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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191600666
Report Date: 03/07/2023
Date Signed: 03/07/2023 01:22:47 PM


Document Has Been Signed on 03/07/2023 01:22 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:ST PETER'S BY THE SEA PRESBYTERIAN CHURCHFACILITY NUMBER:
191600666
ADMINISTRATOR:WHITE, ALEXISFACILITY TYPE:
850
ADDRESS:6410 PALOS VERDES DRIVE SOUTHTELEPHONE:
(310) 377-1194
CITY:RANCHO PALOS VERDESSTATE: CAZIP CODE:
90274
CAPACITY:54CENSUS: 35DATE:
03/07/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Alexis White, DirectorTIME COMPLETED:
01:42 PM
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Licensing Program Analyst (LPA) Miriam Cohen conducted a Case Management visit for the purpose of room addition evaluation. The preschool program is located inside the St. Peter’s Presbyterian Church building. Hours of operation is Monday through Friday from 8:00 PM - 4:30 PM. LPA met with the director, Alexis White, and toured the facility inside and outside. Current license includes three classrooms. The licensee submitted an application for classroom addition, the Sunflower Room, without an increase in the capacity. The preschool program current capacity is for a total of 54 children.
Measurements taken for the Sunflower Room is as follows:
Indoor space:
Sunflower Room
35.4 x 21.7 = 768.18 divided by 35 sq. ft. = 22 children

There are three children's bathrooms designated for children's use. There is a total of six toilets and 11 sinks and two urinals.

The outdoor space is completely fenced in and there are no bodies of water. There is a shaded area.

An approved Fire Clearance from the Fire Department was received on 12/22/2022

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 childcare 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
SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Miriam CohenTELEPHONE: (424) 301-3058
LICENSING EVALUATOR SIGNATURE:
DATE: 03/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/07/2023
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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: ST PETER'S BY THE SEA PRESBYTERIAN CHURCH
FACILITY NUMBER: 191600666
VISIT DATE: 03/07/2023
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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.

There are no corrections noted at the time of inspection.
Licensure for Sunflower Room addition shall be granted.

A copy of this report was explained and issued to Alexis White, Director.
SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Miriam CohenTELEPHONE: (424) 301-3058
LICENSING EVALUATOR SIGNATURE:

DATE: 03/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2023
LIC809 (FAS) - (06/04)
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