191609392-11-21-2019-30-CC-LRIS-BJ62CD-20191121161635

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191609392
Report Date: 11/21/2019
Date Signed: 11/21/2019 04:16:42 PM

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:	CULVER CITY UNI. SCH. DIST.- LINWOOD HOWE ELEM.		FACILITY NUMBER:	191609392
ADMINISTRATOR:	TUCKER, DEE		FACILITY TYPE:	850
ADDRESS:	4100 IRVING PLACE		TELEPHONE:	(310) 204-1317
CITY:	CULVER CITY	STATE: CA	ZIP CODE:	90230
CAPACITY:	64	CENSUS: 15	DATE:	11/21/2019
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	03:00 AM
MET WITH:	Director-Vanessa San Martin		TIME COMPLETED:	04:30 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 November 21sth, 2019 at 3:30 PM, Licensing Program Analysts (LPAs) Lisa Rios and Stella Gutierrez 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, Vanessa San Martin. The facility operates on the grounds of Culver City Unified School District at Linwood Howe Elementary and is located inside 1 bungalow classroom. This facility consists of one classroom: Preschool #1 is a full day program that runs from 7:00am -6:00pm ages 2 to 5 years. LPAs Rios and Gutierrez observed 15 children supervised by three adults, (one teachers and two assistants). LPAs reviewed the sign-in and sign out sheets to verify the census. LPA observed children engaged in story time and others were napping in the classroom. The room was neat and clean with all lower cabinets and overhead cabinets having child proof locks and disinfectants stored out of children's reach.. A smoke detector, fire extinguisher, first aid kit, toilets and sinks were all working. Menu's and licensing documents were properly posted where parents could readily see. Furniture was found to be in good repair and age appropriate. There is adequate heating, lighting and ventilation. Drinking water is readily available in the classroom. LPAs observed classroom space to have dramatic play, arts/crafts, reading, individual cubbies for storage and learning activities. Each child has an emergency kit. Outdoor activity space is located on the elementary kindergarten school yard. Age appropriate equipment was observed. The preschool is on a staggered time schedule to accommodate both the preschool and kindergarten.

SUPERVISOR'S NAME: Jennie Ferreira	TELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2019

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: CULVER CITY UNI. SCH. DIST.- LINWOOD HOWE ELEM.	FACILITY NUMBER: 191609392
	VISIT DATE: 11/21/2019

NARRATIVE

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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.

New Appeal Process: A licensee may file an appeal, in writing 15 business days from the date of receiving the penalty assessment. All appeals must be sent to: California Department of Social Services | Community Care Licensing Division, 300 N. Continental Blvd. Suite, 290-A, El Segundo, CA 90245.

Senate Bill (SB) 277 New Immunization Requirement: Beginning January 1, 2016, personal beliefs exemptions will no longer be an option for the vaccines that are currently required for entry into child care or school in California. Personal beliefs exemptions already on file will remain valid until the child reaches the next immunization checkpoint.

Exit interview was conducted and a copy of the report and Notice of Site Visit was given to the Preschool Director.

SUPERVISOR'S NAME: Jennie Ferreira	TELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2019

LIC809 (FAS) - (06/04)

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