191602269-10-26-2023-30-CC-VWHY-CWYLCK-20231026083827

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191602269
Report Date: 10/25/2023
Date Signed: 10/26/2023 08:38:35 AM

Document Has Been Signed on 10/26/2023 08:38 AM - 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. JOHN'S LUTHERAN CHURCH NURSERY SCHOOL		FACILITY NUMBER:	191602269
ADMINISTRATOR:	MARY JOSEPHINE MEADE		FACILITY TYPE:	850
ADDRESS:	1611 EAST SYCAMORE		TELEPHONE:	(310) 615-0211
CITY:	EL SEGUNDO	STATE: CA	ZIP CODE:	90245
CAPACITY:	90	CENSUS: 32	DATE:	10/25/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:15 PM
MET WITH:	Josephine Meade		TIME COMPLETED:	04:45 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 Analyst (LPA), V. Wheatley and conducted an annual inspection and met with the Director Josephine Meade. LPA toured and inspected the facility and observed 32 children playing on the premises. The children were supervised properly and were within required ratios. The children have been approved to be allowed upstairs. Furniture and equipment was inspected for age appropriateness and good repair. The telephone service, heating, lighting, and ventilation is adequate. The facility has central heating and air conditioning. There are cubbies for children's belongings. There is a first aid kit in each classroom. LPA observed several age appropriate toys. The sheets and blankets are kept separate in the children's bags. The electrical outlets are inaccessible and the trash bins are covered. Children are inspected for illnesses as they arrive. A review of medication policy indicated that medication is administered with parents permission and doctor's authorization. The administered medication is documented on a separate sheet. There is a separate area for isolation and care of ill children in the director's office. The director is aware of Incidental Medical Services. The director has submitted a plan of operation to the department. There is one child receiving these services as needed.

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Veronica Wheatley	TELEPHONE: (424) 301-3051
LICENSING EVALUATOR SIGNATURE:	DATE: 10/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2023

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. JOHN'S LUTHERAN CHURCH NURSERY SCHOOL	FACILITY NUMBER: 191602269
	VISIT DATE: 10/25/2023

NARRATIVE

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LPA inspected the restrooms. The toilets and sinks are functioning properly. There is toilet paper, soap and paper towels in each restroom.

LPA inspected the large outdoor play space. The outdoor equipment was inspected for health, safety, cushioning material, good material, and age appropriateness. LPA inspected the play equipment and observed age appropriate toys. There is a shaded area. The drinking water is taken outside daily. There are no bodies of water on the premises.

LPA inspected the kitchen and observed the chemicals locked and separated from the food. The children bring their lunch. The snacks are provided by the licensee. The children are served 1% milk and 100% juice. LPA observed menus posted.

Teacher child ratios were observed and staff names recorded. All staff members are fingerprint cleared. Care and supervision was evaluated to determine if the basic needs of children are met and appropriate. Staff were questioned to establish their familiarity of emergency reporting requirements, emergency disaster plans and other site operations. Personal rights of children were discussed. Director states they use redirection. A fire drill or earthquake drill are held once a month and logged. Staff were reminded children are to be supervised at all times.

Each child is signed in manually at the front gate. The children are not transported off the premises for field trips.

Children and staff records were reviewed which are complete. The staff have current CPR/first aid certification which expires 8/2024. The staff have required immunization records and have completed the Mandated Child Abuse Training. Additional forms and child care updates may be obtained at the department's website www.ccld.ca.gov. There are no deficiencies according to Title 22 Regulations.

Exit interview conducted. A copy of the report provided.

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Veronica Wheatley	TELEPHONE: (424) 301-3051
LICENSING EVALUATOR SIGNATURE:	DATE: 10/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2023

LIC809 (FAS) - (06/04)

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