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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197413159
Report Date: 11/14/2019
Date Signed: 11/14/2019 11:05:31 AM

COMPREHENSIVE INSPECTION
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:CCUSD-OFFICE OF CHILD DEVELOPMENTFACILITY NUMBER:
197413159
ADMINISTRATOR:ARREOLA, CLAUDIAFACILITY TYPE:
850
ADDRESS:10820 FARRAGUT DRIVETELEPHONE:
(310) 842-4230
CITY:CULVER CITYSTATE: CAZIP CODE:
90230
CAPACITY:24CENSUS: 12DATE:
11/14/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Director-Vanessa San MartinTIME COMPLETED:
09:30 AM
NARRATIVE
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On November 14th, 2019 at 8:30am, Licensing Program Analyst (LPA) Lisa Rios made an unannounced visit for the purpose of conducting an Annual/Random inspection. LPA Rios met with and toured the facility inside and outside with Director, Vanessa San Martin. The facility operates on the grounds of Culver City Unified School District and is located inside 1 bungalow classroom.

This facility consists of one classroom:
Classroom 6 is a half day program that runs from 8:30-11:30 ages 3 to 4. LPA Rios observed 13 children supervised by four adults, (two teachers and two assistants). LPA reviewed the sign-in and sign out sheets to verify the census. LPA observed children engaged in table activities and others playing with age appropriate equipment in the classroom. The room was cluttered, disinfectant wipes were left out within children's reach (the teacher removed immediately) and the bathroom cabinet above the toilet needs a latch as children are capable of climbing and reaching the bleach behind the cabinet. A smoke detector, fire extinguisher, first aid kit, toilets and sinks were all working. Menu's and licensing documents were properly posted where parents could readily see.

Furniture was found to be in good repair and age appropriate. There is adequate heating, lighting and ventilation. Drinking water is readily available in each classroom. LPA observed classroom space to have dramatic play, arts/crafts, reading, individual cubbies for storage and learning activities. There is a first aid kit in the school office and the classroom. Each child has an emergency kit.
SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR SIGNATURE:

DATE: 11/14/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2019
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: CCUSD-OFFICE OF CHILD DEVELOPMENT
FACILITY NUMBER: 197413159
VISIT DATE: 11/14/2019
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Senate Bill (SB) 792: This bill, commencing September 1, 2016, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles.

Mandated Reporter: Beginning on January 1, 2018, AB 1207, requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Website: www.mandatedreporterca.com



Update on Incidental Medical Services: Facilities that provide Incidental Medical Services (IMS) must identify those services in their facility’s Plan of Operation and submit an updated Plan of Operation 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
Incidental Medical Services Include: Blood-Glucose Monitoring for Diabetic Children, Administering Inhaled Medication, Administering EpiPen Jr. and EpiPen or other Epinephrine Auto-Injectors, Glucagon Administration, Gastrostomy Tube Care (G-tube care), Insulin Injections Administration, Anti-Seizure Administration, and Emptying an Ileostomy Bag.

New Appeal Process: A licensee may file an appeal, in writing 15 business days from the date of receiving the penalty assessment. All appeals must be sent to: California Department of Social Services | Community Care Licensing Division, 300 N. Continental Blvd. Suite, 290-A, El Segundo, CA 90245.

Senate Bill (SB) 277 New Immunization Requirement: Beginning January 1, 2016, personal beliefs exemptions will no longer be an option for the vaccines that are currently required for entry into child care or school in California. Personal beliefs exemptions already on file will remain valid until the child reaches the next immunization checkpoint.

Please see the technical advisory note is issued for classroom 6 for cleanliness and disinfectant's within reach.

A copy of this report, along with a Notice of Site Visit, was issued and explained to the Asst. Director. An exit interview was conducted.

SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR SIGNATURE:

DATE: 11/14/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2019
LIC809 (FAS) - (06/04)
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