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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191201970
Report Date: 08/27/2019
Date Signed: 08/27/2019 09:50:13 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:MOUNT OLIVE WILLA LEE NURSERY SCHOOLFACILITY NUMBER:
191201970
ADMINISTRATOR:NULTY, JANETTEFACILITY TYPE:
850
ADDRESS:4519 WILLA LEE AVENUETELEPHONE:
(818) 249-9200
CITY:LA CRESCENTASTATE: CAZIP CODE:
91214
CAPACITY:21CENSUS: 14DATE:
08/27/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Janette Nulty TIME COMPLETED:
10:00 AM
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LPA Dorsey conducted an unannounced Plan of Correction (POC) inspection to determine if the citations cited on 08/01/19 have been corrected. Upon entry LPA met with Dirctor Janette Nulty, LPA conducted census and found 14 children in care.

The following citations cited on 08/01/2019 have been corrected:
  1. 101638.1 (e)(6) - General Sanitation - On 08/01/19 LPA Dorsey observed a staff member using the kitchen sink to wash their hands after changing a child's diaper. LPA observed the changing table has been moved to near the children's restroom. Per Director staff now use the children's sink to wash their hands after changing children.
  3. 1596.8662 - Mandated Reporter - On 08/01/19 LPA Dorsey observed staff #2 did not have proof of taking the mandated reporter training. LPA was sent a photo on 08/13/19 of a completed mandated reporter training certificate taken by staff #2.
The licensee was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Copies of the reports must also be provided to each parent when a serious deficiency, Type A, is cited (LIC9224).

Exit Interview was conducted with Director Janette Nulty. Notice of Site Visit and Appeal rights were given.

SUPERVISOR'S NAME: Adriana HernandezTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 08/27/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2019
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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