197402469-10-12-2023-58-CC-SSAZ-CWK2E8-20231012171931

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197402469
Report Date: 10/12/2023
Date Signed: 10/12/2023 05:19:42 PM

Document Has Been Signed on 10/12/2023 05:19 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:	BURBANK CHILD CARE CENTER		FACILITY NUMBER:	197402469
ADMINISTRATOR:	LINA ESOH		FACILITY TYPE:	850
ADDRESS:	900 N. GLENOAKS BLVD.		TELEPHONE:	(818) 953-7186
CITY:	BURBANK	STATE: CA	ZIP CODE:	91502
CAPACITY:	40	CENSUS: 17	DATE:	10/12/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:20 PM
MET WITH:	Anabel Babayan, Assistant Director		TIME COMPLETED:	05:40 PM

NARRATIVE

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Licensing Program Analyst (LPA) Susann Sanchez conducted an unannounced Annual Required inspection. LPA met with Manar Massond, Teacher who guided analyst on tour of facility. Anabel Babayan, Assistant Director arrived during tour and finished giving LPA the tour of the facility. This is a preschool program which consists of 3 classrooms, and welcoming room; RM Teddy Bear (2-3 year old), RM Busy Bees (3-4 year old), and RM Kangaroos( 4-5 year old). This facility is located on St. Ephraim Syrian Orthodox Church property. Facility operation hours are from Monday to Friday from 7:00 AM to 6:00 PM.

All areas identified on the Facility Sketch were inspected. The following staff was present during this inspection: 2 Staff with 17 napping preschoolers. An additional staff member arrived 3:30pm from lunch. Children are dropped off in welcoming room in the morning. Children walk through the office, and church yard to go to the classrooms. Per Assistant Director, children go to the classrooms, lined up and under two teachers supervision (sometime 3 teachers). The following was observed during tour of facility:

LPA observed all preschool classroom to be clean and in good repair. The floors were clean and lighting was in operable condition. There were age appropriate toys and equipment. LPA observed water bottles. LPA observed cubbies/storage area for children to store their personal belongings. Smoke detector and carbon monoxide detector were observed to be in operable condition. LPA observed 2 Fire extinguishers at the facility and was serviced on 03/04/2023. First Aid kit was observed and inventoried. Appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, paper towels, and general sanitation. Disinfectants and cleaning solutions were observed to inaccessible to children in care. Per Administrator there are no poisons stored at the facility.

Napping equipment and bedding were inspected and found to be clean and in operable condition. Per Assistant Director, bedding is sent home weekly to be washed. The isolation area is located in the main office. Per Assistant Director, currently no child on medication.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) -98-3350
LICENSING EVALUATOR NAME: Susann Sanchez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2023

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: BURBANK CHILD CARE CENTER	FACILITY NUMBER: 197402469
	VISIT DATE: 10/12/2023

NARRATIVE

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LPA toured the outdoor play area. LPA observed age-appropriate toys and material for children, free of loose, sharp, and/or pointed parts. LPA observed required cushioning under climbing structure to absorb a fall. Shade was observed in the outdoor area. Per Director, children also has use there water bottle or water fountain during outdoor play. LPA observed no large bodies of water on the premises.

Children bring lunch from home and is kept in there cubbies until lunch time. Food storage area to be clean and free of litter, rubbish, rodents, and/or any other vermin. LPA observed refrigerators to be clean and in operable condition. LPA observed required posted documentation which included, Facility License, LIC610- Emergency Disaster Plan, Publication (PUB) 393- Notification of Parent Rights, PUB 269- Child Passenger Restraint System, LIC 613A- Notification of Personal Rights. All documents were observed to be posted in the main lobby area. LPA observed Sign in/out sheets, LIC 9148 Earthquake Preparedness, Daily Activity Schedule, and Verification of Disaster and Fire Drills (last conducted on 9/22/23).

At 3:00PM, During the file review LPA observed and cited the following:

Staff Taguhi Harutyunyan and Anastasiya Kimachenko is fingerprint cleared but not associated.

At 3:30PM, During file review. LPA did not observed the following and Assistant Director also stated they are missing the following:

Proof of Lead Testing

At 3:50PM, During the file review LPA observed and cited the following:

Staff CPR & 1st Aid cards are not ESMA approved.

Children’s records were reviewed for LIC 613A- Personal Rights, Admission Agreement, Immunization Records, LIC 700- Identification and Emergency Information, LIC 701- Physician’s Report, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights.

Staff records were reviewed for approved, LIC 508-Criminal Record Statement, LIC 503- Health Screening Report, LIC 9052- Employee Rights, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, and LIC 9108- Statement of Child and Mandated Reporter Training Certificate.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) -98-3350
LICENSING EVALUATOR NAME: Susann Sanchez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 10/12/2023 05:19 PM - It Cannot Be Edited

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: BURBANK CHILD CARE CENTER	FACILITY NUMBER: 197402469
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/12/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview, the licensee did not comply with the section cited above. Founder stated they completed the required lead testing but cannot find her documents. This poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/13/2023
	Plan of Correction
1 2 3 4	Per Babayan, facility will review PIN 21-21 and start the process of being fingerprinted.

Type B

Section Cited

CCR

101170(e)

Criminal Record Clearance

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, record review the licensee did not comply with the section cited above. LPA observed staff Taguhi Harutyunyan and Anastaiya Kimachenko who was fingerprint cleared but not associated with the facility. This poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/13/2023
	Plan of Correction
1 2 3 4	Assistant Director submitted transfer forms during inspection.

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: Valarie Cook	TELEPHONE: (323) -98-3350
LICENSING EVALUATOR NAME: Susann Sanchez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 10/12/2023 05:19 PM - It Cannot Be Edited

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: BURBANK CHILD CARE CENTER	FACILITY NUMBER: 197402469
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/12/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101216(f)

Personnel Requirements

(f) At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above. Director was not able to provide a EMSA approved pediatric CPR/1st aid certificare for a staff member in the Preschool program, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/13/2023
	Plan of Correction
1 2 3 4	Per Director will provide current certificates and email LPA proof by 11/13/23

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: Valarie Cook	TELEPHONE: (323) -98-3350
LICENSING EVALUATOR NAME: Susann Sanchez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2023

LIC809 (FAS) - (06/04)

Page: 3 of 5

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: BURBANK CHILD CARE CENTER	FACILITY NUMBER: 197402469
	VISIT DATE: 10/12/2023

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Consult was provided regarding the following:

TSP
Fingerprint Associations (9182, El Segundo email & fax were given)
Lead Testing (PIN 21-21 was given)

Licensee was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee 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.

Based on the LPA’s observations, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22 Chapter 1 and Section CCR & H&S. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

A notice of site visit was given and must remain posted for 30 days. Appeal Rights were given. Exit interview conducted and report was reviewed with the Assistant Director Babayan.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) -98-3350
LICENSING EVALUATOR NAME: Susann Sanchez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2023

LIC809 (FAS) - (06/04)

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