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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191800750
Report Date: 06/19/2019
Date Signed: 06/19/2019 04:54:41 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:WESTSIDE JEWISH COMMUNITY PRE-SCHOOLFACILITY NUMBER:
191800750
ADMINISTRATOR:DEBORAH KAPLANFACILITY TYPE:
850
ADDRESS:5870 WEST OLYMPIC BOULEVARDTELEPHONE:
(323) 556-5251
CITY:LOS ANGELESSTATE: CAZIP CODE:
90036
CAPACITY:141CENSUS: 66DATE:
06/19/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Lauren Friedman, Assistant Director TIME COMPLETED:
04:05 PM
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Licensing Program Analyst (LPA) Denise Do Amaral Miranda met with Lauren Friedman Assistant Director for the purpose of conducting Annual/Random . At 12:27pm, LPA toured the facility indoors and outdoors as identified per facility sketches. Pre school hours are from 7:30 am to 6pm, Monday through Friday.
Upon LPA arrival, 66 children were observed in care. LPA observed sign/sign out sheets and children’s attendance sheet. LPA observed five classrooms.
Classroom 1-2 : 1 teacher and 1 teacher aide with 11 children, Classroom 3-4: 2 teachers, 2 teaches assistants with 22 children, 5-6: 2 teacher and teachers assistant 2 teachers with 20 children, Classroom TK: 1 teacher and 1 teacher assistant with 13 children and toddler component classroom room: 1 teacher and 2 teachers assistant: 2 children.
Furniture was found to be in good repair and age appropriate. There is adequate heating, lighting and ventilation in each classroom. Drinking water is readily available in each classroom. Director assistant states that the isolation area for sick students is located in the Director's office.
The bathroom area(s) were inspected, there are sufficient toilets and sinks to accommodate the campus capacity. Three classrooms are equipped with a restroom. Toilets flush properly, toilet and sinks are reachable by the children in care. Each rest-room has adequate Toilet paper and paper towels available. Bathrooms were found to be clean. There is adequate lighting/ventilation in the bathroom areas.
Toilets, faucets and sinks are in operable condition. Each restroom has adequate toilet paper, hand soap and paper towels available. Bathrooms were found to be clean. There is adequate lighting/ventilation in the bathroom area(s).
Facility provide snacks are lunch is provided by the parents and a menu was observed posted at the facility.

Inspection of the outdoor play area was conducted climbing structures, slides, play equipment are securely anchored.

SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Denise MirandaTELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2019
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 4
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: WESTSIDE JEWISH COMMUNITY PRE-SCHOOL
FACILITY NUMBER: 191800750
VISIT DATE: 06/19/2019
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New Appeal Process: A licensee may file an appeal, in writing 15 business days from the date of receiving the penalty assessment.
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.
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. 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. 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.htm.

During this visit, LPA provide consultation and copy of the title 22 - 101227 Food Services.


During this visit, Director Assistant was not able to produce immunization card for the following Teachers:
Teacher#1: missing MMR, Pertussis and influenza Teacher#2, #3, #4 and #5: missing TB, influenza, MMR and pertussis.
Director Assistant was not able to proof of completion of mandated reporter.
The facility was found no to be in compliance per Title 22 regulations, Type B deficiencies will be cited today 6/19/2019.

A copy of this report along with an advisory notes and Notice of Site Visit and appeal rights were issued and explained to the Director Assistant. An exit interview was conducted.

SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Denise MirandaTELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2019
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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: WESTSIDE JEWISH COMMUNITY PRE-SCHOOL
FACILITY NUMBER: 191800750
VISIT DATE: 06/19/2019
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Drinking water is available on the outdoor play space. There is adequate shade for the children in care. There is appropriate fencing around the perimeter of the outdoor play area.

First Aid supplies were stored appropriately in the classroom.


Required postings were observed by LPA. LPA observed required postings in the facility (Facility License, Emergency Disaster Plan, Parents Rights Poster).

At 3:10pm LPA reviewed Children’s and staff’s records.

Director advised that records for all children and staff must be maintained for 3 years after separation from the facility.

LPA observed CPR/First Aid for Teacher#3 and #4 expires 09/2021.

The required fire extinguisher, smoke detectors and carbon monoxide detector are in operable condition.
The following was discussed with the licensee:
Mandatory Forms for the children’s files and provider’s files, Requirements for fire drills, earthquake drills and documentation for both. Role and responsibilities of being a mandated reporter were discussed. The licensee was advised how to access forms and Regulations for Family Child Care 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.
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. LPA discussed the influenza waiver during the visit. 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.
SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Denise MirandaTELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2019
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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: WESTSIDE JEWISH COMMUNITY PRE-SCHOOL
FACILITY NUMBER: 191800750
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/19/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/19/2019
Section Cited
HSC
1596.95(a)(1)
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(a) (1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
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The identified Teachers members shall provide proof no later than 7/19/2019. Proof shall be delivered to or reviewed by LPA no later than the due date.
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This standard has not been met as evidence; A file review conducted at 3:10 P.M and LPA observed the following: Teacher#1: missing MMR, Pertussis and influenza Teacher#2, #3, #4 and #5: missing TB, influenza, MMR and pertussis. This is a potential health and safety risk and a type B citation was issued
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Type B
06/26/2019
Section Cited
HSC
1596.8662(2)
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(2) On and after January 1, 2018, a person who applies for a license to be a provider of a child day care facility shall complete the mandated reporter training... (a) as a precondition to licensure and shall complete renewal mandated reporter training every two years ..... This standard was not met as evidence; a file review conducted at 3:10 p.m
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The identified staff members shall provide proof no later than 6/26/2019. Proof shall be delivered to or reviewed by LPA no later than the due date.
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This standard has not been met as evidence;
Disclosed that teachers:#1,2,3, 4 and 5 had not provided complete immunization records. This is a potential health and safety risk and a type B citation was issued
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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: Jennie FerreiraTELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Denise MirandaTELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4