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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191803046
Report Date: 02/07/2023
Date Signed: 02/07/2023 04:38:36 PM


Document Has Been Signed on 02/07/2023 04:38 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:LOS ANGELES FAMILY SCHOOLFACILITY NUMBER:
191803046
ADMINISTRATOR:LISSETT AVILAFACILITY TYPE:
850
ADDRESS:2646 GRIFFITH PARK BOULEVARDTELEPHONE:
(323) 663-8049
CITY:LOS ANGELESSTATE: CAZIP CODE:
90039
CAPACITY:92CENSUS: 40DATE:
02/07/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:29 AM
MET WITH:Lissett Avila, DirectorTIME COMPLETED:
04:45 PM
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Licensing Program Analyst (LPA) Mireya Garcia conducted an unannounced Annual Required Inspection. LPA met with Director, Lissett Avila, who guided LPA on a tour of the facility indoors and outdoors. This facility operates Monday-Friday from 8:30am-5:30pm. Per Director, this facility has seventy-two (72) preschoolers enrolled. This facility has a capacity of 92 pre-school children age 2-5 years.

All areas used by the children were inspected. This program consists of 4 classrooms; Rainforest room, Riverbed room, Hill room and Treehouse room. Upon arrival , the following staff were present during this inspection: Rainforest room: Staff #1 and #2 with 4 preschoolers, Riverbed room: Staff #3 and #4 with 9 preschoolers, Hill room: Staff #5 and #6 with 17 preschoolers and Treehouse room: Staff #7 and #8 with 10 preschoolers. Teacher-child ratios were observed to be in accordance with Title 22 regulations. All children were observed to be under visual supervision of a teacher at all times. Staff names were recorded. All adults present have obtained a criminal record clearance or exemption on file.

LPA observed the facility to be clean, safe, sanitary and in good repair. Furniture and equipment was inspected for good repair, free of sharp, loose, or pointed parts. All indoor classrooms were inspected to ensure that the floors have a surface that is safe and clean. All toilets and hand washing facilities are in safe and sanitary operating conditions. All materials and surfaces accessible to children are toxic free. At this time, the office is used as an isolation area. There are sofas and space for a cot to be placed in the office. A restroom is also available in the office if needed for isolation use. Parents are contacted immediately when children are determined to be ill and staff are ensuring that children with obvious symptoms of illness are not being accepted.

Report continues on next page 1 of 4.
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:
DATE: 02/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/07/2023
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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: LOS ANGELES FAMILY SCHOOL
FACILITY NUMBER: 191803046
VISIT DATE: 02/07/2023
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Snack menus were available for reviewed. LPA Garcia advice the center to ensure that Food menus are being posted at least one week in advance and visible to an authorized representative. Per Director, the facility provides PM Snack and children bring their daily AM snack and lunch. All kitchen, food preparation, and storage areas are clean, free of litter, rubbish, and rodents/vermin. All food is protected from contamination, and LPA inspected that any contaminated food is discarded immediately. There is drinking water containers available in all indoor classrooms and drinking containers are taken outdoors. Per Director, children bring their water bottles from home and water is provided if needed. All storage containers for solid waste, including moveable bins, have tight fitting covers on and are in good repair. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are stored in an area inaccessible to children. Director, Lissett Avila states that there are no poisons stored at the facility.

Facility has one functioning carbon monoxide detector that meets statutory requirements. The carbon monoxide detector is located inside the kitchen in the Riverbed classroom, which was tested at 12:10 p.m., and it is in operable condition. The facility representative takes measures to keep the facility free of flies, other insects and rodents.

Outdoor play equipment was observed to be in good condition, free of sharp, loose or pointed parts. Outdoor activity space surface is maintained in a safe condition as is free of hazards. The Director states that there are no bodies of water on the premises and LPA did not observe any bodies of water during this visit. Areas around and/or under climbing equipment and slides have sand cushioning material to absorb a fall. Director states there are no weapons or firearms on the premises.



Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. Staff Records were reviewed to ensure that a health screening report is on file, LPA Garcia observed Staff #1, Staff #3 and #6 were missing health screening reports. Children’s Records were reviewed to ensure that Identification and Emergency form and a medical assessment are on file. Criminal Records Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed.

Report continues on next page 2 of 4.
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023
LIC809 (FAS) - (06/04)
Page: 2 of 8
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: LOS ANGELES FAMILY SCHOOL
FACILITY NUMBER: 191803046
VISIT DATE: 02/07/2023
NARRATIVE
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SB792 (Immunization Requirements for Staff and Employees) was discussed with the facility representative. During records review LPA Garcia observed Staff #3 and Staff #4 were missing immunization records on file.

AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018 any person who works in a child care facility shall complete the training and renew the training every 2 years. During records review LPA Garcia observed Staff #2-#9 were missing AB1207 Mandated Child Abuse reporting training certificates on file. Website provided: https://www.mandatedreporterca.com/training/child-care-providers

Incidental Medical Services (IMS) policy was discussed. This facility currently has children enrolled who require medication. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. At 10:25 am. LPA Garcia observed Epinephrine Injection for Child #1 expired on 12/2021. In addition, at 10:13 A.M.,LPA Garcia observed expired over the counter medications (Children’s Claritin) stored in the office by the Rainforest (pictures were taken) In review of records LPA observed there is no parent consent form on file for the administration of medication for Child #1, Child #2 and Child #3. LPA Garcia provided Director with Technical assistance for the storage of medication and review of Regulation section 101221 documentation needed for the administration of medication. 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

Report continues on next page 3 of 4.

SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023
LIC809 (FAS) - (06/04)
Page: 3 of 8
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: LOS ANGELES FAMILY SCHOOL
FACILITY NUMBER: 191803046
VISIT DATE: 02/07/2023
NARRATIVE
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The following was discussed:
· Reporting Requirements.
· The facility shall ensure that each child is accorded the following personal rights: to be accorded safe, healthful and comfortable accommodations.
· All personnel shall be in good health and shall be physically and mentally capable of performing assigned tasks; personnel that pose a threat to the health and safety of children shall be relieved of their duties.
· All personnel shall be given on the job training in housekeeping, sanitation principles and universal health precautions.

LPA advised the facility representative to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

The deficiencies listed on the following pages were observed by the LPA and are being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809D for deficiencies that are being cited and needs to be cleared to protect the children’s health & safety.

Upon receipt of this report, the licensee shall post ANY licensing report documenting a type “A” citation. This must remain posted for 30 days during hours of operation. In addition to posting this report, the licensee will also provide copies to the parents of the children in care and any newly enrolled children for up to one year.

A copy of the LIC 9224 - Acknowledgement of Receipt of Licensing Reports was provided.

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

Exit interview conducted, report and Technical Support Program was discussed and reviewed with Director, Lissett Avila.

Report ends here page 4 of 4.

SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023
LIC809 (FAS) - (06/04)
Page: 4 of 8
Document Has Been Signed on 02/07/2023 04:38 PM - It Cannot Be Edited

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754


FACILITY NAME: LOS ANGELES FAMILY SCHOOL
FACILITY NUMBER: 191803046

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(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.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on records review LPA observed that Staff #3, and #4 are not immunized against pertussis, measles, and influenza. This poses a potential health and safety risk to children in care.
POC Due Date: 02/21/2023
Plan of Correction
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Per Director, immunizations will be obtained for Staff #3 and #4 and will be placed on file. In addition, Director will submit proof of obtaining immunizations for staff by sending immunizations to LPA Garcia an email by POC due date 2/21/23.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on records review of Staff #2-#9 not having a certificate of completion for Mandated Reporter training on file. This poses a potential health and safety risk to children in care.
POC Due Date: 02/21/2023
Plan of Correction
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Per Director, she will obtain certificate of completion for the mandated reporter training AB1207 online Course for all staff and will be placed on file. In addition, Director will submit proof of course completion for all staff by sending certificates to LPA Garcia an email by POC due date 2/21/23.
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: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:
DATE: 02/07/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/07/2023
LIC809 (FAS) - (06/04)
Page: 5 of 8


Document Has Been Signed on 02/07/2023 04:38 PM - It Cannot Be Edited

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754


FACILITY NAME: LOS ANGELES FAMILY SCHOOL
FACILITY NUMBER: 191803046

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101215.1(m)
Child Care Center Director Qualifications and Duties
(m) A child care center director shall complete 16 hours of health and safety training if necessary pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on records review of Director's file and Director's disclosure of not having any completion of the EMSA Health, Safety, Nutrition, & Lead Poising training course. This poses a potential health and safety risk to children in care
POC Due Date: 02/21/2023
Plan of Correction
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Per Director, she will take the EMSA Health and safety course and will submit proof of completion to LPA Garcia via email by POC due date 2/21/23.
Type B
Section Cited
CCR
101216(g)(1)
Personnel Requirements
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on records review LPA observed Staff #1, #3 and #6 were missing health screening LIC503 not on file. This poses a potential health and safety risk to children in care.
POC Due Date: 02/21/2023
Plan of Correction
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Per Director, staff will obtain LIC503 from staff, a copy will be placed on file and will send copies to LPA Garcia via email by POC due date 2/21/23
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: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:
DATE: 02/07/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/07/2023
LIC809 (FAS) - (06/04)
Page: 6 of 8


Document Has Been Signed on 02/07/2023 04:38 PM - It Cannot Be Edited

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754


FACILITY NAME: LOS ANGELES FAMILY SCHOOL
FACILITY NUMBER: 191803046

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101221(b)(10)
Child's Records
(b) Each record shall contain information including, but not limited to, the following: (10) Record of current medications, including the name of the prescribing physician, and instructions, if any, regarding control and custody of medications.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on records review of child #1, #2 and #3 were missing physician's documentation for current medications, including instructions for the school on administrating medication. This poses a potential health and safety risk to children in care.
POC Due Date: 02/21/2023
Plan of Correction
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Per Director she will obtain the physician's documentation for current medications including insturctions for the school to administer medication from parent's upon children's return to school and will submit copies to LPA Garcia via email by POC due date 2/21/23.
Type B
Section Cited
CCR
101226(e)(3)(B)
Health-Related Services
(3) Prescription medications may be administered if all of the following conditions are met: (B) For each prescription medication, the licensee shall obtain, in writing, approval and instructions from the child's authorized representative for the administration of the medication to the child.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on records review of child #1, #2 and #3 were missing parent's documentation in writting for the approval, instructions and administration of medication. This poses a potential health and safety risk to children in care.
POC Due Date: 02/21/2023
Plan of Correction
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Per Director she will obtain the documentation for the parent's permission for the school to administer medication LIC 9221, will place copy on file and will submit copies to LPA Garcia via email by POC due date 2/21/23.
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: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:
DATE: 02/07/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/07/2023
LIC809 (FAS) - (06/04)
Page: 7 of 8


Document Has Been Signed on 02/07/2023 04:38 PM - It Cannot Be Edited

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754


FACILITY NAME: LOS ANGELES FAMILY SCHOOL
FACILITY NUMBER: 191803046

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101226(e)(3)(A)

(e) In centers where the licensee chooses to handle medications: (3) Prescription medications may be administered if all of the following conditions are met: (A) Prescription medications shall be administered in accordance with the label directions as prescribed by the child's physician.

This requirement is not met as evidenced by:
Deficient Practice Statement
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3
4
Based on records review of Child #1's medication and staff disclosures the Epinephrine Injection was observed to have an expiration date of 12/2021. This poses an immediate risk to children in care.
POC Due Date: 02/21/2023
Plan of Correction
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Per Director, she will speak to all parents of children currently enrolled who require medication to bring in medication that is not expired, in addition, expired medication will be sent home. Upon children's return back to school the facility will ensure all of the conditions are met prior to accepting children back. Director will send pictures and documentation of new medication to LPA Garcia via email on or before POC due date 2/21/23
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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4
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: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:
DATE: 02/07/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/07/2023
LIC809 (FAS) - (06/04)
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