191200980-10-3-2023-58-CC-SSAZ-CW9RQW-20231003131412

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191200980
Report Date: 10/03/2023
Date Signed: 10/03/2023 01:14:18 PM

Document Has Been Signed on 10/03/2023 01:14 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	BURBANK 1ST UNITED METHODIST CHURCH NURSERY SCHOOL		FACILITY NUMBER:	191200980
ADMINISTRATOR:	VIVIEN FIRTA		FACILITY TYPE:	850
ADDRESS:	700 NORTH GLENOAKS		TELEPHONE:	(818) 848-3233
CITY:	BURBANK	STATE: CA	ZIP CODE:	91502
CAPACITY:	75	CENSUS: 64	DATE:	10/03/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:10 AM
MET WITH:	Kristina		TIME COMPLETED:	01:35 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	Licensing Program Analysts (LPA) Susann Sanchez conducted an unannounced required one year inspection at the above facility. LPA met with Director Kristina Balos and informed her of the purpose of the visit. Director provided LPA a tour of the facility at 10:30am. This is a preschool program which consists of 5 classrooms. Facility operation hours are Monday to Friday from 9:00 AM to 1:00 PM. Facility is located on Burbank 1st United Methodist Church. LPA observed a current Children's roster. All areas identified on this report were inspected. Upon arrival, LPA observed 13 children and 2 teachers in the playground (room 4), 15 children and 2 teachers in Room 1; 12 children and 2 teachers in Room 2, 12 children and 2 teachers in Room 3, and 12 children and 2 teachers in the sand yard (room 5). Teacher-child ratios were observed to be in accordance with Title 22 Regulations. All children were observed to be under visual supervision of a teacher at all times. LPA observed all preschool classroom to be clean and in good repair. The floors were clean and lighting was in operable condition. There were age appropriate toys and equipment. LPA observed water readily available via water pitchers provided by facility. LPA observed cups available in each classroom. LPA observed cubbies/storage area for children to store their personal belongings. Smoke detector and carbon monoxide detector were observed to be in operable condition. LPA observed 4 Fire extinguishers at the facility and was serviced on 01/20/2023. First Aid kit was observed and inventoried. Appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, paper towels, and general sanitation. Disinfectants and cleaning solutions were observed to inaccessible to children in care. Per Administrator there are no poisons stored at the facility. This is a part time school so there is no napping done. The isolation area is located in the main office. Per Director, 5 children is currently on medication. LPA observed medications to be locked in a storage container in the children's classroom inaccessible to children in care. Medication is administered on a as needed basis.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) -98-3350
LICENSING EVALUATOR NAME: Susann Sanchez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2023

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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: BURBANK 1ST UNITED METHODIST CHURCH NURSERY SCHOOL	FACILITY NUMBER: 191200980
	VISIT DATE: 10/03/2023

NARRATIVE

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LPA toured the outdoor play areas (main playground & sand yard). LPA observed age-appropriate toys and material for children, free of loose, sharp, and/or pointed parts. LPA observed required cushioning under climbing structure to absorb a fall. Shade was observed in the outdoor area. Per Director, water is provided to toddlers via water pitchers during out door play. Per Director, children also has use the water fountain during outdoor play. LPA observed no large bodies of water on the premises.

Children bring lunch from home and is kept in there cubbies until lunch time. Food storage area to be clean and free of litter, rubbish, rodents, and/or any other vermin. LPA observed refrigerators to be clean and in operable condition.

During the inspection, children present was observed to be treated with dignity and respect, observed to be receiving safe, healthful, and comfortable accommodations, furnishings and equipment, and free from corporal and/or unusual punishment.

LPA observed required posted documentation which included, Facility License, LIC610- Emergency Disaster Plan, Publication (PUB) 393- Notification of Parent Rights, PUB 269- Child Passenger Restraint System, LIC 613A- Notification of Personal Rights. All documents were observed to be posted in the main lobby area. LPA observed Sign in/out sheets, LIC 9148 Earthquake Preparedness, Daily Activity Schedule, and Verification of Disaster and Fire Drills (last conducted on 9/27/23). Required lead testing was conducted at the facility. LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

Children’s records were reviewed for LIC 613A- Personal Rights, Admission Agreement, Immunization Records, LIC 700- Identification and Emergency Information, LIC 701- Physician’s Report, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights.

Staff records were reviewed for approved Pediatric First Aid and CPR certification, staff qualifications, LIC 508-Criminal Record Statement, LIC 503- Health Screening Report, LIC 9052- Employee Rights, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, and LIC 9108- Statement of Child and Mandated Reporter Training Certificate. There is at least one person trained in CPR and Pediatric First Aid present during this inspection and all staff have obtained a criminal record clearance or exemption.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) -98-3350
LICENSING EVALUATOR NAME: Susann Sanchez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2023

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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: BURBANK 1ST UNITED METHODIST CHURCH NURSERY SCHOOL	FACILITY NUMBER: 191200980
	VISIT DATE: 10/03/2023

NARRATIVE

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Consult was provided regarding the following: director/administrator requirements.

Licensee was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the director Kristina Balos.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) -98-3350
LICENSING EVALUATOR NAME: Susann Sanchez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2023

LIC809 (FAS) - (06/04)

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