197416801-3-1-2022-54-CC-DGIS-CC52NM-20220301163258

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197416801
Report Date: 03/01/2022
Date Signed: 03/01/2022 04:33:33 PM

Document Has Been Signed on 03/01/2022 04:33 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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	WEEMES ELEMENTARY SCHOOL CSPP		FACILITY NUMBER:	197416801
ADMINISTRATOR:	BERNAL, ELIZABETH		FACILITY TYPE:	850
ADDRESS:	1260 WEST 36TH PLACE RM. K3		TELEPHONE:	(323) 733-9186
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90007
CAPACITY:	24	CENSUS: 0	DATE:	03/01/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Cristina Diaz, Facility Representative		TIME COMPLETED:	04:50 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	Licensing Program Analysts (LPA) Denise Gibbs conducted an unannounced annual required inspection at the above facility on 3/1/22 at 9:30 AM. LPA met with Cristina Diaz, Facility Representative (FR) who guided analysts on a tour of the facility. There were no children and one staff present when LPA arrived. Facility is on the campus of Weemes Elementary School and operates an AM and PM program, Mon, Wed, Thurs, Fri 8AM to 11AM and 12PM to 3PM. Tuesday, 8AM to 11PM and 12PM to 1:40PM. All individuals present have obtained a criminal record clearance or criminal record exemption as a condition of employment with the Los Angeles Unified School District. LPA toured Classroom K-3. Classroom furniture was in good condition, free of loose, sharp and/or pointed parts. The floors and surfaces in the classrooms were clean and safe. Rugs are currently not being used right now due to COVID-19 precautions. Water is made readily available by via water bottles labeled with the children's names. Water fountains in the classrooms are not being used due to COVID-19 precautions. Children have cubbies to store personal belongings separate from each other. Children do not nap at facility. Daily activity plans were posted in each classroom. LPA toured the children’s restrooms. Restroom is located in the classroom, preschool children do not share restroom (no waiver needed). Restroom waas observed to be safe and sanitary with operable sinks and toilets. LPA toured the outdoor play area. Outdoor area was observed to have age appropriate toys and material for children, free of loose, sharp, and/or pointed parts. LPA observed required cushioning under climbing structure to absorb fall. Shade was observed throughout the outdoor area and water was observed to be readily available via water bottles. Outdoor water fountains are currently not used. Outdoor area is also used by Head ---------------------PAGE 1

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 03/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2022

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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: WEEMES ELEMENTARY SCHOOL CSPP	FACILITY NUMBER: 197416801
	VISIT DATE: 03/01/2022

NARRATIVE

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Start program. LPA observed a barrier that divides the yard so children do not co-mingle. Per FR, barrier was put in place due to COVID-19 precautions to stop the spread of germs. Waiver on file for shared yard.

LPA reviewed Sign In/Out sheets. Per FR, she has been checking off the children on an attendance form and signing the bottom due to COVID-19 precautions and parents not entering the facility. LPA informed that children still need to be signed in and out by a representative daily with the time, representative's full signature and date and signed out when they leave. Per FR she will have the sign in sheets printed daily and sign the children in and out as they arrive and leave.

LPA observed required posted documentation which included, Facility License, Publication (PUB) 393- Notification of Parent Rights, Licensing Form (LIC) 610- Facility Disaster Plan, PUB 269- Child Passenger Restraint System, LIC 613A- Notification of Personal Rights and Lunch/Snack Menu in the preschool classroom and license in the main office.

Facility records were reviewed for 9148- Earthquake Preparedness form, and Disaster drill log, last drill conducted 2/23/2022.

Children’s records were reviewed for Emergency Card with signed medical consent, Immunization Records, LIC 995 Notification of Parents’ Rights, LIC 701- Physician’s Report, LIC 613A- Personal Rights, and signed Admissions Agreement. Children with medication has signed medication request forms. All file reviewed were complete.

Staff records were reviewed at for approved Pediatric First Aid and CPR certification, LIC 9052- Employee Rights, Proof of immunization against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse, Transcripts or Permit and current Mandated Reporter Training Certificate. Staff is missing Mandated Reporter Training, Immunization's and current CPR and first aid.

At LPA observed the kitchen located on the elementary campus. Facility provides AM snack, PM snack and lunch. Food is not cooked at the facility. Prepackaged food is delivered daily. Extra food is stored in the kitchen. Kitchen was observed to be clean, free of litter, insects and rodents. LPA observed trash cans for solid waste have tight fitting lids. cleaning supplies are stored separate from the food.----------------------PAGE 2

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 03/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2022

LIC809 (FAS) - (06/04)

Page: 2 of 7

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: WEEMES ELEMENTARY SCHOOL CSPP	FACILITY NUMBER: 197416801
	VISIT DATE: 03/01/2022

NARRATIVE

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LPA observed that facility is implementing COVID-19 precautions and procedures as required by Los Angeles Unified School District and the Department of Public Health.

Incidental Medical Services (IMS):
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a plan for providing 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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm

Based on the LPA's observations and records review no deficiencies will be cited today 3/1/22.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

Facility representative was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Facility Representative Cristina Diaz.

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SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 03/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2022

LIC809 (FAS) - (06/04)

Page: 3 of 7