198021050-9-12-2022-33-CC-CGRN-CJ7UVP-20220912155528

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198021050
Report Date: 09/12/2022
Date Signed: 09/12/2022 03:55:37 PM

Document Has Been Signed on 09/12/2022 03:55 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:	BELLA VISTA ELEMENTARY		FACILITY NUMBER:	198021050
ADMINISTRATOR:	DANIEL OROSCO		FACILITY TYPE:	830
ADDRESS:	2410 NORTH FINDLAY AVENUE		TELEPHONE:	(323) 721-4335
CITY:	MONTEREY PARK	STATE: CA	ZIP CODE:	91754
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	09/12/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Luis Gonzalez		TIME COMPLETED:	04:00 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	An announced pre-licensing site inspection was conducted today by Licensing Program Analyst (LPA) Crystal Green to inspect and measure facility for capacity determination. Applicant is seeking to provide care for an Infant Program with a Toddler Option Program. Due to COVID- 19 precautionary measures were taken, individuals present during inspection wore appropriate personal protective equipment. Licensing staff met with Luis Gonzalez, Program Specialist, who guided analyst on a tour of the facility. This proposed Infant Program with Toddler Option Program will operate from Monday through Friday from 7:45 AM until 3:45 PM. This facility is located on the premises of Bella Vista Elementary School. Facility was observed to be physically separated from the elementary school both indoors and outdoors. At 1:52 PM, Licensing staff was guided through a tour of the proposed classroom. This facility will have one designated classroom located in classroom B5. Individual storage space was observed available for each child inside the classroom. Toys were observed to be clean and safe. Furniture and equipment were inspected for age appropriateness and good repair. Central air and heating are available in the classroom. There are napping cots available for the children. There will be drinking water available in form of a water dispenser with disposable cups. There are trash cans with tight fitting lids available in the classroom. There is a parent board with the required postings at the entrance inside the classroom. There are smoke detector and fire extinguisher located in the classroom. LPA observed the classroom to have 1 toilet and 1 sink available to children. LPA observed the classroom to have a changing table within arm’s reach of a sink. The facility will have extra diapers and wipes available in the classroom near the changing table. Report Continues Page 1 of 3.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2022

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 3

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: BELLA VISTA ELEMENTARY	FACILITY NUMBER: 198021050
	VISIT DATE: 09/12/2022

NARRATIVE

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The designated isolation area will be the main office in the nurse’s room. There will be a cot available for ill children. Parents will be called immediately if a child become sick. Ill children will use the staff restroom. LPA observed a medication cabinet and First Aid kit located in the classroom.

Licensing staff was guided through the proposed outdoor activity. The outdoor activity area was observed physically separated via a fence. There is age appropriate play equipment in the playground. Drinking water will be available to children via a water pitcher and disposable cups. There is shade provided via canopy.

Montebello Unified School District will provide snacks and lunches to enrolled children. There is a refrigerator available in the classroom for storing children snacks and lunches. No transportation is being conducted by the facility.

Facility representative 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.

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.

This facility plans to provide Incidental Medical Services- IMS. For IMS information, see Evaluator Manual- Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A 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 Report continues Page 2 of 3

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2022

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: BELLA VISTA ELEMENTARY	FACILITY NUMBER: 198021050
	VISIT DATE: 09/12/2022

NARRATIVE

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Based on measurements obtained today from both indoors and outdoors, capacity for the proposed Infant program with a Toddler option program will be eight (8) Toddlers. The department has received an approved Fire Clearance from Monterey Park Fire Department. A recommendation will be made to license the above facility for a capacity of (8) toddlers.

Per Program Specialist, applicant is requesting to obtain an Infant license however is choosing to provide care for only the toddler age group (18 to 36 months). Based on this request, once license the applicant must inform Community Care Licensing prior to providing care to Infants. LPA did not observe inform equipment during this inspection.

Exit interview conducted and report was reviewed with the Luis Gonzalez, Program Specialist.

Report Ends Page 3 of 3

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2022

LIC809 (FAS) - (06/04)

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