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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198015619
Report Date: 01/23/2025
Date Signed: 01/23/2025 10:19:46 AM

Document Has Been Signed on 01/23/2025 10:19 AM - 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:NORWALK-LA MIRADA USD HEAD START/STATE PS-CHAVEZFACILITY NUMBER:
198015619
ADMINISTRATOR/
DIRECTOR:		JACQUELINE FLIETESFACILITY TYPE:
850
ADDRESS:12110 E. WALNUT AVENUETELEPHONE:
(562) 210-4533
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY: 48TOTAL ENROLLED CHILDREN: 34CENSUS: 31DATE:
01/23/2025
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:50 AM
MET WITH:Rocio De La CruzTIME VISIT/
INSPECTION COMPLETED:
10:40 AM
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On 1/23/25, at 8:50AM. Licensing Program Analyst (LPA), T. Tran conducted an unannounced annual required visit at the Norwalk-La Mirada Chavez Head Start. Upon arrival, LPA met with teacher, Rocio De La Cruz. LPA announced the purpose of today’s visit. About 9:10AM, we toured the facility inside and outside. LPA observed proper care and supervision. All center staff that were present during today’s inspection had fingerprint cleared and associated to the designated license number.

This is a Head Start Pogram. Facility hours of operation are 8:30am - 3:00pm Monday - Friday. There is no extended care offered. LPA observed all posting requirements for operation on the posting board LIC 203A-License, LIC 610 A-Emergency Disaster Plan, LIC 9148-Earthquake Preparedness Check List, PUB 394-Notification of parent’s rights poster, LIC 613A- Personal Rights, PUB 269- Child Car Seat Law, Menus, Activity Schedule, and completion testing and remediated lead exceedances. Children Records were reviewed for completeness. LPA observed current CPR and First Aid Certification for all center staff.

Facility is operating two full-day classes in rooms 42 & 43. Classrooms furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting, and ventilation were evaluated. Children napping equipment met the requirement regulation. individual storage for children's belongings, bathrooms facilities, and isolation areas were inspected. Children drinking water is available and accessible to children in care. First Aid supplies were inventoried. A review of medication policy, including administering, labeling, storage, and records was made. Documentation of current Fire & Earthquake drill was observed.

Facility served breakfast, lunch, and snacks. All food items are delivered daily to the site from the main kitchen. Food and snack items are properly stored. The food preparation area was toured for safety, cleanliness, and proper equipment. Facility is reminded that smoking is prohibited on the premises.
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Tiffanie Tran
LICENSING EVALUATOR SIGNATURE: DATE: 01/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/23/2025
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 3
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: NORWALK-LA MIRADA USD HEAD START/STATE PS-CHAVEZ
FACILITY NUMBER: 198015619
VISIT DATE: 01/23/2025
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Outdoor equipment was inspected for safety, cushioning material, good repair and age appropriateness. Required shade, drinking water and fencing were inspected. Play area was inspected for hazards and inaccessibility to bodies of water.

Facility was informed of responsibility to report suspected Child Abuse by calling the Child Abuse Hotline at 1-800-540-4000. LPA advised of the requirement to report Unusual Incidents and/or injuries to the parent/guardian and to CCL within the time frame specified by the regulation, this includes any changes as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your location.

LPA informed the Facility Representative of the Child Care Advocate Program (CCAP) to provide many other helpful resources to the licensees and the public. LPA advised 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 may 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 CARE tools, please send email inquiries 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.

Facility representative (FR), was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

CCC COMPLETED TESTING AND REMEDIATED LEAD EXCEEDANCES.
Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.
LPA referred FR to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Tiffanie Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2025
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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: NORWALK-LA MIRADA USD HEAD START/STATE PS-CHAVEZ
FACILITY NUMBER: 198015619
VISIT DATE: 01/23/2025
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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 PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

The facility was found in compliance with Title 22 regulations, no deficiency was cited at this time. A notice of site visit was given and must remain posted for 30 days.
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.

Exit interview conducted and report was reviewed with the facility representative, Rocio De La Cruz.
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Tiffanie Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2025
LIC809 (FAS) - (06/04)
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