198019066-9-10-2021-54-CC-RNAO-C6PQGB-20210909120915

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019066
Report Date: 09/09/2021
Date Signed: 09/10/2021 04:08:35 PM

Document Has Been Signed on 09/10/2021 04:08 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:	GOLDEN CITY CHILD DEVELOPMENT CENTER INC.		FACILITY NUMBER:	198019066
ADMINISTRATOR:	ANGELICA HERRERA		FACILITY TYPE:	830
ADDRESS:	812 E. CARSON ST.		TELEPHONE:	(310) 634-5664
CITY:	CARSON	STATE: CA	ZIP CODE:	90745
CAPACITY: 18	TOTAL ENROLLED CHILDREN: 18	CENSUS: 2	DATE:	09/09/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Angelica Herrera		TIME COMPLETED:	12:28 PM

NARRATIVE

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Licensing Program Analyst (LPA) Raul Navarro conducted an unannounced annual inspection on 09/09/2021 at 8:30AM. LPA met with Angelica Herrera, Director, who guided analyst on a tour of the facility. This is an infant program which consists of one classroom. Facility operation hours are Monday to Friday from 6:00 AM to 6:00 PM.

The infant program is located adjacent to the center's pre-school program. The infant program has no shared areas. All areas identified on the Facility Sketch were inspected. Upon arrival, the following staff were present during this inspection: Room 1: Staff #1 with two infants. The facility was observed to be within the license capacity and limitations. The following was observed during the tour of the facility.

Furniture and equipment were inspected for age appropriateness and good repair. The facility has sufficient napping equipment, feeding chairs, and changing tables. Cribs were observed to be free from loose articles and objects including blankets, pillows and no objects were observed to be hanging above or to the side of the cribs. The facility has a separate napping area and the nap area was observed to have a transparent wall that allows for constant auditory and visual supervision. No infants were observed to be swaddled. Telephone service, heating, lighting and ventilation were evaluated. Children have their own cubby to store their belongings. Linens are taken home each week to be washed. Age appropriate sinks and toilets were inspected for availability and good repair in all restrooms. General sanitation was observed. Availability of indoor drinking water was observed in classrooms. Infants are provided with their own drinking water bottle that is labeled with the infants name.

Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Carbon monoxide detectors were observed and are operable.

Report continues- Page 1 of 3

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Raul Navarro
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2021

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 09/10/2021 04:08 PM - It Cannot Be Edited

Created By: Raul Navarro On 09/09/2021 at 10:49 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: GOLDEN CITY CHILD DEVELOPMENT CENTER INC.	FACILITY NUMBER: 198019066
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/09/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above. Staff #1 completed the mandated reporter training over two years and has expired. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/23/2021
	Plan of Correction
1 2 3 4	Per Director, she will have staff renew the Mandated Reporter Training and send a copy of the certificate to LPA by the POC date of 9/23/21.

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:

Karen Chambers

LICENSING EVALUATOR NAME:

Raul Navarro

LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2021

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: GOLDEN CITY CHILD DEVELOPMENT CENTER INC.	FACILITY NUMBER: 198019066
	VISIT DATE: 09/09/2021

NARRATIVE

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All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish, rodents, or any other vermin. All storage containers for solid waste, including moveable bins have tight-fitting covers that are kept on, and are in good repair. Trash cans used to discard food have tight fitting lids or solid waste bags are discarded immediately after each meal. Breakfast, lunch and snack menu was observed to be posted. Food in refrigerator was labeled. There were no Infant formula is available. Kitchen counter tops were clean and free of clutter or standing food.

The outdoor playground was observed to be physically separate from the preschool and school-age components. Outdoor playground equipment is in a safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under climbing equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard. Availability of outdoor drinking water was observed. LPA advised that no children shall be left without the supervision of a teacher at any time.

All floors were observed to be clean and safe. All materials accessible to children were observed to be toxic free. There are no firearms stored on the premises. There are no pools or bodies of water at the facility.

All individuals present have obtained a criminal record clearance or criminal record exemption. There is at least one person trained in CPR and Pediatric First Aid present during this inspection.

Children’s Records were reviewed. Infant Needs and Service plans were reviewed and observed to be in each file including the LIC 9227 Individual Infant Sleeping Plan. Staff physically check on sleeping infants every 15 minutes and document whether there is labored breathing, signs of distress, and sleep position (on their backs). Inspection of required forms was made and documented on the LIC 857.

LPA also reviewed staff records. The review of Staff records was documented on the LIC 859. Staff present did have proof of the AB 1207 Mandated Reporter Training certificate on file, however it was last taken in 2018 and is expired. Staff present did have proof against TB, measles, pertussis, and influenza. All staff have been given on the-job training sanitation principles, housekeeping, including universal health precautions.

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SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Raul Navarro
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2021

LIC809 (FAS) - (06/04)

Page: 4 of 4

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: GOLDEN CITY CHILD DEVELOPMENT CENTER INC.	FACILITY NUMBER: 198019066
	VISIT DATE: 09/09/2021

NARRATIVE

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Sign-In and Sign-Out sheets were reviewed. Children present were signed in. Disaster drill log was available, last drill was conducted on September 2021.

Menus are posted one month in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request. Snacks were reviewed for availability, quantity and appropriateness to children in care. The facility provides breakfast, lunch, and dinner. Facility also provides an AM and PM snack.

First Aid supplies were observed in the classroom in a cabinet. According to Director, medication is not administered at the facility. The facility was observed to be equipped with an isolation area for any child who becomes ill and it is located in the office.

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

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

The following deficiency listed on the attached deficiencies page are being cited in accordance with California Code of Regulations Title 22.

Exit interview was conducted with Director. The Director was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these forms. The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Report ends- Page 3 of 3

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Raul Navarro
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2021

LIC809 (FAS) - (06/04)

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