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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197409233
Report Date: 09/08/2022
Date Signed: 09/08/2022 03:23:52 PM

Document Has Been Signed on 09/08/2022 03:23 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:RHUMC - KID ZONE AFTER SCHOOL PROGRAMFACILITY NUMBER:
197409233
ADMINISTRATOR:GABRIELA PALACIOSFACILITY TYPE:
840
ADDRESS:26438 CRENSHAW BOULEVARDTELEPHONE:
(310) 377-6771
CITY:ROLLING HILLS ESTATESTATE: CAZIP CODE:
90274
CAPACITY: 195TOTAL ENROLLED CHILDREN: 195CENSUS: 0DATE:
09/08/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:GABRIELA PALACIOS, DIRECTORTIME COMPLETED:
03:45 PM
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On September 8, 2022 at 1:00 PM, Licensing Program Analyst (LPA) Miriam Cohen met with Gabriela Palacios, Director of RHUMC -Kid Zone After School Program 197409233 located at 26438 Crenshaw Blvd., Rolling Hills Estate, CA 90274 for the purpose of conducting a one year required inspection. LPA Cohen toured and inspected the following classrooms: Classroom #208 and Classroom #209 as identified in the facility sketch. The after-school program hours of operation are from 7:30 AM to 6:00 PM, Monday through Friday. The facility is operating within capacity limitations. Upon arrival, LPA did not observe any children. LPA did not observe bodies of water in the premises. Per director, there are no firearms or weapons in the classroom. LPA did not observe firearms or weapons. LPA observed disinfectants, cleaning solutions, poisons, and other dangerous items stored in a locked cabinet, inaccessible to children in care. Per director, children currently enrolled in the program do not require medications.
LPA observed the classrooms to have age appropriate material and equipment. Furniture in the classroom was found to be in good condition, free from sharp, loose, or pointed parts. All kitchen, food prep, and storage areas were observed to be clean, free of litter, rubbish, and rodent or vermin. Snacks are provided by the facility and a menu was observed posted at the facility. Food and snacks were inspected for availability, quantity and appropriateness to children in care. Solid waste storage vessels, including moveable bins, were observed to have tight fitting covers on, and are in good repair. LPA observed uncontaminated drinking water available both indoors and outdoors. Fencing around the perimeter of the outdoor play area is at least 4 feet high. Playground is free from miscellaneous debris such as tree branches, trash, leaves, etc. First Aid supplies are stored in a locked cabinet. Staff records were reviewed during inspection for completeness including but not limited to Criminal Record Clearances, Director Qualifications and verification of CPR/First Aid and Health and Safety preventative practices documentation. LPA Cohen observed CPR/First Aid expires 10/2023.
All Staff members are currently associated to the campus where they are assigned to work. Required postings were observed by LPA.
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Miriam Cohen
LICENSING EVALUATOR SIGNATURE: DATE: 09/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/08/2022
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: RHUMC - KID ZONE AFTER SCHOOL PROGRAM
FACILITY NUMBER: 197409233
VISIT DATE: 09/08/2022
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The following requirements were discussed with the licensee:
Mandatory forms for all the staff files; requirements for fire drills, earthquake drills, and documentation for both; role and responsibilities of being a mandated reporter. The licensee was advised on how to access forms and Regulations for Child Care Center online at www.ccld.ca.gov . Licensee was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care. The licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must have the facility’s phone number at all times; if the phone number is changed, licensing must be notified. Regulation prohibits the smoking of tobacco on the premises.
Incidental Medical Services (IMS) policy was discussed. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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: http://www.ada.gov/childqanda.htm
The ADA requires that child care providers not discriminate against persons with disabilities on the basis of disability, that is, that they provide children and parents with disabilities with an equal opportunity to participate in the child care center's programs and services.
Requirements for fingerprint clearances and associations were discussed with the licensee. Licensee can be cited a civil penalty of $100 per day, up to $500.00 (5 days) for the 1st offense and up to $3000.00 for the 2nd offense within a 12-month period. The licensee was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and licensing within the time frame specified by the regulation. The "Notification of Parent's Rights" (PUB394) poster must be posted in an area accessible to parents. The information regarding new legislation with regards to exemptions and Parent’s Rights was also discussed. The licensee was informed of The Child Care Advocate Program (CCAP) that is available from within the Community Care Licensing Division. CCAP participates in many community activities and special projects in order to disseminate information on the State’s licensing role, provide information to the public and parents on child care licensing, and provide many other helpful resources to the licensees and the public. CCAP’s direct contact information is as followed: Phone number: (916) 654-1541
Email Address: childcareadvocatesprogram@dss.ca.gov
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Miriam Cohen
LICENSING EVALUATOR SIGNATURE:

DATE: 09/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2022
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: RHUMC - KID ZONE AFTER SCHOOL PROGRAM
FACILITY NUMBER: 197409233
VISIT DATE: 09/08/2022
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The licensee was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Copies of the reports must also be provided to each parent when a serious deficiency, Type A, is cited (LIC9224).

The facility was found to be in compliance per Title 22 regulations.
There shall be NO Type A or B deficiencies cited during today’s visit.
A copy of this report along with a Notice of Site Visit were issued and explained to the licensee.
An exit interview was discussed and conducted with after-school program director, including, but not limited to: Provider Rights, Appeal Procedures and Agency's Consultative Role.
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Miriam Cohen
LICENSING EVALUATOR SIGNATURE:

DATE: 09/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2022
LIC809 (FAS) - (06/04)
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