198016791-3-8-2024-33-CC-CTUA-D36RP2-20240308121113

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198016791
Report Date: 03/08/2024
Date Signed: 03/08/2024 12:11:24 PM

Document Has Been Signed on 03/08/2024 12:11 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	KINDER KOUNTRY ACADEMY		FACILITY NUMBER:	198016791
ADMINISTRATOR:	LUCY SALAZAR		FACILITY TYPE:	850
ADDRESS:	456 W. SAN JOSE AVE #B		TELEPHONE:	(909) 621-0226
CITY:	CLAREMONT	STATE: CA	ZIP CODE:	91711
CAPACITY: 27	TOTAL ENROLLED CHILDREN: 14	CENSUS: 9	DATE:	03/08/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Anna Vartevaryan		TIME COMPLETED:	12:30 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	On 03/08/2024, Licensing Program Analyst (LPA) Carolyn Tuba conducted an unannounced 3-year inspection. LPA entered facility through an iron gate and then through a glass door before entering the facility. Ther is also a camera monitoring the entrance. LPA met with staff and Director, Anna Vartevaryan. LPA was guided on a tour of the facility indoors and outdoors. This is a preschool program which is licensed for 27 children including a school-age program that is on a separate license. The facility operates Monday through Friday from 6:30 AM to 6:00 PM. The Director stated that there are currently 14 children enrolled on various schedules. The facility is located in a business center that has a chiropractor’s office next door. LPA observed a total census of 9 children and 1 staff and a therapist who was currently assisting as a one-on-one. The following classrooms were inspected: 2-year-old classroom, 3-year-old classroom, 4-year-old classroom, kitchen, food pantry, 1 restroom with 2 toilets and 2 sinks. In the 2-year-old classroom there is a changing table with a sink that is an arm’s length away. The classroom furniture and equipment were inspected for good repair, free of sharp, loose, or pointed parts. Indoor classrooms were inspected to ensure that the floors have a surface that is safe and clean. Telephone service, heating, lighting, and ventilation were evaluated. Storage for children’s belongings and napping equipment was inspected and meet all regulatory requirements. LPA did observe a trash can for disposing of food items that was not a covered trash can and LPA advised Director that they will need to replace with a covered trash can. The facility provides the napping sheets and they launder once a week. Children bring their own blankets, which are sent home at the end of each week to be laundered. Availability of drinking water was reviewed and per Director they provide bottled water and disposal cups. Children may also bring water bottles from home. Toys and surfaces are observed to be safe and clean. Staff restroom is available near the 4-year-old Page 1 of 4

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:	DATE: 03/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024

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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Document Has Been Signed on 03/08/2024 12:11 PM - It Cannot Be Edited

Created By: Carolyn Tuba On 03/08/2024 at 11:47 AM

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: KINDER KOUNTRY ACADEMY	FACILITY NUMBER: 198016791
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/08/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101238.2(e)

Outdoor Activity Space

(e) As a condition of licensure, the areas around and under high climbing equipment, swings, slides and other similar equipment shall be cushioned with material that absorbs falls. 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 the outside playground underneath the play structure the cushion tiles have separated due to weather conditions, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/22/2024
	Plan of Correction
1 2 3 4	Per Director the cushion will either be repaired or replaced.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Ana Chico

LICENSING EVALUATOR NAME:

Carolyn Tuba

LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: KINDER KOUNTRY ACADEMY	FACILITY NUMBER: 198016791
	VISIT DATE: 03/08/2024

NARRATIVE

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classroom. All staff members were fingerprint cleared. Licensed facility is within the conditions, limitations, and capacity specified on the license.

Combination Carbon monoxide and smoke detectors were present in the facility and were tested. LPA observed that they were operable. Fire extinguishers are serviced annually and were last serviced April 19, 2023. Storage cabinets in classrooms were inspected and no hazardous items were found, cleaning items were located on the top shelves of each classroom and inaccessible to children in care. No poisonous cleaning compounds were found in the childcare center. Emergency disaster drill was last conducted on 12/2023 and documented. There is a First Aid kit available in the hallway near the classroom and in the school’s office. The supplies were inventoried and found to be in good condition. LPA advised that the first aid was missing scissors and tweezers.

There is a Lobby that is currently not used, Director’s office, additional classroom for School-age that is being used at this time and is used for storage. There is a School-Age classroom that is separate from the 4-year-old classroom and two additional restrooms that is used by the school age children with doors for privacy.

Food preparation areas were toured for safety, cleanliness, and proper equipment. Breakfast is served at 8:00 am, Lunch at 11:45 am and afternoon snack served at 3:00 pm. The facility provides all meals. Menu is posted in the main lobby of the facility. LPA observed parent board with all required documentation located in the entrance of the facility. Sign-in and Sign-out sheets are located at the entrance of the facility and was reviewed for accuracy and reminded Director that parents use full signatures.

LPA was informed that there are no children currently on medication, but LPA reviewed with Director about their IMS plan and documentation. Per Director medication would be stored in the office and a mini fridge is available in case medication requires refrigeration.

Outdoor playground equipment is in safe condition, free of sharp, loose, or pointed parts. The surface of the outdoor activity space is currently not in a safe condition as the surface under the play structure which has a cushion in the shape of tiles are separating due to weather conditions. There is currently 1 playground for the preschoolers, and 1 playground for the school age separated with an iron gate. Both playgrounds are surrounded with block cement walls and iron gates near the entrance of the playground. There is adequate shade in the play yard with awnings. There is plenty of play equipment and plastic playhouses.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:	DATE: 03/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024

LIC809 (FAS) - (06/04)

Page: 3 of 5

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: KINDER KOUNTRY ACADEMY	FACILITY NUMBER: 198016791
	VISIT DATE: 03/08/2024

NARRATIVE

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LPA reviewed Licensing staff records and found that they were complete. Clearance for adults and verification of mandated reporting training certificates, CPR/First Aid, educational requirements, immunization records and health preventative practices documentation was reviewed. Children’s records were reviewed to ensure that Identification and Emergency form and a medical assessment are on file. Director has completed Orientation, Record Keeping and Health, Safety, Nutrition and Lead trainings.

Director was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.

AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018, any person who works in a childcare facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers. 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 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) 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/.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:	DATE: 03/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024

LIC809 (FAS) - (06/04)

Page: 4 of 5

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: KINDER KOUNTRY ACADEMY	FACILITY NUMBER: 198016791
	VISIT DATE: 03/08/2024

NARRATIVE

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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.

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

The deficiency listed on the following page were observed by the LPA and is being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809-D. The deficiency that is being cited needs 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 the Director, Anna Vartevaryan.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:	DATE: 03/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024

LIC809 (FAS) - (06/04)

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