197402429-10-9-2020-30-CC-DLOE-BU8L5A-20201009082646

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197402429
Report Date: 10/08/2020
Date Signed: 10/09/2020 08:26:56 AM

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:	SAINT PAUL'S FIRST LUTHERAN PRESCHOOL		FACILITY NUMBER:	197402429
ADMINISTRATOR:	CYNTHIA CLENDENEN		FACILITY TYPE:	850
ADDRESS:	11330 MC CORMICK STREET		TELEPHONE:	(818) 763-2892
CITY:	NORTH HOLLYWOOD	STATE: CA	ZIP CODE:	91601
CAPACITY:	41	CENSUS: 15	DATE:	10/08/2020
TYPE OF VISIT:	Case Management - Other	ANNOUNCED	TIME BEGAN:	04:00 PM
MET WITH:	Cynthia Clendenen - Center Director		TIME COMPLETED:	05:30 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	On 10/08/2020 Licensing Program Analyst (LPA) Deborah Lowe conducted a tele visit inspections via Zoom with Cynthia Clendenen, Center Director. The purpose of the visit was to assess the areas that will be used as part of the temporary waiver for child care for St. Paul's First Lutheran Preschool, due to the COVID-19 pandemic. Cynthia Clendenen guided LPA lowe on a tour of the child areas, preschool class #1 and preschool class #2 in addition to three unlicensed rooms. The unlicensed rooms requesting to use for the addition of 35 school age children ages 5-8 years-old will be wagner hall, kindergarten, and the K4 classroom. LPA Lowe advised Ms. Clendenen that cohort sizes are no more than 12 per room. The three additional unlicensed classroom were observed to have enough equipment and supplies for 12 children per room including cots for nap time. Wagner Hall was observed to have two individual bathrooms each with one toilet and one sink within the classroom. The Kindergarten and the K4 classroom share a bathroom located outside of the classrooms near the K4 classroom. LPA Lowe ask Ms. Clendenen how supervision for the bathroom will be handled for the bathroom located outside of the classroom space. Ms. Clendenen stated that each classroom will have a teacher and an aid to ensure there will be enough staff to take children to the restroom. The bathroom near K4 classroom was observed to have a girls bathroom with 3 toilets and 2 sinks, the boys bathroom was observed to have 2 toilets, 1 urinal, and 2 sinks. Ms. Clendenen guided LPA Lowe through the check-in areas for preschool which is located at the entrance of the preschool. The check in area for the school age children will be at the walk through gate located on Bakman Ave. LPA Lowe observed two playground areas one for preschool and one for school age. There is an outdoor courtyard with benches for children to eat outside with social distancing. page 1 of 2

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (434) 301-3069
LICENSING EVALUATOR NAME: Deborah Lowe	TELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2020

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

FACILITY NAME: SAINT PAUL'S FIRST LUTHERAN PRESCHOOL	FACILITY NUMBER: 197402429
	VISIT DATE: 10/08/2020

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

Continued from page 1

Ms. Clendenen, stated all children will bring lunch from home.

Each classroom was observed to have a sanitation station with gloves and hand sanitizer.

LPA Lowe advised Ms. Clendenen to cover an exposed outlet in both the kindergarten and K4 classrooms. Ms. Clendenen stated she has them at her desk and will cover.

LPA Lowe advised no more than 12 children per cohort, LPA Lowe observed 15 children in the preschool classroom with two teachers. Ms. Clendenen stated she thought they could be in the same room if they were a distance apart. LPA Lowe explained COVID-19 most recent cohort sizes and informed Ms. Clendenen that LPA Lowe will send an email with additional resources with the waiver for Ms. Clendenen to use as a resource with the most recent Health Department updates. LPA Lowe advised Ms. Clendenen that all children over the age 2 should wear mask.

School age children will be cared for within Wagner Hall, the Kindergarten classroom, and K4 classroom. Ms. Clendenen was advised that school age is not to commingle with any other age groups.

Exit interview conducted over the phone at approximately 5:35 pm.

Page 2 of 2

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (434) 301-3069
LICENSING EVALUATOR NAME: Deborah Lowe	TELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2020

LIC809 (FAS) - (06/04)

Page: 2 of 2