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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191609744
Report Date: 10/04/2022
Date Signed: 10/04/2022 05:08:51 PM


Document Has Been Signed on 10/04/2022 05:08 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:STAR - WESTWOODFACILITY NUMBER:
191609744
ADMINISTRATOR:DAVIS, YOLANDAFACILITY TYPE:
840
ADDRESS:2050 SELBY AVENUETELEPHONE:
(424) 420-6985
CITY:LOS ANGELESSTATE: CAZIP CODE:
90025
CAPACITY:250CENSUS: 76DATE:
10/04/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:27 PM
MET WITH:Jarid Stevens- DirectorTIME COMPLETED:
05:20 PM
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Licensing Program Analyst (LPA), Keyona Scott, conducted an unannounced annual required inspection to the child care center on 10/04/2022. LPA met with Director, Jarid Stevens, at 12:42 PM. LPA was guided on a tour of the classrooms, restrooms, cafeteria areas and play yards utilized by the STAR program. At the time of LPAs arrival, there were no children present. All Adults present, working and/or volunteering have a criminal record clearance or exemption.

This is a school-age program that is located at Westwood Charter Elementary School. The program operates after school hours Mondays, Wednesdays and Fridays from 2:40 PM to 6:00 PM and Tuesdays and Thursdays from 1:40 PM to 6:00 PM. The program serves children attending Westwood Charter Elementary School, grades T-K through fifth grade. The program utilizes two to three classes daily.

LPA observed proper teacher to children ratios. At 2:27 PM, LPA observed three T-K and Kindergarten classes with each group having a ratio of 14 children with one (1) teacher. LPA also observed the first grade through fourth graders with 34 children present with three (3) teachers. Per Director, although the program also serves children in the fifth grade, there are currently no fifth graders enrolled.

Physical Plant
LPA observed facility sketch that was provided to the El Segundo Child Care Regional Office (ESCCRO), on 09/30/2022. The facility was kept clean, neat and orderly. LPA observed the boys and girls restroom that are utilized by the STAR program. The restrooms are located adjacent to the outdoor cafeteria seating area. Per Health and Safety Code (HSC) 1596.806, this program is exempt from toilet requirements. LPA observed both the restrooms to be safe, sanitary and functioning. All poisons and hazardous items are stored in the STAR office, which is inaccessible to children in care. All floors are clean and safe. LPA observed the classroom to be clean and free of litter, rubbish and rodents, other vermin, flies, gnats and other insects. Drinking water is readily available both indoors and outdoors. PAGE 1
SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Keyona ScottTELEPHONE: (424) 301-3091
LICENSING EVALUATOR SIGNATURE:
DATE: 10/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/04/2022
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 6


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: STAR - WESTWOOD
FACILITY NUMBER: 191609744
VISIT DATE: 10/04/2022
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STAR outdoor play yard for the first through fifth graders is located on the main school play yard at the rear of the school. Outdoor play area for the T-K and Kindergarteners is located on the Kindergarten play yard adjacent to the main office. Both outdoor play areas are fully fenced and free of hazardous and dangerous conditions. Outdoor play equipment is in safe condition and is 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.

FACILITY RECORDS
There is at least one person present at facility that is trained in CPR and First Aid. LPA observed Director's Pediatric CPR/First Aid with an expiration date of 11/03/2023. Director completed Mandated Reporting training on 10/24/2021.

LPA reviewed four (4) staff files of the following personnel records during today's inspection: Staff Qualifications; Proof of immunization of measles (MMR), pertussis (Tdap) and influenza; Current Pediatric CPR and First Aid Certification; TB clearance or risk assessment; LIC 503 (Health Screening Report); LIC 508 (Criminal Record Statement); LIC 9108 (Statement Acknowledging Requirement to Report Child Abuse); Mandated Reporter Training Certificate; LIC 9052 (Employee Rights)

LPA reviewed six (6) children's files of the following children's records: LIC 613A (Personal Rights); Admission Agreement; LIC 701 (Physician's Report); LIC 995 (Notification of Parents' Rights); LIC 627 (Consent for Emergency Medical Treatment); Immunization Record

LPA observed the following during today's inspection:
  • Facility License
  • Menu
  • PUB 269- Child Passenger Restraint System Poster
  • LIC 610- Emergency Disaster Plan
  • LIC 613A- Personal Rights

LPA provided Director with the following updated required posting to place on the parent board:
  • PUB 393- Notification of Parents' Rights
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SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Keyona ScottTELEPHONE: (424) 301-3091
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2022
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: STAR - WESTWOOD
FACILITY NUMBER: 191609744
VISIT DATE: 10/04/2022
NARRATIVE
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LPA reviewed the following documents during today's inspection:
  • Verification of Disaster Fire Drills: Per review, last fire and earthquake drill was conducted on 09/22/2022.
  • Daily Activity Schedule
  • Sign In/Out Sheets

LPA provided Director with the following form for review and completion:
  • LIC 9148 Earthquake Preparedness Checklist


The following was thoroughly discussed:
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted 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

Director 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.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

The facility was operating in substantial compliance during today’s inspection on 10/04/2022. Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies cited.

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

Exit interview conducted and report was reviewed with Director, Jarid Stevens.

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SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Keyona ScottTELEPHONE: (424) 301-3091
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2022
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: STAR - WESTWOOD
FACILITY NUMBER: 191609744
VISIT DATE: 10/04/2022
NARRATIVE
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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.


PAGE 4
SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Keyona ScottTELEPHONE: (424) 301-3091
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2022
LIC809 (FAS) - (06/04)
Page: 6 of 6