors in the classrooms and throughout the facility and are in functioning order. Availability of indoor drinking water was observed in classrooms in form of water jugs and disposable cups. First Aid supplies were observed. Medication is kept in a lock box by the Program Director's area with appropriate documentation.



Per Director, food is prepared and provided on site by the chef who has undergone culinary training. Food and snacks menu was reviewed for availability and appropriateness to children in care. Children are provided breakfast, lunch and snacks during the day. LPA inspected the kitchen and observed no deficiencies or hazards.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Thelma Razo
LICENSING EVALUATOR SIGNATURE: DATE: 11/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/02/2023
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 2
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: KIDS KLUB SAN GABRIEL / ROSEMEAD
FACILITY NUMBER: 198014168
VISIT DATE: 11/02/2023
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
26
27
28
29
30
31
32
The Director states that there are no bodies of water on the premises which LPA was able to verify during the inspection. Director also states there are no weapons or firearms in the facility.

Staff Records were reviewed to ensure that a health screening report is on file. Criminal Records Clearance for staff and verification of CPR/First Aid and Mandated Reporter Training was reviewed.

Children’s Records have the required documents on file.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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. LPA advised the licensee to access forms, regulations, and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

Analyst reviewed new Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, which requires the testing of water for lead in Child Care Centers (CCCs) with facility director during the inspection. Per AB 2370, all CCCs that are located in buildings constructed before January 1, 2010, must have their water tested and post the results by January 1, 2023, and every 5 years after the date of the first testing. Per Director, lead testing was completed and results showed that the facility passed.



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/inspection-process.

No deficiencies cited under California Code of Regulations Title 22 during this visit. 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 with Director Maria Rennard. Copy of report and Appeal Rights were provided.

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Thelma Razo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2