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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191602644
Report Date: 11/15/2022
Date Signed: 11/16/2022 02:27:51 PM


Document Has Been Signed on 11/16/2022 02:27 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:SECOND MT. NEBO DAY CARE CENTERFACILITY NUMBER:
191602644
ADMINISTRATOR:WATSON, VICKIFACILITY TYPE:
850
ADDRESS:11118 YUKON AVE.TELEPHONE:
(310) 674-6980
CITY:INGLEWOODSTATE: CAZIP CODE:
90303
CAPACITY:40CENSUS: 8DATE:
11/15/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:25 AM
MET WITH:Vicki Watson - DirectorTIME COMPLETED:
03:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Jillinda Chandler conducted an unannounced Required 1 Year inspection at Second Nebo Day Care Center. LPA met with Vicki Watson - director, who provided a tour of the center. The center is located at a church by the same name, day care is conducted in the churches auditorium, and three additional classrooms, currently due census day is only being conducted in the main activity area.
SUPERVISION
During todays inspection LPA observed appropriate teacher to child ratios and proper supervision being provided to 8 children in care.
PHYSICAL PLANT
Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Furniture and equipment were age appropriate and in good condition, free of sharp, loose, or pointed parts, LPA advised director that indoor climbing equipment should have resilient cushioning beneath them. The floors in the classroom were observed to be in good condition all rugs and floors were clean. Temperature in classrooms were set at a comfortable setting, the center has central air and heating. The center has a working telephone.Trash cans had tight fitting lids. Drinking water is readily available. The facility was observed to be free of flies, other insects and rodents. Children have individual cubbies to store their personal belongings, mats for napping were in good repair. The director’s office office and a designated restroom shall be used for isolation. Age appropriate sinks and toilets were inspected LPA observed 1 toilet and 1 sink in non-operable condition. Restrooms were equipped with the necessary toileting supplies (toilet paper, soaps, and paper towels). Fire extinguishers were in need of servicing. First Aid kits were observed containing the required, scissors, bandages, and thermometers. Smoke and carbon monoxide were present and operable.
SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Jillinda ChandlerTELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:
DATE: 11/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/15/2022
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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Document Has Been Signed on 11/16/2022 02:27 PM - It Cannot Be Edited

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: SECOND MT. NEBO DAY CARE CENTER
FACILITY NUMBER: 191602644

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/15/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101174(d)
Disaster and Mass Casualty Plan
(d) Disaster drills shall be conducted at least every six months.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview, the licensee did not comply with the section cited above per the director fire and emergency drills have not been conducted, LPA did not observe a drill log which poses safety risk to persons in care.
POC Due Date: 11/17/2022
Plan of Correction
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Center shall conduct a fire drill no later than 11/17/2022 copies of shall be emailed or mailed to the department.
Type B
Section Cited
CCR
101217(a)
Personnel Records
(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in staff member Kimberly Daniels and Janisa Hawkins files did not required documents, files only contained personnel records, Acknowlagement to Report child abuse and transcripts which poses potential health and safety risk to persons in care.
POC Due Date: 11/25/2022
Plan of Correction
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Director shall update files no later than 11/25/2022. Copies of completed documents shall be mailed or emailed to the department no later than the above due date.

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: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Jillinda ChandlerTELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:
DATE: 11/15/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/15/2022
LIC809 (FAS) - (06/04)
Page: 2 of 9


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: SECOND MT. NEBO DAY CARE CENTER
FACILITY NUMBER: 191602644
VISIT DATE: 11/15/2022
NARRATIVE
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Outdoor playground equipment was in a safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under high climbing equipment and similar equipment are cushioned with resilient cushioning materials,in good repair. There is adequate shade and benches for resting. the playground is enclosed with a gate higher than the required 4-feet regulation. Per the director fire and emergency drills have not been conducted, a "B" citation was issued and director was advised to update the Emergency Disaster Plan (LIC. 610)

FACILITY RECORDS
Reviewed staff and children records were not current and/or updated, while reviewing the children's files it was disclosed that the center did not have the required prescription medicine for one child and another child had medicine with out a prescription or label, the center was given a "B" citation. During review of the children's record it was disclosed that two children where not within the centers age range, the center was cited an "A" citation for operating out of stated limitations of the license. The center did not have a current roster (LIC, 9040), a technical advisory was issued. LPA advised the director to devise a plan to have children signed in and out each day.

FOOD SERVICES:
Meals are provided by the center, children eat inside the classroom. Menus shall be posted one week in advance where it is visible by the child's authorized representative.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Jillinda ChandlerTELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2022
LIC809 (FAS) - (06/04)
Page: 6 of 9
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: SECOND MT. NEBO DAY CARE CENTER
FACILITY NUMBER: 191602644
VISIT DATE: 11/15/2022
NARRATIVE
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facility representative was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the facility representative Vicki Watson.

SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Jillinda ChandlerTELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2022
LIC809 (FAS) - (06/04)
Page: 8 of 9
Document Has Been Signed on 11/16/2022 02:27 PM - It Cannot Be Edited

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: SECOND MT. NEBO DAY CARE CENTER
FACILITY NUMBER: 191602644

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/15/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101161

Limitations on Capacity: 101161(a) A licensee shall not operate a childcare center beyond the conditions and limitations specified on the license, including the capacity limitation.
This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in C1 and C7 were not within the stated age on the license which poses an immediate, safety risk to persons in care.
POC Due Date: 11/15/2022
Plan of Correction
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Children shall be immediately removed from the roster and must not return until the age requirement is met or a license is granted to provide care and supervision to children within needed age range
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Jillinda ChandlerTELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:
DATE: 11/15/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/15/2022
LIC809 (FAS) - (06/04)
Page: 7 of 9


Document Has Been Signed on 11/16/2022 02:27 PM - It Cannot Be Edited

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: SECOND MT. NEBO DAY CARE CENTER
FACILITY NUMBER: 191602644

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/15/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101223(a)(2)
Personal Rights 101223(a)The licensee shall ensure that each child is accorded the following personal rights:(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.


This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review the licensee did not comply with the section cited above in nessary prescribed medicines as stated in Incidenta Medical Services (IMS) for child #7 where not readily available,The center does not provide IMS services, which poses an immediate health, safety and personal rights risk to persons in care.
POC Due Date: 11/16/2022
Plan of Correction
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Parents shall provide the necessary medicines no later than 11/16/2022. If the no longer requires said medicines an updated medical report shall be provided from a physcian before the child can return.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Jillinda ChandlerTELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:
DATE: 11/15/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/15/2022
LIC809 (FAS) - (06/04)
Page: 9 of 9