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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020839
Report Date: 06/12/2023
Date Signed: 06/12/2023 05:04:37 PM

Document Has Been Signed on 06/12/2023 05:04 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:ESGVJCC KOKORO NO SATO PRESCHOOLFACILITY NUMBER:
198020839
ADMINISTRATOR:PEARL OMIYAFACILITY TYPE:
850
ADDRESS:1203 W. PUENTE AVETELEPHONE:
(626) 960-2566
CITY:WEST COVINASTATE: CAZIP CODE:
91790
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
06/12/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:01 PM
MET WITH:Pearl Omiya TIME COMPLETED:
05:15 PM
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Licensing Program Analyst (LPA) Cynthia Reyes, conducted an unannounced annual site inspection, on this date. This inspection is to ensure the health and safety standards as required by the regulations governing child care centers are met. LPA met with Pearl Omiya, Director and a copy of the Entrance Checklist for Child Care Centers form (LIC 125) was provided. The facility operates Monday-Friday 6:30 AM-6:30 PM. Facility is located on the premise of the East San Gabriel Valley Japanese Community Center. Licensee has been informed that children shall be kept separate physically from any community center activities during the day care operation days and hours.

1:15PM, LPA began the tour of the facility with Pearl and Melissa Kozono, Assistant Director, who was also present during this inspection, beginning at the office. Pearl states preschool parents will enter and exit the gate from the back parking lot of the facility. Parents will sign the children in and out using the Bright Wheel application. Parents will walk the child inside the class room where health checks will be conducted at that time. LPA observed a parent board in each class room with all the required licensing forms visible for all to see.

The ill/isolation area is located in the main office and is close to the staff rest room for an ill child to use. The ill/isolation area has a mat/pack in play for a child to rest if needed. A staff lounge/lunch area is located in the kitchen area that is used just for snack/meal prep and no cooking.

LPA observed 2 preschool class rooms to be located on the second floor. LPA observed the bottom of the stairs leading to the preschool class rooms, has a small wrought iron gate with a self latch on top to keep closed. The licensee modified the original adult stairs to smaller child steps and added extra child size railing to hold on to while climbing up and down the stairs. PAGE 1 OF 5
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 06/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/12/2023
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: ESGVJCC KOKORO NO SATO PRESCHOOL
FACILITY NUMBER: 198020839
VISIT DATE: 06/12/2023
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The preschool child and adult will need to go up and down two flights of stairs with a small portion for stopping if needed which is located in between each flight of stairs. LPA and licensee proceeded to enter class room 1 at the top of the stairs and when entering the class room a small portion is closed off for parent to sign in/out and children's cubbies are located in this same area. Class room 2 entrance is identical to class room 1.

During the tour of the class rooms, preschool, Furniture and equipment were inspected for age appropriateness and good repair. LPA observed napping mats are located in a storage cabinet in the kitchen for class room 1 and for class room 2 they are located in a cabinet in their own class room. There is accessible drinking water readily available, by use of a gallon water bottle with pump. Preschoolers will bring their own Sippy cups labeled with their name.

LPA observed in class room 1, a large sink for adults and 2 small sinks for the children. Behind the preschool activity space in room 1, is a small kitchen with a gate to prevent children access to that area unless walking through to the bath room escorted by a staff member. LPA observed in room 2, a large sink for the adults and 2 small sinks for the children. In class room 2 behind the activity space is a small bathroom with 2 toilets and 1 sink and a changing table that is with in arms reach of a small wall sink.

In both class rooms toys were observed to be clean and safe and are age appropriate. Telephone service, heating, lighting and ventilation were evaluated. preschoolers each have their own cubby to store their belongings. Facility provides linens and will wash at the end of each week. LPA observed the facility has a carbon monoxide detector and smoke detector in each classroom. There is a serviced fire extinguisher (06/28/2022) available in each class room. Disinfectants, cleaning solutions, and other items that are dangerous to children, will be inaccessible at all times and located in locked cabinets in each class room.
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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2023
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: ESGVJCC KOKORO NO SATO PRESCHOOL
FACILITY NUMBER: 198020839
VISIT DATE: 06/12/2023
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Menus were reviewed to ensure that they are being posted at least one week in advance and visible to an authorized representative. Menus for the past 30 days are available upon request. The parents bring breakfast, lunch and PM snack. Food/Snacks are prepared in each class rooms small kitchen area. Facility will provide snack if needed and snacks were reviewed for availability, quantity and appropriateness to children in care. All kitchen, food preparation, and storage areas are clean, free of litter, rubbish, and rodents/vermin. The licensee takes measures to keep the facility free of flies, other insects and rodents. All food is protected from contamination. Facility has extra linen and food available if needed. LPA inspected and consulted that any contaminated food is discarded immediately. All storage containers for solid waste, including moveable bins, have tight fitting covers on and are in good repair. First Aid kits are available in each classroom and were observed to contain the required first-aid supplies.

Outdoor play equipment was inspected for safety, free of sharp, loose pointed parts, good repair and age appropriateness. The surface of the outdoor activity area was observed to be maintained in a safe condition, and free of hazards. All areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with material that absorbs a fall. Required shade and fencing were inspected. Drinking water will be available by children using their own Sippy cups or water bottles. The playground was inspected to ensure no bodies of water or hazards which were not observed. (Waiver is on file to share the play yard with the infants and requested toddler option using a staggered play schedule). LPA advised the Director that all children need to be within the direct care and supervision, including visual observation and supervision of the teacher(s) at all times.

Pearl was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2023
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: ESGVJCC KOKORO NO SATO PRESCHOOL
FACILITY NUMBER: 198020839
VISIT DATE: 06/12/2023
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Children’s Records were reviewed on this date for completeness; and Inspection of required forms were made and documented on the LIC 857. LPA reviewed Staff records, which were documented on the LIC 859. All staff had proof against TB, measles, pertussis, and influenza, as well as current Mandated reporter. Children's roster was reviewed and is current and number of total enrolled at this time was documented. Disaster drill log was available, conducted on 01/24/2023 and documented.

There is at least one person trained in EMS (emergency medical services) Pediatric CPR and First Aid present during this inspection. Pediatric CPR & First Aid is documented for staff who have it and is current for the Director. No transportation is being conducted by the facility for preschool children at this time.

Access forms, regulations and quarterly updates on the Child Care Licensing website at www.ccld.ca.govReporting Unusual Incidents: MPROIncidentReports@dss.ca.gov. CCL Resources for Parents & Providers: https://ccld.childcarevideos.org/ Provider Information Notices (PINs): https://www.cdss.ca.gov/inforesources/community-care-licensing/policy/provider-information-notices/child-care

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/process.



At this time, the licensee is in compliance in the preschool program with California Code of Regulations Title 22. Deficiencies cited during today’s inspection is documented on the 809D.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative, Pearl Omiya, Director
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/12/2023 05:04 PM - It Cannot Be Edited


Created By: Cynthia Reyes On 06/12/2023 at 04:16 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: ESGVJCC KOKORO NO SATO PRESCHOOL
FACILITY NUMBER: 198020839

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/12/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101216.3(a)
Teacher-Child Ratio
(a) There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance, except as specified in (b) and (c) below.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA observation, the licensee did not comply with the section cited above. LPA observed an aide alone with 5 preschool children in class room 1, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 06/12/2023
Plan of Correction
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Director states will write to the department stating that she will adjust the staff days and hours to ensure that the regulation of teacher child ratio is met at all times. Director will submit proof by the plan of correction (POC) date by the end of the work day date 06/13/2023.
Type A
Section Cited
CCR
101223(a)(2)
Personal Rights
(a) The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA observation, the licensee did not comply with the section cited above. Upon LPA arrival LPA observed in the back parking lot of the facility, staff walking children around the parking lot, while cars were driving in and out. The parking lot was never approved for chidren activity space, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 06/12/2023
Plan of Correction
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Director submitted a waiver request to be apporved for use of part of the parking lot as a walking activity, away from the intended regulation.
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:Christina Gabelman
LICENSING EVALUATOR NAME:Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:
DATE: 06/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/12/2023


LIC809 (FAS) - (06/04)
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