<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197402850
Report Date: 09/22/2021
Date Signed: 09/22/2021 03:00:55 PM

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:PARK WESTERN PLACE SCHOOLFACILITY NUMBER:
197402850
ADMINISTRATOR:FAIRCHILD, RENA K.FACILITY TYPE:
850
ADDRESS:1214 PARK WESTERN PLACE, RM.15TELEPHONE:
(310) 833-3591
CITY:SAN PEDROSTATE: CAZIP CODE:
90732
CAPACITY:22CENSUS: 9DATE:
09/22/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:ABIGAIL LOYATIME COMPLETED:
03:10 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 9/22/2021 Licensing Program Analyst (LPA) Loyce Phillips, conducted an unannounced Annual Required Inspection for Preschool Room 16. LPA met with Lead Teacher, Abigail Loya and toured the facility indoors and outdoors. Days and hours of operation are Monday through Friday 8:00am to 2:30pm, this is a 6 hour day program. LPA observed 9 Preschool Children with 2 Staff members.

There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition allowed or stored on the premises. Disinfectants, cleaning solutions, medication, poisons and other hazardous items are made inaccessible and kept in a locked cabinet. No poisons or hazardous items were observed during the inspection.

Furniture and equipment are in good condition, free of sharp, loose or pointed parts. Playground equipment is in 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 toilets and hand washing facilities are in safe and sanitary operating condition. Floors in the facility are clean and safe. All kitchen, food preparation and storage areas are clean, free of litter/rubbish and free of rodents/vermin. All food is protected against contamination and any contaminated food is discarded immediately. The solid waste storage containers does not have a tight fitted lid. Drinking water is available both indoors and outdoors. Areas around high climbing equipment, swings and slides have cushioning material to absorb falls. The facility is free of flies, insects and rodents.

SUPERVISOR'S NAME: Peter FloresTELEPHONE: (424) 301-3063
LICENSING EVALUATOR NAME: Loyce PhillipsTELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2021
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 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: PARK WESTERN PLACE SCHOOL
FACILITY NUMBER: 197402850
VISIT DATE: 09/22/2021
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
Incidental Medical Services (IMS) are currently not being provided. The facility is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

LPA and Lead Teacher discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are being cited: (see next page, 809 D) The facility was provided a copy of their appeal rights.

An exit interview was conducted, a copy of this report was read and provided to Lead Teacher, Abigail Loya. This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit was provided and required to be posted for 30 days.

SUPERVISOR'S NAME: Peter FloresTELEPHONE: (424) 301-3063
LICENSING EVALUATOR NAME: Loyce PhillipsTELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2021
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: PARK WESTERN PLACE SCHOOL
FACILITY NUMBER: 197402850
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/22/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/06/2021
Section Cited

1
2
3
4
5
6
7
Every licensed child day care center shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections.
8
9
10
11
12
13
14
This requirement is not met as evidenced by: during inspection and interviews conducted. The classroom does not have a working carbon monoxide. If not corrected, this poses a potential health and safety risk to children in care.
8
9
10
11
12
13
14
Type B
10/06/2021
Section Cited

1
2
3
4
5
6
7
All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair.
8
9
10
11
12
13
14
This requirement is not met as evidenced by: during inspection and interviews conducted. LPA observed the outdoor trash can with out a tight fitted lid. If not corrected, this poses a potential health and safety risk to children in care.
8
9
10
11
12
13
14
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: Peter FloresTELEPHONE: (424) 301-3063
LICENSING EVALUATOR NAME: Loyce PhillipsTELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:
DATE: 09/22/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/22/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3