191890481-7-18-2023-58-CC-LHEZ-CTURXQ-20230718132507

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191890481
Report Date: 07/18/2023
Date Signed: 07/18/2023 01:25:15 PM

Document Has Been Signed on 07/18/2023 01:25 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	PACOIMA EARLY EDUCATION CENTER		FACILITY NUMBER:	191890481
ADMINISTRATOR:	SUSAN HAN		FACILITY TYPE:	850
ADDRESS:	11059 HERRICK ST.		TELEPHONE:	(818) 896-3722
CITY:	PACOIMA	STATE: CA	ZIP CODE:	91331
CAPACITY:	115	CENSUS:	DATE:	07/18/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:05 AM
MET WITH:	Sheila Hardy, Principal for Jennifer Movessian, Principal		TIME COMPLETED:	01:30 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 Analyst (LPA) Lilia Hernandez conducted an unannounced annual inspection to the above facility on 07/18/2023. LPA arrived at the facility at 09:05AM, identified self and met with Mojgan (Nikki) Farjad, Head Teacher, who guided analyst on a tour of the facility. LPA provided Licensee/facility representative with a copy of the LIC 125 Entrance Checklist to help facilitate the inspection. LPA was later met by Sheila Hardy, Principal. This is a preschool program which consists of 3 classrooms: RM 1, RM 2 and RM 3. Facility operation hours are Monday to Friday from 7:00 AM to 5:30 PM. All areas identified on the Facility Sketch were inspected. There were 51 children and 16 staff present when LPA arrived. The facility was observed to be within the license capacity and limitations. Criminal record clearance was not reviewed. However, per condition of employment with the Los Angeles Unified School District, all individual’s present have obtained a criminal record clearance or criminal record exemption. The following was observed during the tour of the facility: Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Children have their own cubby to store their belongings. Cots and linens are provided for each child enrolled. Linens are washed weekly by school district. Age-appropriate sinks and toilets were inspected for availability and good repair in the restroom. Each classroom also has an additional sink for handwashing. General sanitation was observed. Availability of indoor drinking water was observed in classrooms.----Page 1 of 4

SUPERVISOR'S NAME: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia Hernandez	TELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2023

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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: PACOIMA EARLY EDUCATION CENTER	FACILITY NUMBER: 191890481
	VISIT DATE: 07/18/2023

NARRATIVE

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Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Principal states that poisons are locked in the hopper room. Carbon monoxide detector was observed and are operable.

All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish, 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 or solid waste bags shall be discarded immediately after each meal.

Outdoor playground equipment is in a 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. Availability of outdoor drinking water was observed. LPA advised that no children shall be left without the supervision of a teacher at any time.

All floors were observed to be clean and safe. All materials accessible to children were observed to be toxic-free. Per principal, there are no firearms stored on the premises. LPA observed no pools or bodies of water at the facility.

CCC completed testing and is in the process of remediating lead exceedances.
LPA referred Principal to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

There is at least one person trained in CPR and Pediatric First Aid present during this inspection.

Children’s Records were reviewed. Inspection of required forms was made and documented on the LIC 857. Children's roster was reviewed and is current. Sign-In and Sign-Out sheets were reviewed. Children present were signed in.

LPA also reviewed staff records. The review of Staff records was documented on the LIC 859. Staff present did have proof of the AB 1207 Mandated Reporter Training certificate on file. Staff present did have proof against TB, measles, pertussis, and influenza on file.----Page 2 of 4

SUPERVISOR'S NAME: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia Hernandez	TELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2023

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: PACOIMA EARLY EDUCATION CENTER	FACILITY NUMBER: 191890481
	VISIT DATE: 07/18/2023

NARRATIVE

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Disaster drill log was available, last drill was conducted on 6/28/2023.

Menus are posted one month in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request. The facility provides breakfast, lunch, and snack to children. Food is prepared in the neighboring middle school cafeteria. Meals are brought to the facility daily.

First Aid supplies were observed in the classroom in the emergency supply rolling bin. According to Principal, medication is only administered to a child when accompanied with a doctor's note and is stored in the office. The facility was observed to be equipped with an isolation area for any child who becomes ill and it is located in the office.

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 PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care- centers/.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Principal was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California. ---Page 3 of 4

SUPERVISOR'S NAME: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia Hernandez	TELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2023

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: PACOIMA EARLY EDUCATION CENTER	FACILITY NUMBER: 191890481
	VISIT DATE: 07/18/2023

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 26 27 28 29 30 31 32	There were no deficiencies cited during today’s inspection. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Sheila Hardy, Principal. ---Page 4 of 4

SUPERVISOR'S NAME: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia Hernandez	TELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2023

LIC809 (FAS) - (06/04)

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