191205046-12-20-2019-30-CC-CESO-BK2W4J-20191220155738

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191205046
Report Date: 12/20/2019
Date Signed: 12/20/2019 03:58:03 PM

COMPREHENSIVE INSPECTION

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:	BOULEVARD NURSERY SCHOOL AND KINDERGARTEN		FACILITY NUMBER:	191205046
ADMINISTRATOR:	RENEE KING		FACILITY TYPE:	850
ADDRESS:	23022 VICTORY BOULEVARD		TELEPHONE:	(818) 883-0607
CITY:	WOODLAND HILLS	STATE: CA	ZIP CODE:	91367
CAPACITY:	192	CENSUS: 121	DATE:	12/20/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:10 AM
MET WITH:	Renee King-Director		TIME COMPLETED:	04:20 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	On 12/20/2019 at 10:10 a.m. Licensing Program Analysts (LPAs), Antonio Almanza and Claudia Escobedo conducted an unannounced annual inspection at the facility to ensure that health, safety and personal rights as required by Title 22 Regulations governing California Child Care Centers are met. Upon arrival into the office, LPAs were greeted by Director-Renee King. Director King states that the child care center operates Monday-Friday from 7:30 a.m. to 5:30 p.m. Director King states that there are 16 classrooms and 4 play areas (Toddler/2-year-old play area, 2 year-old play area, 3 year-old play area and 4-year-old play area). Director King states that the facility is equipped with cameras that record video (no audio) in all of the classrooms. Recordings are stored for 2 months. The facility is equipped with central air and heat. LPA's observed all classrooms to be equipped with a working telephone that places calls to the inside of the facility and 911. LPA's observed a first-aid kit, 5 fire extinguishers (2A 10BC) and smoke/carbon monoxide detectors. Children have drinking water available in each classroom and in the outdoor play areas. Director led LPAs on a tour of the outdoor and indoor areas of the facility. At 10:21 a.m., LPAs entered Classroom #1 (Toddler Room) and observed 2 teachers and 9 children present. The classroom is equipped with a 12 compartment cubby cabinet and age-appropriate toys. LPAs observed cleaning products that are inaccessible to children by safety latch located underneath the classroom sink. This Classroom shares a bathroom with 3 working toilets with Classroom #2. A hallway leads to Classroom #2. This hallway is equipped with a changing table. Director states that this changing table is for parent use only, as teachers will change children's diapers in the classroom. At 10:26 a.m. LPAs entered Classroom #2 (2-year-olds). Children and Teachers were outside in the play area. The classroom is equipped with a 12 compartment cubby cabinet and age-appropriate toys. Page 1 Continued on LIC809-C

SUPERVISOR'S NAME: Victor Bautista	TELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2019

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 6

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: BOULEVARD NURSERY SCHOOL AND KINDERGARTEN	FACILITY NUMBER: 191205046
	VISIT DATE: 12/20/2019

NARRATIVE

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LPAs observed Lysol cleaning spray in an accessible cabinet located underneath the children's sink. At 10:30 a.m. Director King observed the Lysol cleaning spray located in an accessible bottom cabinet and moved product to a top cabinet.

LPAs toured the Toddler/2-year-old play area that children from Classroom #2 were playing in and counted 10 children.

LPAs were then led to Classroom 16 (4-year-olds) and observed 1 teacher and 8 children present. The classroom is equipped with an 18 compartment cubby cabinet and age-appropriate toys. The bathroom in this classroom has 3 working toilets. LPAs observed an outlet missing the wall plate. Director was informed of the missing plate.

LPAs entered Classroom 17 (4-year-olds) at 10:35 a.m. and observed 1 teacher and 12 children present. The classroom is equipped with an 18 compartment cubby cabinet and age-appropriate toys. LPAs observed an electrical outlet without a safety plug. Director was informed of the missing safety outlet plug.

At 10:43 a.m., Director King requested that Maintenance Worker install the wall plate in Classroom #16 and outlet safety plug in Classroom #1. Director King states that the facility has a maintenance worker on staff Monday-Friday from 6:30 a.m.-3:30 p.m.

LPAs were then led to Classrom #18. Children and teacher were not present in the classroom, as they were in the outdoor play area. Classroom is equipped with a 15 compartment cubby cabinet and age-appropriate toys. There is 1 bathroom with 2 working toilets. The classroom has a pet tortoise.

At 10:47 a.m., LPAs entered Classroom #15 (4-year-olds) and observed 1 teacher and 10 children. Classroom is equipped with a 15 compartment cubby cabinet and age-appropriate toys. This classroom shares a bathroom with Classroom # 14. This bathroom is equipped with 3 working toilets.

Classroom #14 (4-year-olds). Teacher and children were not present in the classroom, as they were in the outdoor play area.

Page 2 Continued on LIC 809-C

SUPERVISOR'S NAME: Victor Bautista	TELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2019

LIC809 (FAS) - (06/04)

Page: 2 of 6

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: BOULEVARD NURSERY SCHOOL AND KINDERGARTEN	FACILITY NUMBER: 191205046
	VISIT DATE: 12/20/2019

NARRATIVE

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At 10:53 a.m., LPAs entered Classroom 12 (3-year-olds). Children and teacher were not present in the classroom, as they were in the outside play area. The classroom is equipped with a 15 compartment cubby cabinet and age-appropriate toys. There is a bathroom in this classroom with 3 working toilets.

LPAs observed that the facility is equipped with a pool that is fenced in with padlocks installed. Director King states that the pool is used in the summer months only.

LPAs observed the 3-year-old outdoor play area. Classroom #6 and Classroom #12 were present. LPAs observed 3 teachers and 20 children. The area is equipped with age-appropriate play equipment that is in safe conditions, free of loose objects.

At 10:55 a.m., LPAs toured Classroom #6 and observed an 18 compartment cubby cabinet and age-appropriate toys and equipment. The bathroom in this classroom is equipped with 4 working toilets. Director King states that classrooms 4, 5, and 6 share this bathroom.

LPAs toured Classroom #5 (3-year-olds) and observed 1 teacher and 8 children.

LPAs toured Classroom #4 and observed 1 teacher and 6 children. The classroom is equipped with an 18 compartment cubby cabinet and age-appropriate toys and equipment.

At 11:10 a.m., LPAs toured the 2-year-old outdoor play area. LPAs observed 2 teachers and 8 children from classrooms 9 and 10. The area is equipped with age-appropriate play equipment that is in safe conditions, free of loose objects.

Classroom #9 is equipped with a 21 compartment cubby cabinet and age-appropriate toys and equipment. This classroom has a bathroom with 2 toilets that is shared with classroom #10.

LPAs toured Classroom #10 and observed age-appropriate toys and equipment.

Page 3 Continued on LIC 809-C

SUPERVISOR'S NAME: Victor Bautista	TELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2019

LIC809 (FAS) - (06/04)

Page: 5 of 6

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: BOULEVARD NURSERY SCHOOL AND KINDERGARTEN	FACILITY NUMBER: 191205046
	VISIT DATE: 12/20/2019

NARRATIVE

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LPAs toured Classroom #11 (2-year-olds) and observed 2 teachers and 12 children present. This classroom holds 1 bathroom with 2 working toilets. LPAs observed age-appropriate toys and equipment.

LPAs toured Classroom #8 and observed 9 children and 1 teacher. The classroom has 1 kitchen and 1 bathroom with 2 working toilets.

LPAs toured Classroom #7 and observed 1 teacher and 9 children. The classroom has 1 bathroom with 2 toilets. At 11:23 a.m. LPAs observed an outlet missing a safety plug.

At 11:32 a.m., Director King requested that maintenance worker install an outlet safety plug in Classroom #7.

LPAs toured the 4-year-old outdoor play area. Play equipment (slides and swings) is in safe conditions and free of any loose or sharp objects. This play area has a covered art area. At 11:32 a.m. LPAs informed Director King that a bush and play house present with areas where children may be out of sight from teachers. Director states that she will make the area inaccessible by putting a barrier/fence.

At 2:30 p.m. LPAs observed that corrections, including the installation of a wall plate and safety plugs were made to classroom 7, 16, and 17.

There were two deficiencies cited during today's visit in accordance to the California Code of Regulations Title 22, Division 12, Chapter 1. A civil penalty was issued see LIC421BG.

Upon receipt of this report, the Licensee shall post the Notice of Site Visit and any Licensing report documenting a type “A” deficiency. The report and the Notice of Site Visit shall be posted for 30 consecutive days. Failure to maintain posting as required, will result in an immediate $100 civil penalty. A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year).

Page 4 Continue on LIC 809-C

SUPERVISOR'S NAME: Victor Bautista	TELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2019

LIC809 (FAS) - (06/04)

Page: 3 of 6

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: BOULEVARD NURSERY SCHOOL AND KINDERGARTEN	FACILITY NUMBER: 191205046
	VISIT DATE: 12/20/2019

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 26 27 28 29 30 31 32	The Acknowledgement of Receipt (LIC 9224 form must be maintained in each child’s file immediately upon receipt from parent. Licensee was provided with a copy of the Acknowledgement of Receipt of Licensing Reports (LIC 9224) Form during this visit. Exit interview, copy of report was given. Appeal rights were issued and discussed.

SUPERVISOR'S NAME: Victor Bautista	TELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2019

LIC809 (FAS) - (06/04)

Page: 6 of 6

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: BOULEVARD NURSERY SCHOOL AND KINDERGARTEN	FACILITY NUMBER: 191205046
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/20/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 12/21/2019 Section Cited	1 2 3 4 5 6 7	1012389(g)-Buildings and Grounds-Disinfectants, cleaning solutions ...that could pose a danger if readily available to children shall be stored where inaccessible to children. This requirement is not met as evidenced by:
	8 9 10 11 12 13 14	Based on observation, the licensee did not ensure inaccessibility to cleaning solution in classroom 2, which poses an immediate Health, Safety or Personal rights risk to persons in care.	8 9 10 11 12 13 14
Type A 12/21/2019 Section Cited	1 2 3 4 5 6 7	101170(e)(2)-Criminal Record Clearance-All individuals subject to a criminal record review...shall prior to working...:Obtain a California clearance...as required by the Department... This requirement is not met as evidenced by:
	8 9 10 11 12 13 14	Based on observation, record review and interview, the licensee did not ensure criminal record clearance for 1 of 24 staff, which poses an immediate Health, Safety or Personal rights risk to persons in care.	8 9 10 11 12 13 14

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Victor Bautista	TELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2019

LIC809 (FAS) - (06/04)

Page: 4 of 6