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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191690248
Report Date: 10/20/2022
Date Signed: 10/20/2022 01:54:52 PM


Document Has Been Signed on 10/20/2022 01:54 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:BEVERLY GLEN PLAYGROUP, INC.FACILITY NUMBER:
191690248
ADMINISTRATOR:SHADI BAKHTIARIFACILITY TYPE:
850
ADDRESS:10409 SCENARIO LN.TELEPHONE:
(310) 470-0992
CITY:LOS ANGELESSTATE: CAZIP CODE:
90077
CAPACITY:24CENSUS: 17DATE:
10/20/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Shadi BakhtiaraTIME COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) Doris Whitmore conducted an unannounced annual/random inspection at the above-mentioned facility. LPA met with Shadi Bakhtiari, who guided analyst on a tour and inspection of the facility. This facility operates Monday through Friday, The Morning Program is from 9:00a.m. to 12:30p.m. with an option to stay until 1:30p.m. or 2:30p.m. The two and three years olds comes Monday, Wednesday, & Fridays from 2: 30p.m, to 4:30p.m.

LPA observed 17 children present with 1 Center Director ,2 teachers and 1 parent volunteer. LPA verified that all adults present in the facility have obtained criminal record clearances and are associated to the facility. LPA also reviewed the sign in and sign out sheet to verify the census. On Bright Wheel.

A walk through of the classroom room space was conducted, the space was found to be clean and free from any potential hazards. Furniture was found to be in good repair and age appropriate. There is adequate heating, lighting and ventilation. Drinking water is readily available. Isolation area for sick students is located in the Director's office. LPA observed adequate arrangements for isolation and care of ill children.

The bathroom and toileting areas were inspected, LPA observed (2) toilets and (2) sinks to accommodate the facility’s capacity. Toilets flush properly, toilet and sinks are reachable by the children in care. The restroom has adequate toilet paper and paper towels available. The bathroom was found to be clean. There is adequate lighting/ventilation in the bathroom area.



Children bring their own snacks and lunches from home. Food preparation area was toured for safety, cleanliness and proper equipment. Food and snacks were reviewed for availability, quantity and appropriateness to children in care. A review of cleaning and food supply storage areas was made.

Inspection of the outdoor play area was conducted climbing structures, swings, slides and other large play equipment is found to be securely anchored with adequate resilient cushioning material underneath and around the perimeter.

SUPERVISOR'S NAME: Karren StarksTELEPHONE: (424) 301-3069
LICENSING EVALUATOR NAME: Doris WhitmoreTELEPHONE: 424-301-3029
LICENSING EVALUATOR SIGNATURE:
DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/20/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: BEVERLY GLEN PLAYGROUP, INC.
FACILITY NUMBER: 191690248
VISIT DATE: 10/20/2022
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Drinking water is readily available on the play yard. The is adequate shade for the children in care. Fencing around the perimeter of the play area is at least 4 feet high. Playground is free from miscellaneous debris such as tree branches, trash, leaves, etc.

The facility has one or more functioning fire extinguishers, smoke detectors that meet statutory requirements. LPA observed a fully charged 2A10BC fire extinguisher. LPA also observed an working carbon monoxide. Facility was observed to be operating within the conditions, limitations, and capacity specified on the license.


LPA observed a couple of teachers in the files has completed the Mandated Reporter Training 8/24/2021 and First Aid and CPR 09/1/21

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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.html.

Mandatory forms for the children’s files and staff’s files were observed. Requirements for disaster drills and documentation for both were reviewed. Role and responsibilities of being a mandated reporter were discussed. The licensee was advised how to access forms and Regulations for Child Care Center online at www.ccld.ca.gov. Licensee was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care. Licensee was advised on how to access quarterly reports, forms, and regulations for Child Care online at www.ccld.ca.gov. The licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must have the facility’s phone number at all times; if the phone number is changed, licensing must be notified. Regulation prohibits the smoking of tobacco on the premises.

SUPERVISOR'S NAME: Karren StarksTELEPHONE: (424) 301-3069
LICENSING EVALUATOR NAME: Doris WhitmoreTELEPHONE: 424-301-3029
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022
LIC809 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: BEVERLY GLEN PLAYGROUP, INC.
FACILITY NUMBER: 191690248
VISIT DATE: 10/20/2022
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The Center Director was informed 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 child care 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

The following were also discussed with the Center Director:


Assembly Bill 633: Upon receipt of a citation for a Type A Deficiency, the director shall post the licensing report for 30 days in addition to the Notice of Site Visit & provide copies of the licensing report (LIC 809D/9099D) to parents/guardians of children in care at the facility by the close of business the following day or the next day child returns to the facility. The same report must be provided to parents/guardians of children newly enrolled at the facility during the next 12 months & licensee will obtain a signed Acknowledgement of Licensing Reports (LIC 9224) from parent/guardian & place it in each child's file.

Senate Bill 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

New Immunization Requirement: Law enacted by SB 277, 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.

Assembly Bill 1207: California Child Care Workers; Mandated Training Requirement. Beginning January 1, 2018, all licensed providers, applicants, directors and employees must complete Mandated Reported Training prior to March 30, 2018 and renew training every two years at: www.mandatedreporterca.com.

Nutrition Requirement: Beginning January 1, 2016, AB 290 will require for each new license issued, at least one director or teacher at each child care center or family child care home to have at least one hour of training in the importance of childhood nutrition. This applies to anyone submitting a new application, relocating their facility, selling their facility or transferring their license. Please note this training cannot be completed online or by home study programs. The training must be taken from an Emergency Medical Services Authority (EMSA) approved training program OR an accredited college or university.

SUPERVISOR'S NAME: Karren StarksTELEPHONE: (424) 301-3069
LICENSING EVALUATOR NAME: Doris WhitmoreTELEPHONE: 424-301-3029
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: BEVERLY GLEN PLAYGROUP, INC.
FACILITY NUMBER: 191690248
VISIT DATE: 10/20/2022
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The facility was found to be in compliance per Title 22 regulations, Type A and B deficiencies will not be cited today 10/20/2022

An exit interview was conducted with the Director Shadi Bakhiara and the report was given.

SUPERVISOR'S NAME: Karren StarksTELEPHONE: (424) 301-3069
LICENSING EVALUATOR NAME: Doris WhitmoreTELEPHONE: 424-301-3029
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022
LIC809 (FAS) - (06/04)
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