<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191200980
Report Date: 06/25/2019
Date Signed: 06/25/2019 09:50:11 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:BURBANK 1ST UNITED METHODIST CHURCH NURSERY SCHOOLFACILITY NUMBER:
191200980
ADMINISTRATOR:SALLIE THOMASFACILITY TYPE:
850
ADDRESS:700 NORTH GLENOAKSTELEPHONE:
(818) 848-3233
CITY:BURBANKSTATE: CAZIP CODE:
91502
CAPACITY:75CENSUS: 35DATE:
06/25/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:20 AM
MET WITH:Vivien Firta - Director TIME COMPLETED:
10:10 AM
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) Peter Flores, conducted a Case Management Incident inspection to follow up on the self reported incident that occurred at Burbank 1st United Methodist Nursery School on March 5, 2019. The El Segundo Child Care Office received the incident report via phone call March 7, 2019.

The preschool is currently operating the summer program which operates Monday through Friday 9:00 AM to 12:00 PM.

LPA met with Director Vivien Firta, who guided the analyst on a tour of the facility. LPA observed 35 children present and 7 staff members. LPA verified that all adults present in the facility have obtained criminal record clearances and are associated to the facility.

On the unusual incident, reporter stated that a child touched another child's body.

Staff states that the children were not in the bathroom at the same time and there is always a Teacher present when children go to the bathroom.

Staff took proper precaution and informed the Director. At this time, based on the available information, it does not appear this incident was the result of a Title 22 violation.

The notice of site visit must be posted for 30 days upon receipt.

An exit interview was conducted and a copy of this report was given to Director Vivien Firta.
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Peter FloresTELEPHONE: (424) 301-3063
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2019
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 1