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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191600388
Report Date: 12/12/2019
Date Signed: 12/12/2019 11:36:26 AM

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:LA PLAYA COOPERATIVE NURSERY SCHOOLFACILITY NUMBER:
191600388
ADMINISTRATOR:HOLLENSTEINER, BETTY RUTHFACILITY TYPE:
850
ADDRESS:5041 RHODA WAY,LINDBERG PARKTELEPHONE:
(310) 751-6827
CITY:CULVER CITYSTATE: CAZIP CODE:
90230
CAPACITY:40CENSUS: 25DATE:
12/12/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Director-Betty HollensteinerTIME COMPLETED:
12:00 PM
NARRATIVE
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 On December 12th, 2019 at 9:30am, Licensing Program Analyst (LPA) Lisa Rios made an unannounced visit for the purpose of conducting an Annual/Random inspection. LPA Rios met with and toured the facility inside and outside with Director, Betty Hollensteiner. The facility operates on the grounds of a park in Culver City. The facility has a large main room that consists of table, toys, carpet space, cubbies and a large kitchen. Outside is a large playground with bikes and other age appropriate activities. At the time of arrival, LPA Rios observed 14 children and 6 adults. All in all, the school has 35 children enrolled, 7 parent volunteers and 3 staff.
Inside: Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Storage for children's belongings, bathrooms facilities, and isolation area was inspected. First Aid supplies were inventoried and complete. Documentation of current Fire/Earthquake drills was observed by LPA. Director has current First Aid/CPR with an expiration of .
Outside: Outdoor equipment was inspected for safety, good repair and age appropriateness. Proper cushioning material was observed beneath climbing structures but did not cover all areas. Required shade, drinking water and fencing was inspected. The play area was inspected for hazards and inaccessibility of bodies of water. There was proper and adequate supervision of all children all times.

LPA Rios reviewed licensing boards to ensure that all required postings were displayed. Snack/lunch menus were posted. Food and snacks are prepared in the kitchen and children bring their own lunches. Food preparation area was inspected for safety, cleanliness, proper equipment, protection against contamination and storage. Food and snacks were inventoried for availability, quality, quantity, and appropriateness to children in care. Storage areas were inspected for toxins/cleaning compounds inaccessibility.
SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2019
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 4
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: LA PLAYA COOPERATIVE NURSERY SCHOOL
FACILITY NUMBER: 191600388
VISIT DATE: 12/12/2019
NARRATIVE
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Assembly Bill (AB) 633: Upon receipt by the licensee, licensees are to provide to parents/guardians the following: Copies of any licensing reports that document a Type A citation- this includes facility visits and substantiated complaint investigations; copy of licensing documents pertaining to a conference conducted by a local licensing agency management representative and the licensee of this family child care home in which issues of noncompliance are discussed or copies of a summary of an accusation indicating the Department's intent to revoke the facility's license. Copies of any of the above licensing documents the licensee has received in the prior 12 months shall be provided to parents/guardians of newly enrolled child at the facility. Senate Bill (SB) 792: This bill, commencing September 1, 2016, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles.

Mandated Reporter: Beginning on January 1, 2018, AB 1207, requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Website: www.mandatedreporterca.com

Update on Incidental Medical Services: Facilities that provide Incidental Medical Services (IMS) must identify those services in their facility’s Plan of Operation and submit an updated Plan of Operation to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Incidental Medical Services Include: Blood-Glucose Monitoring for Diabetic Children, Administering Inhaled Medication, Administering EpiPen Jr. and EpiPen or other Epinephrine Auto-Injectors, Glucagon Administration, Gastrostomy Tube Care (G-tube care), Insulin Injections Administration, Anti-Seizure Administration, and Emptying an Ileostomy Bag.


SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: LA PLAYA COOPERATIVE NURSERY SCHOOL
FACILITY NUMBER: 191600388
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/12/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/12/2019
Section Cited

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Immunizations 101220.1
(a) Prior to admission to a child care center, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, commencing with Section 6000. This requirement is not met as evidenced by:
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Based on a children's record review of all files, 3 children were found to be missing their immunization records.
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Type B
12/12/2019
Section Cited

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(101174 (d) Disaster drills shall be conducted at least every six months.
(2) The drills shall be documented. This documentation shall be kept in the child care center for at least one year.
This requirement is not met as evidenced by:
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The Director was unable to show that disaster drills are performed a minimum of once every 6 months.
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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: Jennie FerreiraTELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR SIGNATURE:
DATE: 12/12/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/12/2019
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: LA PLAYA COOPERATIVE NURSERY SCHOOL
FACILITY NUMBER: 191600388
VISIT DATE: 12/12/2019
NARRATIVE
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Licensee was made aware of The Child Care Advocate Program (CCAP) that is administered from within the Community Care Licensing Division. CCAP participates in many community activities and special projects in order to disseminate information on the State’s licensing role, provide information to the public and parents on child care licensing, and provide many other helpful resources to the licensees and the public. CCAP’s direct contact information is as followed: Phone number: (916) 654-1541
Email Address: childcareadvocatesprogram@dss.ca.gov


Deficiencies: Documentation of current Fire/Earthquake drills was not observed. A review of the children files indicated that immunization records were missing for three children.

Exit interview, copy of report and Notice of Site visit issued.
SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4