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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020567
Report Date: 08/23/2024
Date Signed: 08/23/2024 04:19:20 PM

Document Has Been Signed on 08/23/2024 04:19 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:MYKKIDS - PRESCHOOLFACILITY NUMBER:
198020567
ADMINISTRATOR/
DIRECTOR:		STEPHANIE LIFACILITY TYPE:
850
ADDRESS:1507 GARFIELD AVE.TELEPHONE:
(323) 258-3690
CITY:SOUTH PASADENASTATE: CAZIP CODE:
91030
CAPACITY: 30TOTAL ENROLLED CHILDREN: 7CENSUS: 5DATE:
08/23/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:55 PM
MET WITH:Tida FloresTIME VISIT/
INSPECTION COMPLETED:
04:35 PM
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On 08/23/24, at 12:55 PM ,Licensing Program Analyst (LPA) Shushanik Safaryan conducted an unannounced annual required inspection. At 12:55 PM, LPA met with Facility Representative , Tida Flores , Teacher /Assistant Director ,who guided the LPA on a tour of the facility. Director Richard Webb came in later. This is a preschool age program which operates Monday through Friday from 08:00 am to 6:00PM. Program consists of 1 classroom. Per Facility Representative there are 7 children enrolled.

LPA observed all required forms/publications posted on the wall .
During the visit ,LPA observed 5 children with 1 staff member. Teacher child ratios were observed to be in accordance with Title 22 Regulations. Staff names were recorded. Licensed facility is within the conditions, limitations, and capacity specified on the license.

The classroom furniture and equipment were inspected for good repair, free of sharp, loose, or pointed parts. Classroom was inspected to ensure that the floors have a surface that is safe and clean. All materials and surfaces accessible to children are toxic free. All toilets and washing facilities are in safe and sanitary operating conditions.

Napping equipment and bedding were inspected for good condition, appropriate storage, and cleanliness. Storage for children's belongings was inspected. Parents take linens home on Friday and returned on Monday.



LPA observed that there are functioning smoke and carbon detectors in the facility. LPA observed a fully charged and serviced fire extinguisher with the service date 06/20/24. Emergency disaster drill was last conducted on 08/08/24. Facility representative states there are no weapons, firearms, or bodies of water on the premises.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE: DATE: 08/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/23/2024
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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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: MYKKIDS - PRESCHOOL
FACILITY NUMBER: 198020567
VISIT DATE: 08/23/2024
NARRATIVE
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Snack menus are posted one week in advance where it is visible by the child's authorized representative. Snacks were reviewed for availability, quantity. The facility provides AM and PM snacks , children bring their own lunch .

Trash cans used to discard food have tight fitting lids. Drinking water is readily available both indoors and outdoors, children bring their own water bottles too. The facility was observed to be free of flies, other insects, and rodents.

The office area is used for the ill children. Cot will be available upon request.

At 1:20 PM , LPA toured the outdoor play area where observed dry leaves , dry branches , dry sticks in the outdoor play area.(Pictures taken ). LPA observed broken toys , pieces of toys in the planter area. LPA discussed with an Assistant Director Tida Flores and Director Richard Webb regarding outdoor area and potential risk to the children in care. Director and Assistant Director agreed to clean up the outdoor area from the debris in 2 weeks time frame .

Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. Facility Representative was reminded to make sure that parents sign in during the drop off and pick up.


Children’s Records were reviewed to ensure that Identification and Emergency form and a medical assessment are on file. Inspection of required forms was made and documented on the LIC 857.

LPA reviewed staff records. Criminal Records Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed. There is at least one person trained in CPR and Pediatric First Aid present during this inspection. The review of Staff records was documented on the LIC 859. Staff present had proof of the AB 1207 Mandated Reporter Training certificate on file.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2024
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MYKKIDS - PRESCHOOL
FACILITY NUMBER: 198020567
VISIT DATE: 08/23/2024
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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.

SB792 (Immunization Requirements for Staff and Employees) was discussed with the Director.

At 1:10 PM ,LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. During the review LPA observed Epinephrine for child # 6 was expired on Jun 2024 which poses immediate risk to the health and safety of child #6.



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/.

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


Facility Representative 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.

Facility Representative 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.

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.


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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2024
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: MYKKIDS - PRESCHOOL
FACILITY NUMBER: 198020567
VISIT DATE: 08/23/2024
NARRATIVE
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Based on the LPA’s observations and records reviews, 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 and safety.

Licensing staff informed Facility Representative a copy of this licensing report dated 08/23/24 that documents any Type A citation(s) need to provide to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

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.

An exit Interview was conducted, a copy of this report along with Notice of Site visit , Deficiency pages and Appeal Rights were explained and provided to the Facility Representative , Richard Webb on 08/23/2024.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/23/2024 04:19 PM - It Cannot Be Edited


Created By: Shushanik Safaryan On 08/23/2024 at 03:50 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MYKKIDS - PRESCHOOL
FACILITY NUMBER: 198020567

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/23/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101226(e)(3)(A)
Health-Related Services
(3) Prescription medications may be administered if all of the following conditions are met: (A) Prescription medications shall be administered in accordance with the label directions as prescribed by the child's physician.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations interview and records review , the licensee did not comply with the section cited above . Child #6 Epinephrine was expired in June .( Pictures taken ), which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 08/26/2024
Plan of Correction
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Director will contact the parent to obtain new medication in original package with doctor`s label . Director will assign staff member to be in charge of medication .
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Brandi VanOosten
LICENSING EVALUATOR NAME:Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:
DATE: 08/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/23/2024


LIC809 (FAS) - (06/04)
Page: 5 of 6
Document Has Been Signed on 08/23/2024 04:19 PM - It Cannot Be Edited


Created By: Shushanik Safaryan On 08/23/2024 at 03:50 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MYKKIDS - PRESCHOOL
FACILITY NUMBER: 198020567

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/23/2024

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
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Based on observations , interviews and records review , the licensee did not comply with the section cited above . During the visit LPA observed debris in the outdoor play area ,which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/09/2024
Plan of Correction
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Per Director , outdoor area will be cleaned from teh debris and broken toys .
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Brandi VanOosten
LICENSING EVALUATOR NAME:Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:
DATE: 08/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/23/2024


LIC809 (FAS) - (06/04)
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