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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021030
Report Date: 07/14/2022
Date Signed: 07/14/2022 02:14:08 PM

Document Has Been Signed on 07/14/2022 02:14 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:FUTURE LEADERS SCHOOLFACILITY NUMBER:
198021030
ADMINISTRATOR:BERTHA GIRGISFACILITY TYPE:
840
ADDRESS:1172 E. CYPRESS STTELEPHONE:
(562) 417-0802
CITY:COVINASTATE: CAZIP CODE:
91724
CAPACITY: 42TOTAL ENROLLED CHILDREN: 42CENSUS: 0DATE:
07/14/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
12:31 PM
MET WITH:Bertha Girgis Owner & Cassandra Santos DirectorTIME COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Cynthia Reyes, conducted an announced pre-licensing change of ownership site Inspection to ensure the facility is following the state laws and the health and safety regulations, as well as to measure the requested School Age component for capacity determination. LPA met with Bertha Girgis, Owner & Cassandra Santos, Director. Due to COVID- 19 precautionary measures were taken during the entire inspection and all individuals wore appropriate personal protective equipment. The applicant is requesting a total capacity of 42 School Age children. The facility days & hours will be Monday-Friday 6AM-6PM. This facility will also house a Preschool component F# 198021029 .

At 12:45 PM, LPA began the tour of the facility with Bertha and Cassandra beginning at the front gate of the day care off Cypress Street. The gate has a key pad that uses a code to enter the day care. Parents will sign the child in/out 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: 07/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/14/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 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: FUTURE LEADERS SCHOOL
FACILITY NUMBER: 198021030
VISIT DATE: 07/14/2022
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1 PM Licensing staff was then guided to the School Age 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. 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 96, however the applicant is asking for a capacity of 42 School age children. LPA advised Bertha and Cassandra 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 Bertha and Cassandra that no standing water is allowed and needs to be empty after each use.

LPA was then guided through the School Age classrooms that will be labeled with room numbers. (Room 1 and Room 2) which was inspected and measured for capacity determination. LPA observed in the classrooms, toys to be age appropriate clean and safe. Age appropriate furniture and equipment were also inspected to be in good condition. No Napping is conducted in the school age however if they want to rest, their are rugs and pillows if needed. .

School Age children have two bathrooms located in between class room 1 and 2, each with 2 toilet and 2 sinks. Total capacity for toilets (4=60) and sinks (4=60). All toilets and sinks are in good condition, water temperature, paper towels, hand soap, toilet paper were observed and everything was inspected for safety and sanitation.
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2022
LIC809 (FAS) - (06/04)
Page: 2 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: FUTURE LEADERS SCHOOL
FACILITY NUMBER: 198021030
VISIT DATE: 07/14/2022
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2 PM 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.

Breakfast, Lunch, and PM snack will be provided for a full day program by the facility and housed and prepared in the kitchen. Breakfast and PM snack will be provided for before and after school care. Menu was observed on the parent board, kitchen and in each class room. In the kitchen there is a refrigerator, stove and microwave. The kitchen was inspected for safety and cleanliness. Containers used to discard food have tight fitting lids. Facility has extra food available if needed. Cleaning solutions will be locked under the kitchen sink.

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 in and 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 06/16/2022. 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 provide transportation for School age children, pick up and drop off.
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2022
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: FUTURE LEADERS SCHOOL
FACILITY NUMBER: 198021030
VISIT DATE: 07/14/2022
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The ill/isolation area is located in the directors office, until the parents will pick up the ill child. The ill child will use the staff rest room located between class room 1 and the Kitchen. The isolation area will have a chair and mat available for rest.

2:30 PM LPA reviewed with applicant, Bertha Girgis Owner & Cassandra Santos Director, 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 Bertha Girgis Owner & Cassandra Santos Director, Reporting and Notification Requirement

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

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.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2022
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: FUTURE LEADERS SCHOOL
FACILITY NUMBER: 198021030
VISIT DATE: 07/14/2022
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Bertha Girgis Owner & Cassandra Santos 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, 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) Final File review.

The total capacity measurements for bathrooms is toilets (4=60) and sinks (4=60), Indoor (42) and outdoor (96). Capacity will be approved for 42 School Age children based on measurements taken on this date. The Department has received an approved fire clearance for a capacity of 42 school age children.

3 PM Exit interview conducted, and report was reviewed with the Bertha Girgis Owner & Cassandra Santos Director.
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2022
LIC809 (FAS) - (06/04)
Page: 5 of 5