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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021114
Report Date: 04/11/2023
Date Signed: 04/11/2023 11:19:03 AM

Document Has Been Signed on 04/11/2023 11:19 AM - 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:MONTEBELLO USD FREMONT ELEMENTARYFACILITY NUMBER:
198021114
ADMINISTRATOR:OROSCO, DANIELFACILITY TYPE:
830
ADDRESS:200 W MADISON AVENUETELEPHONE:
(323) 721-2435
CITY:MONTEBELLOSTATE: CAZIP CODE:
91754
CAPACITY: 15TOTAL ENROLLED CHILDREN: 15CENSUS: 0DATE:
04/11/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Luis GonzalezTIME COMPLETED:
12:00 PM
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An announced pre-licensing site inspection was conducted today by Licensing Program Analyst (LPA) Cynthia Reyes, to inspect and measure the Infant with Toddler Option facility for capacity determination. Applicant is requesting an Infant License with capacity of 0, with a Toddler Option with a capacity of 08.

LPA met with applicants Luis Gonzalez, Program Specialist Early Head Start and Maria Gonzalez, Tosa Early Education, who guided analysts on a tour of the facility indoors and out. The facility operating hours will be Monday-Friday 7:45 AM-3:45 PM. The facility is part of the Montebello School District and is located on the Fremont Elementary School site..

LPA began the tour of the facility with applicants beginning at the front entrance to the facility where the parents will enter and exit gate 5 from Madison street. The class room will have its own electronic sign in/out for the parents to use. The parent board is located in the class room with all the licensing required postings and are visible for all to see. Temperatures and health checks and use of hand sanitizer will be conducted and used in the children class room. The ill/isolation area is located in the staff office located in the class room and the staff rest room is located next to that office. The ill/isolation area has a cot for a child to rest if needed.

LPA was guided through the Toddler class room (Early Head Start). LPA observed in the classroom, toys to be age appropriate clean and safe. Furniture and equipment was inspected for age appropriateness and is in good repair. Per measurements, Capacity in this class room can be 30. .
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 04/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/11/2023
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: MONTEBELLO USD FREMONT ELEMENTARY
FACILITY NUMBER: 198021114
VISIT DATE: 04/11/2023
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Napping equipment (cots) were inspected and observed to be in good condition. All cots are located in the staff office. The facility will provide blankets/sheets and the facility will wash at the end of each week. Appropriate Individual storage space was observed to be available for each child and cleanliness was observed in all rooms. The children will be provided jugs of water and disposable cups and they can bring their own labeled Sippy cups. Breakfast, Lunch and PM snack will be provided by the facility. All food is brought to the child care by the school district kitchen. Menus were observed posted. Containers used to discard food have tight fitting lids. Facility has extra linen and food available if needed.

LPA observed in the class room a bathroom with 1 toilet and 1 sink. Total capacity can be 15. LPA observed a changing table in arms reach f the sink in the bathroom. All are in good condition, water temperature, paper towels, toilet paper, and all were inspected for safety and sanitation.

The facility has a kitchen/food pre area in the class room and is blocked off by a small partician so children do not have access. LPA observed a refrigerator, washer & dryer and a large counter top for use of a food preparation in this area. Space was inspected for safety and cleanliness. The licensee takes measures to keep the facility free of flies, other insects and rodents. There is a fully equipped first aid kit available in the class room. LPA observed the facility has central heat and air. Overhead lights as well as natural light, is used.

Carbon monoxide detectors and smoke detectors are present and are in operable condition in the facility. Smoke and Carbon Monoxide detectors should be checked and batteries replaced as needed. The fire extinguisher type 2A-10BC (Service date 12/06/2022) must be serviced annually or as often as necessary. Hazardous items including poisonous cleaning compounds were observed to be stored inaccessible to children. Fire and earthquake drills must be done every 3 months and documented.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2023
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: MONTEBELLO USD FREMONT ELEMENTARY
FACILITY NUMBER: 198021114
VISIT DATE: 04/11/2023
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Licensing staff was then guided to the Toddler outdoor play area which is located right outside the class room front door. The yard is self contained by a gate around it for separation from the other areas on this site. Water jugs with disposable cups 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 available by use of cloth sails above the yard and the building itrsellf. All areas around 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 16 children. LPA advised the applicant that the children need to be within the direct care and supervision, including visual observation and supervision of the teacher(s) at all times.

Facility has no transportation policy for Toddler children. Applicant states that any lifesaving medication will be stored in a locked area inaccessible to children in care.

Items discussed during this Inspection:



Licensing does not tolerate the following: Refused Entry to a Facility or Any Part of a Facility is a
violation of Section 1596.852, 1596.853 or 1597.09. Regulations 101238 (g) (2), The Presence of an Excluded Individual, Fire Clearance Violations, Accessible Bodies of Water, Accessible Firearms, Ammunition or Both.
Breakfast/Lunch/Snack Menus: Menus are required to be posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days must also be available upon request.
Pediatric First Aid and CPR: At least one person in the facility, along with the Director/Administrator must be trained in Pediatric First Aid and CPR and present in the facility.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2023
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: MONTEBELLO USD FREMONT ELEMENTARY
FACILITY NUMBER: 198021114
VISIT DATE: 04/11/2023
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Continued Items discussed during this Inspection:

Current Children’s Roster LIC 9040: Each child day care facility shall maintain a current roster of children who are provided care in the facility. The roster shall include the name, address, and daytime telephone number of the child's parent or guardian, and the name and telephone number of the child's physician. This children roster must be updated and available to the licensing agency upon request.
Designated Staff: The name of the childcare center director or fully qualified teacher(s) designated to act in the director's absence must be on file.
Qualifications and staff files: Educational background, training, and/or experience and all required documents by the department for each staff present must be available for review.
Children’s Records: All required licensing documents must be available for review; including but not limited to, the following: Name, address and telephone number of the child's authorized representative and of relatives or others who can assume responsibility for the child if the authorized representative cannot be reached when necessary. Visit www.shotsforschool.org for immunization information.
Immunization Requirements: Commencing September 1, 2016, a person shall not be employed or
volunteer at a day care center if he or she has not been immunized against flu, pertussis, & measles
Criminal background clearance: LPA advised Director that all adults 18 years of age and older providing Care & Supervision and/or have continuous presence in the facility shall adhere to a criminal background clearance with the Department of Justice, FBI and Child Abuse Index Check.
Reporting Requirements Section 101212: Changes at the facility must be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your location. The Director was also advised of the requirement to report Unusual Incidents and/or injuries to the parent/guardian and to CCL within the time frame specified by the regulation.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2023
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: MONTEBELLO USD FREMONT ELEMENTARY
FACILITY NUMBER: 198021114
VISIT DATE: 04/11/2023
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LPA discussed the safe sleep regulations with Director 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 Director 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): This facility will provide Incidental Medical Services at this time – 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.

Based on LPA measurements taken and observations of the facility, the indoor measurements allow for 30 Toddlers, and the outdoor play yard allows for 16 Toddler. Applicant is requesting a capacity of 8 toddlers. Fire clearance is on file and approved for a capacity of 8 Toddlers.

Per Program Specialist Luis, the 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 licensed the applicant must inform Community Care Licensing prior to providing care to Infants. LPA did not observe infant equipment, class room or outdoor play yard during this inspection.

Exit interview conducted with applicant Luis Gonzalez, Program Specialist Early Head Start and a signed copy of this report was given on this date.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2023
LIC809 (FAS) - (06/04)
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