191870647-8-17-2022-54-CC-DGIS-CHDRBT-20220817125315

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191870647
Report Date: 08/17/2022
Date Signed: 08/17/2022 12:53:25 PM

Document Has Been Signed on 08/17/2022 12:53 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:	DACOTAH STREET EARLY EDUCATION CENTER		FACILITY NUMBER:	191870647
ADMINISTRATOR:	SHAMEKA ROBINSON		FACILITY TYPE:	850
ADDRESS:	3142 LYDIA DRIVE		TELEPHONE:	(323) 268-9868
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90023
CAPACITY:	184	CENSUS: 39	DATE:	08/17/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Shamika Robinson, Facility Representative		TIME COMPLETED:	01:00 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 8/17/22 at 9:00 AM. LPA met with Shemika Robinson Horn, Facility Representative (FR) who guided analysts on a tour of the facility. FR informed that this is her first week at the facility as Principal. This is a preschool program that operates Monday - Friday from 7:00AM-5:30PM. There were 39 children and 12 staff present when LPA arrived. 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 #1-4. 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 or brought from home. Facility does have extra water bottles on hand. Water fountains are not being used due to COVID-19 precautions. Per FR, there are children with medication. LPA reviewed storage, documentation and expiration dates 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. LPA observed four play areas. Per FR, one play area is temporarily closed due to district request for maintenance of surface under the climbing structure. LPA informed FR of LIC624, Unusual Incident Report and reporting requirements. Outdoor areas were observed to have age appropriate equipment, toys and material for children. LPA observed required cushioning under climbing structure to absorb ---------------------PAGE 1

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2022

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: DACOTAH STREET EARLY EDUCATION CENTER	FACILITY NUMBER: 191870647
	VISIT DATE: 08/17/2022

NARRATIVE

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fall. Shade was observed throughout the outdoor area. Water bottles are taken outdoors for children. LPA did not observed any hazards in the outdoor space.

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. Items were discussed.

Facility records were reviewed for LIC 9040- Facility Roster, 9148- Earthquake Preparedness form, Daily schedules and Disaster drill log, last drill conducted on 7/23/22. 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 delivered daily. Food is brought for the number of students in attendance for the day. All extra food is discarded. Food Storage area was observed to be clean, free of litter, insects and rodents. Trash cans for solid waste have tight fitting lids. Cleaning supplies are stored separate from the food. Carbon monoxide detector is wired with facility smoke and fire alarm.

LPA reviewed Sign In/Out sheets are located in the main office. All children present were signed in with 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.

Children’s records were reviewed for Emergency Card with consent for medical treatment, Immunization Records, LIC 995 Notification of Parents’ Rights, LIC 701- Physician’s Report, LIC 613A- Personal Rights, and signed Admissions Agreement. All documents were observed.

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.

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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: 08/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2022

LIC809 (FAS) - (06/04)

Page: 2 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: DACOTAH STREET EARLY EDUCATION CENTER	FACILITY NUMBER: 191870647
	VISIT DATE: 08/17/2022

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.

Incidental Medical Services (IMS):
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – 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

No deficiencies will be sited today 8/17/22.

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 Shemika Robinson Horn.

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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: 08/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2022

LIC809 (FAS) - (06/04)

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