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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191890437
Report Date: 02/24/2022
Date Signed: 02/24/2022 11:43:11 AM

Document Has Been Signed on 02/24/2022 11:43 AM - 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:SAN FERNANDO EARLY EDUCATION CENTERFACILITY NUMBER:
191890437
ADMINISTRATOR:SUSAN HANFACILITY TYPE:
850
ADDRESS:1204 WOODWORTH ST.TELEPHONE:
(818) 365-9105
CITY:SAN FERNANDOSTATE: CAZIP CODE:
91340
CAPACITY: 165TOTAL ENROLLED CHILDREN: 165CENSUS: DATE:
02/24/2022
TYPE OF VISIT:Case Management - COVID-19UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Susan HanTIME COMPLETED:
10:15 AM
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On 02/24/2022 Licensing Program Analyst (LPA) Judy Laureano conducted an unannounced Case Management – COVID-19 inspection for the purpose of following up on Unusual Incident Reports (UIR) submitted on 12/29/2022, 12/28/2021, 12/27/2021, 1/4/2022 and 1/3/2022. LPA Laureano with Susan Han, Principal, who toured LPA through the inside and outside of the facility. LPA observed 58 children in care with 18 staff.

According to the UIR, on 12/27/2021- 2 staff tested positive-facility on winter break.
According to the UIR, on 12/29/2021 - 1 child tested positive- facility was on winter break.
According to the UIR, on 12/28/2021 – 1 child tested positive- facility was on winter break.
According to the UIR, 01/4/2022 – 1 child was reported as testing positive for COVID-19.
According to the UIR, on 01/03/2022- 1 child was reported as testing positive for COVID-19.

Principal stated all the children and staff who were reported positive COVID have all isolated and have since all returned to the facility. The LAUSD Family Engagement, clears all individuals and follows up with the Department of Health to ensure all protocols and recommendations are being met.

During inspection, LPA observed children and staff members wearing masks while indoors. Additional mask available through the classrooms, soap and paper towels were observed to be available at all handwashing sinks and hand sanitizer available in each room. Additional PPE is available in all classrooms and in the check in stations.

Facility continues to conduct wellness checks before children and staff enter the facility. Principal confirmed facility has tables set up for sign in/ out. Parents use LAUSD Daily pass to access screening questions and generate a QRI code to display during drop off.

LPA Laureano observed COVID-19 signage throughout the facility for mask wearing, washing hands, and stay safe 6 feet apart. At the front entrance LPA Lowe observed signs

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE: DATE: 02/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/24/2022
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: SAN FERNANDO EARLY EDUCATION CENTER
FACILITY NUMBER: 191890437
VISIT DATE: 02/24/2022
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advising, “If you have a fever, cough, shortness of breath or have been exposed to someone with COVID-19. Facility communicates through email, district wide Blackboard Connect and CLASS Dojo and the most updated Guidance was distributed to all. Parents are allowed to enter the building after a wellness check has been completed. Parents and visitors are not allowed in the classrooms.

LPA Laureano observed facility supply of PPE COVID supplies such as gloves, gowns, hand sanitizing wipes, liquid hand sanitizer, cleaning wipes, children mask, adult masks, and thermometers in all classrooms. Designated is staff assigned to ensure facility has sufficient PPE supplies available for use.

LPA Laureano discussed with Director current COVID-19 resources and guidance.

No deficiencies are cited, per Title 22, Division 12, Chapter 3, of the California Code of Regulations.

An exit interview was conducted and a copy of this report (LIC 809) and Notice of Site Visit were provided to Principal Susan Han.

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2022
LIC809 (FAS) - (06/04)
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