198020972-5-4-2022-33-CC-CRES-CE4TRC-20220504145719

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020972
Report Date: 05/04/2022
Date Signed: 05/04/2022 02:57:43 PM

Document Has Been Signed on 05/04/2022 02:57 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:	BLOSSOM GARDEN LEARNING ACADEMY		FACILITY NUMBER:	198020972
ADMINISTRATOR:	MEGHA SAHNI		FACILITY TYPE:	830
ADDRESS:	101 S. ATLANTIC BLVD		TELEPHONE:	(626) 627-2318
CITY:	ALHMABRA	STATE: CA	ZIP CODE:	91801
CAPACITY: 20	TOTAL ENROLLED CHILDREN: 20	CENSUS: 0	DATE:	05/04/2022
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	01:11 PM
MET WITH:	Megha Sahni		TIME COMPLETED:	03:00 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	Licensing Program Analyst (LPA) Cynthia Reyes, conducted an announced pre-licensing site Inspection to ensure the facility is following the state laws and the health and safety regulations, as well as to measure the requested Infant component for capacity determination. LPA met with Megha Sahni , Applicant/Director. Due to COVID- 19 precautionary measures were taken during the entire inspection and all individuals present during this inspection wore appropriate personal protective equipment. The applicant is requesting a total capacity of 20 Infant children. The facility days & hours will be Monday-Friday 7AM-6PM. The Infant program is located on a church site, First Baptist. This facility will also house a preschool component F# 198020970. At 1:15 PM, LPA began the tour of the facility with Megha Sahni beginning at the front gate of the day care off Olive Street. Parents will sign the child in/out electronically at a table outside the main office. Parents will walk the child to the class room door where the teacher will do a temperature and health check before the child enters the class room. A parent board is located in the hall way by the sign in/out area and in each class room, with Licensing and Covid-19 posting which are visible for all to see. Use of hand sanitizer will also be available. Parents will only stop at the classroom door at this time, unless they request to enter, which at that time all precautionary measures will be taken for that individual entering. Facility staff will walk the child inside the classroom and bring the child out at pick up time. Facility was observed to be adhering to local public health guidelines. (According to CDC guidelines, children under the age of (2) are not required to wear masks.)

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2022

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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: BLOSSOM GARDEN LEARNING ACADEMY	FACILITY NUMBER: 198020972
	VISIT DATE: 05/04/2022

NARRATIVE

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1:45 PM Licensing staff was then guided to the Infant outdoor play area. The play yard is self-contained by a gate around it for separation from other areas located in this entire gated facility. Child's own labeled water bottle will be used for children while outdoors. LPA observed age appropriate outdoor toys and play equipment to be clean, safe and in good repair, as well as adequate shade is available by material sails. All areas around and under play equipment and slides are cushioned with material to absorb a fall. Measurements were taken of the outdoor play yard and the total outside capacity allows for 36. LPA advised Megha Sahni that the children need to be within the direct care and supervision, including visual observation and supervision of the teacher(s) at all times. LPA advised Megha that no standing water is allowed and needs to be empty after each use.

LPA was then guided through the Infant classroom, that is labeled with a name and number. (102 Orchids) which was inspected and measured for capacity determination. LPA observed in the classroom, toys to be age appropriate clean and safe. Age appropriate furniture and equipment were also inspected to be in good condition. Napping equipment (8 Cribs and 4 mats) were inspected and observed to be in good condition. Refrigerator was observed in this class room.

Infant children do not have a bathroom of their own and the applicant states will submit a waiver to share the one bathroom in between the infant room and the Preschool Daisies class room, which has 1 toilet and 1 sink. The Infant class room has 1 sink and applicant states will have a changing table placed in arms reach of it and submit proof. Sink is in good condition, water temperature, paper towels, hand soap, and in the requested shared bathroom, toilet paper was also observed Everything was inspected for safety and sanitation.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2022

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: BLOSSOM GARDEN LEARNING ACADEMY	FACILITY NUMBER: 198020972
	VISIT DATE: 05/04/2022

NARRATIVE

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2PM The parents will provides the Infants with a blanket/Sheet. Parents will wash all linen at the end of each week. Individual storage space was observed to be available, appropriate and clean for each child. Child's own labeled water bottle will be used for children while in the class room.

There is a fully equipped first aid kit available in each class room containing all the required supplies. The facility has central cooling and Heating, lighting and ventilation which were all evaluated by the LPA.

AM and PM snack will be provided by the facility and housed in the kitchen next to the Lilys preschool class room 109, Lunch will be brought in my each parent. Menu was observed on the parent board and in the kitchen. Food preparation area will be in the kitchen, where a refrigerator and cold drinks and food items will be located. The kitchen was inspected for safety and cleanliness. Containers used to discard food have tight fitting lids. Facility has extra linen and food available if needed.

Carbon monoxide detectors and smoke detectors were observed to be in operable condition and located in the class rooms. Smoke and Carbon Monoxide detectors should be checked regularly, and batteries replaced as needed. LPA observed a fire extinguisher located outside some of the classrooms which is a type 2A-10BC and the valve on it indicated that it is fully charged.

Fire Extinguisher tag has a service date of 05/26/2021. Fire extinguishers need to be serviced annually or as often as necessary. Hazardous items including poisonous cleaning compounds were observed to be stored inaccessible to children. Facility does not provide transportation for Infant children.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2022

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: BLOSSOM GARDEN LEARNING ACADEMY	FACILITY NUMBER: 198020972
	VISIT DATE: 05/04/2022

NARRATIVE

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The ill/isolation area is located in the Directors office. The ill child will use the staff rest room located in the staff lounge right across from the directors office. The isolation area has a cot available for rest.

230 PM LPA reviewed with applicant, Megha Sahni, the LIC 311A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted. LPA also discussed with Megha Sahni, Reporting and Notification Requirement

LPA discussed the safe sleep regulations with applicant Joshua Goldman and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed [applicant, licensee, or facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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)/ (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

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2022

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: BLOSSOM GARDEN LEARNING ACADEMY	FACILITY NUMBER: 198020972
	VISIT DATE: 05/04/2022

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Page 5 Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Applicant Megha Sahni 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, 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.

Based on LPA measurements taken on this date and observations of the facility, the following is needed before a license can be granted. 1) Waiver for shared bathroom based on no infant bathroom is available. 2) Changing Table placed in arm reach of a sink 3) Final File review.

The total capacity measurements for bathrooms (0), Indoor (10) and outdoor (36). Capacity will be approved for 10 infant children based on measurements, once all corrections are made and if waiver is approved. The Department has received an approved fire clearance for a capacity of 99 ONLY preschool & Infants. Total Fire approval for Infant room 102 is 15.

3PM Exit interview conducted, and report was reviewed with the Applicant Megha Sahni.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2022

LIC809 (FAS) - (06/04)

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