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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197414470
Report Date: 04/15/2024
Date Signed: 04/16/2024 08:44:55 AM


Document Has Been Signed on 04/16/2024 08:44 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:SHEPHERD OF THE VALLEY LUTHERAN CHURCHFACILITY NUMBER:
197414470
ADMINISTRATOR:SUZANNE LEGUMFACILITY TYPE:
850
ADDRESS:23838 KITTRIDGE STREETTELEPHONE:
(818) 347-6784
CITY:WEST HILLSSTATE: CAZIP CODE:
91307
CAPACITY:104CENSUS: 22DATE:
04/15/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:SUZANNE LEGUMTIME COMPLETED:
01:15 PM
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On 4/15/2024 Licensing Program Analyst (LPA), Suzette Ornelas conducted unannounced required annual inspection at 23838 KITTRIDGE STREET WEST HILLS CA 91307. LPA met with Center Director, SUZANNE LEGUM and discussed the purpose of the visit. The Director guided LPA on a tour of the facility inside and out. Days and hours of operation are Monday through Friday 8:00am to 5:00pm.

LPA observed all required postings in a prominent area. LPA observed 22 children and 7 adults. All children are under supervision, including visual supervision, of a teacher at all times. Capacity and limitations as specified on the license are being maintained. A walk through of the classroom area was conducted. LPA observed 7 licensed preschool classrooms on the premises and 2 toddler classrooms.

All areas identified on the Facility Sketch were inspected. Due to low enrollment, Red Room is not currently being used.



RM 1 (toddler): 7 children with a ratio of 2 teachers
RM 2 (toddler) : 0 children with a ratio of 0 teachers
RM 3 (blue): 3 children with a ratio of 2 teachers
RM 4 (green): 4 children with a ratio of 1 teachers
RM 5 (purple): 3 children with a ratio of 1 teachers
RM 6 (red): 0 children with a ratio of 0 teachers
Sunshine: 5 children with a ratio of 1 teachers

A walk through of the classroom room space was conducted, the space was 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. Isolation area for sick students is in the Director’s office. LPA observed adequate arrangements for isolation and care of ill children. Children will use the restroom located in the office.
SUPERVISOR'S NAME: Betty BellTELEPHONE: (424) 301-3063
LICENSING EVALUATOR NAME: Suzette OrnelasTELEPHONE: 424-301-3008
LICENSING EVALUATOR SIGNATURE:
DATE: 04/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/15/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: SHEPHERD OF THE VALLEY LUTHERAN CHURCH
FACILITY NUMBER: 197414470
VISIT DATE: 04/15/2024
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The bathroom and toileting areas were inspected, LPA observed toilets and sinks to accommodate the facility’s capacity. Facility is equipped with 5 toilets 2 urinals and 6 sinks. Toilets flush properly, toilet and sinks are reachable by the children in care. The restrooms have adequate toilet paper and paper towels available. The bathrooms were found to be clean. There is adequate lighting/ventilation in the bathroom area.

Playground equipment is in safe condition and free of hazards. 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. All kitchen, food preparation and storage areas are clean and safe. Per Director, parents provide daily meals including snacks for children. Solid waste storage containers have tight-fitting covers and are in good repair. Drinking water is readily available both indoors and outdoors via Brita filter water in every classroom to refill children's zippy cup, disposable cups are provided as needed. The facility is equipped with a working smoke detector and carbon monoxide detector. LPA observed fire extinguishers (2A 10BC) located throughout the facility with service date of 4/2/2024. There is no swimming pool or other bodies of water on the premises. First Aid Kit was observed to be complete. Fire Drill log was observed to be complete and current. There are no firearms or ammunition allowed or stored on the premises. Disinfectants, cleaning solutions, medication and other hazardous items are made inaccessible.

The facility has sufficient cots or mats for napping. Each mat or cot is occupied by only one child at time. LPA reviewed a sample of children’s files and observed files were complete. 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. CPR and Pediatric First Aid certificates were observed to be current. 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. LPA reviewed a sample of staff files and observed files were complete.

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/.

SUPERVISOR'S NAME: Betty BellTELEPHONE: (424) 301-3063
LICENSING EVALUATOR NAME: Suzette OrnelasTELEPHONE: 424-301-3008
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2024
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: SHEPHERD OF THE VALLEY LUTHERAN CHURCH
FACILITY NUMBER: 197414470
VISIT DATE: 04/15/2024
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LPA and Administrator 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.

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.

Administrator 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 in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

Administrator 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.

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. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director,
SUPERVISOR'S NAME: Betty BellTELEPHONE: (424) 301-3063
LICENSING EVALUATOR NAME: Suzette OrnelasTELEPHONE: 424-301-3008
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2024
LIC809 (FAS) - (06/04)
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