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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191806530
Report Date: 12/17/2019
Date Signed: 12/17/2019 01:51:09 PM

COMPREHENSIVE INSPECTION
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:CHILDREN'S HOSPITAL INFANT CARE CENTERFACILITY NUMBER:
191806530
ADMINISTRATOR:LAURA HERNANDEZFACILITY TYPE:
830
ADDRESS:4601 SUNSET BOULEVARDTELEPHONE:
(323) 361-4601
CITY:LOS ANGELESSTATE: CAZIP CODE:
90027
CAPACITY:27CENSUS: 16DATE:
12/17/2019
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Laura HernandezTIME COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) Janeth Chavez conducted an unannounced Annual Required inspection. LPA met with designated facility Director, Laura Hernandez, who guided LPA on a tour of the facility indoors and outdoors. This facility operates Monday-Friday from 6:30am-8:00pm. This is an infant program that is licensed for 27 children. There are 16 infants present with 8 staff. Teacher-child ratio is met. There is a combination center with a preschool on site license # 191806528. All adults present have obtained a criminal record clearance or exemption on file.

All areas used by the children were inspected. The program consists of two classrooms: Infant 1 & Infant 2. Upon arrival, LPA observed 8 infants in Infant 1 with 5 staff and 8 infants from Infant 2 room in the infant playground. The infant classrooms and outdoor activity space are physically separate from the preschool component. Teacher-child ratios were observed to be in accordance with Title 22 regulations. Staff names were recorded. All children were observed to be under visual supervision of a teacher at all times. LPA observed all required forms/publications to be posted and visible to children's authorized representatives. The Licensee is within the conditions, limitations, and capacity specified on the license.

Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. The floors in Infant 1 & 2 were observed to be clean. Cribs and sheets were inspected for good condition, appropriate storage and cleanliness. The infants sleep in cribs and there is a staff present in the napping room. Napping equipment meets the requirements of Title 22 regulations. Sufficient storage for children's belongings were observed. As per Director, the office is used as an isolation area.

LPA observed the changing tables and had the required padded surface and are covered with washable vinyl. LPA also observed disposable paper that is used to cover each pad after each change. Toys were observed to be clean. Director stated that the facility provides breakfast, hot lunch, AM & PM snacks, and a dinner snack for the children enrolled in the program. LPA observed a refrigerator in each room to keep infants’ milk, breast milk, baby food and formula. LPA observed these items labeled with each infant’s name.

REPORT CONTINUES ON NEXT PAGE
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) -98-3417
LICENSING EVALUATOR NAME: Janeth ChavezTELEPHONE: (323) 981-3376
LICENSING EVALUATOR SIGNATURE:

DATE: 12/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2019
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 2
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: CHILDREN'S HOSPITAL INFANT CARE CENTER
FACILITY NUMBER: 191806530
VISIT DATE: 12/17/2019
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Parents provide their own infant milk, breast milk, baby food and formula for the infants enrolled. All items were observed to be labeled with each infants’ name. Snack and lunch menus were observed to be posted.

LPA observed drinking water available via water jug in each classroom. 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.

Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. The licensee takes measures to keep the facility free of flies, other insects and rodents. LPA observed the outdoor play equipment to be in good condition, free of sharp, lose or pointed parts. LPA observed the infant play yard is cushioned with rubber to absorb a fall. LPA did not observe any bodies of water or weapons in the facility. The Director stated there are no bodies of water or weapons in the facility.

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. All children were observed to be signed in. All staff records were reviewed to ensure they are complete. All staff have an Acknowledgement to Report Child Abuse (LIC 9108) on file. Staff present have proof of the required infant units on file. A random sample of Children’s Records were reviewed to ensure that they are complete. Infant files were observed to have current Needs and Services plans on file. Criminal Record Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed.



Incidental Medical Services (IMS) policy was discussed. Per Director, there are currently no children on 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.

REMINDER: Failure to obtain a criminal record background check clearances prior to initial presence in the facility will result in an immediate $100.00 dollar or more per day Civil Penalty. LPA advised the licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov. At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.

The Notice of Site Visit (LIC 9213)must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. Exit interview was conducted with Director, Laura Hernandez . Appeal Rights and Procedures explained and provided.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) -98-3417
LICENSING EVALUATOR NAME: Janeth ChavezTELEPHONE: (323) 981-3376
LICENSING EVALUATOR SIGNATURE:

DATE: 12/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2019
LIC809 (FAS) - (06/04)
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