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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197413960
Report Date: 11/17/2022
Date Signed: 03/10/2023 01:17:55 PM


Document Has Been Signed on 03/10/2023 01:17 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:ST. TIMOTHY SCHOOL PRE-KFACILITY NUMBER:
197413960
ADMINISTRATOR:GEETHA SUGUNANFACILITY TYPE:
850
ADDRESS:10479 W. PICO BLVD.TELEPHONE:
(310) 474-1811
CITY:LOS ANGELESSTATE: CAZIP CODE:
90064
CAPACITY:25CENSUS: 12DATE:
11/17/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Lorraine Selva-SpeightsTIME COMPLETED:
02:00 PM
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On 11/17/2022, Licensing Program Analyst (LPA) Lillian Casillas conducted an unannounced annual inspection. LPA met with Director, Lorraine Selva-Speights, who guided LPA on a tour of the facility. Day and hours of operation are Monday through Friday, TIME.

The facility has 1 Pre-K classroom. LPA observed 12 children in care and 1 teacher present during this inspection. Director also teaches. LPA verified that all adults present in the facility have obtained criminal record clearances and are associated to the facility. LPA reviewed the sign in/out sheet to verify the census.

A walkthrough of the classroom was conducted, and classroom were found to be clean and free from any potential hazards. Furniture was found to be in good repair and age appropriate. There is adequate heating, lighting and ventilation. LPA observed classroom space to include dramatic play, arts/crafts, reading, individual cubbies for storage and learning activities. The director's office is the designated Isolation area.

Facility offers children bottled water and children bring their own water bottle. Director stated children bring their own lunch or they can order a hot lunch from the facility. Director stated the facility provides AM and PM snacks. and snacks. Children eat inside on their desks.

LPA observed the children's bathroom inside the classroom. In the bathroom, LPA observed 2 toilets and 2 sinks. There are sufficient toilets and sinks to accommodate the facility’s capacity. Bathrooms were found to be clean.

LPA observed one large outdoor play area that is in safe condition. The surface of the outdoor activity space is maintained in safe condition and is free of hazards.


[CONTINUE ON PAGE 2]
SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Lillian J CasillasTELEPHONE: (424) 301-3097
LICENSING EVALUATOR SIGNATURE:
DATE: 11/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/17/2022
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: ST. TIMOTHY SCHOOL PRE-K
FACILITY NUMBER: 197413960
VISIT DATE: 11/17/2022
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The 2A10:BC fire extinguisher is located in the hallway. LPA observed a carbon monoxide detector in the classroom. LPA observed fire sprinklers in the classroom. Facility was observed to be operating within the conditions, limitations, and capacity specified on the license.



LPA observed staff records to contain appropriate documentation of education credits. All staff are trained in CPR and Pediatric First Aid (expiration date in 4/2023 and 8/2023) and Mandated Reporter training expires on 8/2023. LPA reviewed a sample of children’s files and observed files were complete.

Director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated. Upon notification from the Department, the licensee will comply and act immediately to terminate the employment of, remove from the facility or bar from entering the facility for any person it is deemed necessary while the Department considers granting or denying an exemption.

Incidental Medical Services (IMS) are not currently being provided. Director 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.


Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

Exit interview conducted and report was reviewed with the Director, Lorraine Selva-Speights.

SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Lillian J CasillasTELEPHONE: (424) 301-3097
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2