Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016557
Report Date: 03/02/2016
Date Signed 03/04/2016 07:20:54 AM

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:BURROUGHS HEAD STARTFACILITY NUMBER:
198016557
ADMINISTRATOR:SOPHIA JOHNSONFACILITY TYPE:
850
ADDRESS:1260 E. 33RD STREETTELEPHONE:
(562) 591-9258
CITY:SIGNAL HILLSTATE: CAZIP CODE:
90755
CAPACITY:60CENSUS: 52DATE:
03/02/2016
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:05 AM
MET WITH:Sophia JohnsonTIME COMPLETED:
10:15 AM
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LPA, Shameka Robinson-Horn arrived at the above facility for the purposes of conducting an Annual/Random site visit. Upon arrival LPA met with Lead Teacher, Sophia Johnson and informed the individual of the nature of the inspection.

LPA toured and inspected the facility to ensure the health & safety standards as required by regulations governing Child Care Centers were in compliance. Facility operates 2 head start sessions from 745am- 1115am and 1245pm-415p and 1 Full day session from 800am-300pm. The facility operates from 730am -430pm daily.

Areas inspected during today’s visit included, indoor and outdoor activity spaces, children's restrooms, storage areas and closets.

The furniture and equipment were inspected for age appropriateness and good repair. The facilities telephone service, heating, lighting and ventilation were also evaluated. Individual storage for children's belongings and an isolation area with sink, toilet, and mat/cot were inspected. Children's napping equipment for the full day program was also inspected.

Availability of drinking water indoors and outdoors was reviewed. Age appropriate sinks and toilets were inspected for availability, good repair, water temperature/pressure, toilet paper, paper towels, area safety and sanitation.

First Aid supplies were inventoried. A review of medication policy, including administering, labeling, storage, and records were made. The facility may provide incidental medical services as needed to children in care. The Agency is scheduled to review and update all IMS plans simultaneously.

Breakfast/Snack/Lunch menus were reviewed. Food and snacks were reviewed for availability, quantity and ensuring appropriate serving sizes are issued to children in care. The meals are prepared and delivered to the facility.

SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Shameka Robinson-HornTELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2016
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: BURROUGHS HEAD START
FACILITY NUMBER: 198016557
VISIT DATE: 03/02/2016
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The teaching staff may warm and then serve the food to children in care. There are no food or snacks stored in the classrooms.

The outdoor equipment and space was inspected for safety, cushioning material, good repair, and age appropriateness. Required shade, drinking water and fencing were inspected and observed. The outdoor activity area was inspected for hazards and inaccessibility to bodies of water.



LPA observed teacher child ratios and documented staff names. Children's sign in and out sheets were reviewed. A review of children’s was conducted.

Staff records were not reviewed at the facility on this date. The LPA has received verification of experience and qualification for 2 facility designee's. This information is located in the facilities administrative file. The staff have received criminal record clearances as a condition of their employment with the Long Beach Unified School District. The LPA will conduct a mass file review for facilities at a later date.

Based on the completion of today’s inspection there were no deficiencies cited. LPA advised the Lead Teacher how to access forms and regulations and current regulation updates on line at: www.ccld.ca.gov.

The Notice of Site Visit (LIC 9213)must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted on this date with Lead Teacher, Sophia Johnson.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Shameka Robinson-HornTELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2016
LIC809 (FAS) - (06/04)
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