191800316-7-21-2022-54-CC-DGIS-CGJQVE-20220721123014

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191800316
Report Date: 07/21/2022
Date Signed: 07/21/2022 12:30:25 PM

Document Has Been Signed on 07/21/2022 12:30 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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	ONE HUNDRED TWELFTH STREET EARLY EDUCATION		FACILITY NUMBER:	191800316
ADMINISTRATOR:	CHARLETHA ROBINSON		FACILITY TYPE:	850
ADDRESS:	1319 EAST 112TH STREET		TELEPHONE:	(323) 567-9631
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90059
CAPACITY:	108	CENSUS: 20	DATE:	07/21/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Brandi Reed, Facility Representative		TIME COMPLETED:	12:45 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 Analysts (LPA) Denise Gibbs conducted an unannounced annual required inspection at the above facility on 7/21/22 at 8:45 AM. LPA met with Brandi Reed, Facility Representative (FR) who guided analysts on a tour of the facility. This is a preschool program that operates Monday - Friday from 7:00AM-5:30PM. There were 20 children and five staff present when LPA arrived. Per FR, the Principal, some staff and children are at the neighboring elementary school for culmination. LPA was informed that Principal Tamara Corley's last day was 7/20/22 and Vernida Watson will be taking over as Principal. Facility is in compliance with license capacity and Title Five ratio guidelines. All individuals present have obtained a criminal record clearance or criminal record exemption as a condition of employment with the Los Angeles Unified School District. LPA toured Classrooms #1-3. During inspection classroom #2 was combined with classroom #1 due to staffing, low ratio and special event . All classrooms had furniture in good condition, free of loose, sharp and/or pointed parts. The floors and surfaces in the classrooms were clean and safe. Rugs were observed to be flat on the ground to avoid tripping hazards. Water is made readily available via labeled bottles provided by facility. Facility does have extra water bottles on hand and water fountains in the classrooms. Per FR, there are children with medication. LPA reviewed storage, expiration dates and required documentation for medication. Children have cubbies to store personal belongings separate from each other. Children have cots to nap. Bedding is provided by facility and washed weekly by laundry service. There is extra bedding on hand to change as needed. LPA toured the children’s restrooms. Restrooms were observed to be safe and sanitary with operable sinks and toilets. LPA toured outdoor play areas. Outdoor areas were observed to have age appropriate equipment, toys and material for children. LPA observed required cushioning under climbing structure to absorb fall. Shade was ---------------------PAGE 1

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 07/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022

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 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ONE HUNDRED TWELFTH STREET EARLY EDUCATION	FACILITY NUMBER: 191800316
	VISIT DATE: 07/21/2022

NARRATIVE

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observed throughout the outdoor area. Water bottles are taken outdoors for children. Per FR water fountains are are being fixed. LPA observed caution tape around one of the climbing structures. Per FR the tape is there for extra safety precaution. The structure is not broken are XXXX. LPA did not observed any hazards.

LPA observed required posted documentation in the main entrance hallway, which included, Facility License, Publication (PUB) 393- Notification of Parent Rights, Licensing Form (LIC) 610- Facility Disaster Plan, PUB 269- Child Passenger Restraint System, LIC 613A- Notification of Personal Rights and Lunch/Snack Menu. All items were observed.

Facility records were reviewed for LIC 9040- Facility Roster, 9148- Earthquake Preparedness form, Daily schedules and Disaster drill log, last drill conducted on 5/24/22. All items were observed.

LPA toured the kitchen on site. Facility provides AM snack, PM snack and lunch. Food is not cooked at the facility. Prepackaged food is brought from the neighboring elementary school. Extra food is taken back to elementary. Kitchen was observed to be clean, free of litter, insects and rodents. LPA reminded FR that trash cans for solid waste must have tight fitting lids. Cleaning supplies are stored separate from the food. Carbon monoxide detector is combined with facility wired smoke/fire alarm.

LPA reviewed Sign In/Out sheets located at front desk. All children present were signed in with date, time and full signature of the child's representative. Due to COVID-19 precautions, parents are not entering the facility. Children are dropped off and picked up at the main entrance. A digital daily pass (approved child health assessment) is scanned for added precaution.

Children’s records were reviewed for Emergency Card, Immunization Records, Licensing Form (LIC) 627- Consent for Medical Treatment, LIC 995 Notification of Parents’ Rights, LIC 701- Physician’s Report, LIC 613A- Personal Rights, and signed Admissions Agreement. Documents were discussed. Children's who's files were discussed recently culminated and will not be returning. The school year is ending.

Staff records were reviewed for approved Pediatric First Aid and CPR certification, LIC 9052- Employee Rights, Proof of immunization against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse, Transcripts or Permit and current Mandated Reporter Training Certificate. Documents were discussed. ----PAGE 2

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 07/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022

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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ONE HUNDRED TWELFTH STREET EARLY EDUCATION	FACILITY NUMBER: 191800316
	VISIT DATE: 07/21/2022

NARRATIVE

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During inspection all children were observed to be treated with dignity and respect, they were observed to be receiving safe, healthful and comfortable accommodations, furnishings and equipment, and free from corporal and/or unusual punishment.

LPA observed that facility still is implementing COVID-19 precautions and procedures as required by Los Angeles Unified School District and the Department of Public Health.

New Car Seat Law poster and Lead Flyer was provided.

Incidental Medical Services (IMS):
This facility provides Incidental Medical Services- IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personal, and administrative records. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm

Based on the LPA's observations and records review no deficiencies will be cited today 7/21/22.

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.

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 Vernida Watson.

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SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 07/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022

LIC809 (FAS) - (06/04)

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