191806530-12-1-2021-33-CC-RLOZ-C9B3UE-20211201173324

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191806530
Report Date: 12/01/2021
Date Signed: 12/01/2021 05:33:34 PM

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 CENTER		FACILITY NUMBER:	191806530
ADMINISTRATOR:	LAURA HERNANDEZ		FACILITY TYPE:	830
ADDRESS:	4601 SUNSET BOULEVARD		TELEPHONE:	(323) 361-4601
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90027
CAPACITY:	27	CENSUS: 10	DATE:	12/01/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:03 AM
MET WITH:	Maria Burrieta, Site Supervisor		TIME COMPLETED:	05:40 PM

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Licensing Program Analyst (LPA’s) Roxana Lopez and Mireya Garcia conducted an unannounced Random inspection. LPA’s met with Maria Birrueta, Site Director, who guided analyst on tour of the facility. This facility operates Monday-Friday from 6:30am-8:00pm. This is an infant program that is licensed for 27 children. There is also a preschool with toddler component on site license # 191806528.

All areas identified on the Facility Sketch were inspected. The infant program consists of two classrooms- Infant 1 and Infant 2. LPA’s observed in the Infant 1 classroom- 4 children and 1 teacher and in the Infants 2 classroom 6 children and 2 teachers. Teacher-child ratio is met. All adults present have obtained a criminal record clearance or exemption on file. The following was observed during the tour of facility:

PHYSICAL PLANT

Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Site Supervisor states that there is no poisons in the facility. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. All toilets and hand washing facilities are safe, sanitary and are operating properly. All floors are clean and safe.

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SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana Lopez	TELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2021

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 6

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: 12/01/2021

NARRATIVE

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All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish and rodents and/or any other vermin. All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids. Drinking water is readily available both indoors and outdoors. The facility was observed to be free of flies, other insects and rodents.

Outdoor playground equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under high climbing equipment, slides, and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard.

INFANT PROGRAM

Infant changing tables have a padded surface no less than one inch thick and are covered with washable vinyl or plastic and have raised sides at least three inches high. Toys were observed to be clean and safe. Infant napping equipment and cribs were observed. Sheets are washed daily on site. Indoor activity space for this infant program is physically separate from the other components at this facility.

The facility is in compliance with the staff-infant ratios. A fully qualified teacher is directly supervising no more than 12 infants. Each aide is responsible for the direct care and supervision of a group of no more than four infants. Individual Feeding Plans are on file for each infant. Infant Needs and Services Plan are on file for each infant. Teachers present have proof of the required infant units on file and meet the qualification requirements.
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SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana Lopez	TELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2021

LIC809 (FAS) - (06/04)

Page: 3 of 6

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: 12/01/2021

NARRATIVE

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LPA's did not observed the LIC 9227 Individual Sleeping Plan on file. The LIC 9227 was provided and explained during the visit.

LPA’s discussed the safe sleep regulations with Maria Birrueta, Site Supervisor and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed site supervisor of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

FACILITY RECORDS

All individuals present have obtained a criminal record clearance or criminal record exemption. There is at least one person trained in CPR and Pediatric First Aid present during this inspection.

The name of the child care center director or fully qualified teacher(s) designated to act in the director's absence is on file. Educational background, training, and/or experience for each staff present are on file and were reviewed.

In review of children’s records, files contain information including, but not limited to the following: Name, address and telephone number of the child's authorized representative and of relatives or others who can assume responsibility for the child if the authorized representative cannot be reached when necessary.
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SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana Lopez	TELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2021

LIC809 (FAS) - (06/04)

Page: 4 of 6

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: 12/01/2021

NARRATIVE

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LPA's issued a copy of the LIC 857 Children’s Records Review and the LIC859 Staff Records Review to the licensee during this inspection.

Children's roster was reviewed and is current. Children present were signed in. Disaster drill log was available, last drill was conducted on 9/20/2021.

Menus are posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request. Snacks were reviewed for availability, quantity and appropriateness to children in care. Infants 0-12 months bring their own food. Infants 12-24 months have an option to participate in a hot lunch program or they can bring their own lunch. The facility provides breaksfast, AM snack lunch, PM snack and dinner.

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

LPA advised the licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov
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SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana Lopez	TELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2021

LIC809 (FAS) - (06/04)

Page: 5 of 6

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: 12/01/2021

NARRATIVE

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Maria Birrueta, Site Supervisor was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

The following deficiency listed on the attached LIC 809 deficiencies page is being cited in accordance with California Code of Regulations Title 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 atwww.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 Site Supervisor, Maria Birrueta. Site Supervisor

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SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana Lopez	TELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2021

LIC809 (FAS) - (06/04)

Page: 2 of 6

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
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/01/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101419.2(b)(2)

Infant Needs and Services Plan

(b) The needs and services plan shall be in writing and shall include the following: (2) Infants up to 12 months of age shall have a completed Individual Infant Sleeping Plan [LIC 9227 (3/20)], which is incorporated by reference. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above in 3 out of 10 children's files did not include the LIC 9227. Per Site Supervisor, none of the infants younger than 12 months have this on file. which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/15/2021
	Plan of Correction
1 2 3 4	Per Site Supervisor the LIC 9227 Individual Sleeping Plan will be sent our today. Signed copies will be sent to LPA Lopez via email by POC Due Date

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 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 VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana Lopez	TELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2021

LIC809 (FAS) - (06/04)

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