197414108-2-6-2024-30-CC-JLAO-D27VE7-20240206152153

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197414108
Report Date: 02/06/2024
Date Signed: 02/06/2024 03:22:05 PM

Document Has Been Signed on 02/06/2024 03:22 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:	SAMUEL GOLDWYN FOUNDATION CHILDREN'S CENTER		FACILITY NUMBER:	197414108
ADMINISTRATOR:	CHRISTINE ESTOQUE		FACILITY TYPE:	840
ADDRESS:	2114 PONTIUS AVENUE		TELEPHONE:	(310) 445-8993
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90025
CAPACITY:	12	CENSUS: 6	DATE:	02/06/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	11:59 AM
MET WITH:	Christine Estoque, Director		TIME COMPLETED:	02:50 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 2/6/2024 Licensing Program Analyst (LPA) Judy Laureano conducted an unannounced Annual Required Inspection for the school age license at above mentioned facility. LPA met with Director Christine Estoque and toured the facility indoors and outdoors. Days and hours of operation are Monday through Friday 7:45 a.m. to 6:15 p.m. Facility is licensed for 12 school age children ages 5 years old to 6 years old. Facility is a combo center with a preschool program (191606360) and infant program (191606360). Outdoor waiver on file; school age program utilizes the preschool outdoor space and director confirmed that school age program children do not commingle with preschool programs. LPA recommended director to post both waiver and schedule in a prominent place. 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 and other hazardous items are made inaccessible. LPA observed the emergency bag back in the classroom. LPA reminded director to have a system in place to ensure that equipment and First Aid kit is checked annually.Cleaning solutions that are used daily are kept in the top cabinet in the classroom; cabinet was observed with a safety latch, making the content inaccessible to the children in care. No poisons were observed during the inspection. Director confirmed that medication is stored in the child’s perspective classroom and director’s office. LPA reminded facility to ensure that all medication is stored with all necessary LIC forms. All prescription and nonprescription medication shall be centrally stored in accordance with the following requirements: medication shall be kept in a safe place inaccessible to the children in care, each container shall have an unaltered label. Currently facility does not have any children that need medication in the school age program.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy Laureano	TELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2024

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: SAMUEL GOLDWYN FOUNDATION CHILDREN'S CENTER	FACILITY NUMBER: 197414108
	VISIT DATE: 02/06/2024

NARRATIVE

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Furniture and equipment are in good condition, free of sharp, loose or pointed parts. All materials and surfaces accessible to children are toxic free. All toilets and handwashing facilities are in safe and sanitary operating condition. All 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. Contaminated food is discarded immediately. Facility provides snacks only and families are required to provide meals in appropriate containers. Menus are posted at least one week in advance where an authorized representative can view them. LPA observed menu posted in the classroom. Families receive menu monthly through Mybright Day, online application. Copies of the menus as served shall be dated and kept on file for at least 30 days. Menus shall be made available for review by the child's authorized representative and the Department upon request.

Solid waste storage containers have tight-fitting covers and are in good repair. Drinking water is available both indoors and outdoors.

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. Areas around high climbing equipment, swings and slides have cushioning material to absorb falls. School age children do not comingle with the preschool children.
The facility is free of flies, insects and rodents. The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. Facility was observed to have a centralized fire and smoke alarm. LPA observed director test the carbon monoxide alarm in the space. Director confirmed that fire drills and earthquake drills are completed monthly.

Prior to working or volunteering in a licensed child care facility, all individuals subject to a criminal record review have received a criminal record clearance or exemption. 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.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy Laureano	TELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2024

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: SAMUEL GOLDWYN FOUNDATION CHILDREN'S CENTER	FACILITY NUMBER: 197414108
	VISIT DATE: 02/06/2024

NARRATIVE

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Capacity and limitations as specified on the license are being maintained; 6 children and 1 staff member during today's inspection.

At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at offsite activities.

LPA reviewed a sample of staff files and observed files were complete with health screening, immunization records for influenza, pertussis and measles and current documentation of completed mandated reporter training.
Lead teacher/Kindergarten teacher’s CPR and Pediatric First Aid was completed 5/26/2023. Mandated Reporter training was completed 4/28/2023. LPA reviewed a sample of children’s files and observed files were complete with contact information for authorized representative and or relatives or others who can assume responsibility for the child and medical assessment. LPA provided director with a copy of the LIC 311A and LIC 125 Entrance Check List- Child Care Center to use as a reference when auditing files.

The name of the child care center director or fully-qualified teacher(s) designated to act in the director’s absence has been reported to the Department. The person who signs the child in/out of the facility shall use their full legal signature and record the time of day. LPA observed programs sign in sheet at the entrance of the classroom.

All personnel, including the licensee, administrator and volunteers, shall be in good health and are physically and mentally capable of performing assigned task. Personnel that pose a threat to the health and safety of children shall be relieved of their duties.
All personnel are trained on housekeeping and sanitation principles, including universal health precautions or have related experience.
All children are under supervision, including visual supervision, of a teacher at all times. Facility maintains a ratio of one teacher supervising no more than 14 children in care.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy Laureano	TELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2024

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: SAMUEL GOLDWYN FOUNDATION CHILDREN'S CENTER	FACILITY NUMBER: 197414108
	VISIT DATE: 02/06/2024

NARRATIVE

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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.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for
drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.
For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).
LPA verified that the lead testing was completed on 12/16/2022 in accordance to the Written Directives outlined in PIN 21-21.1-CCP. PIN 22-05-CCP Page Four

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/. PIN 22-05-CCP Page Five

Licensee Christine Estoque 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.

A notice of site visit was given and must remain posted for 30 days. Exit interview completed and a copy of the report was reviewed and provided.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy Laureano	TELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2024

LIC809 (FAS) - (06/04)

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