197416805-2-22-2024-33-CC-SPEY-D2PSCN-20240222124549

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197416805
Report Date: 02/22/2024
Date Signed: 02/22/2024 12:46:17 PM

Document Has Been Signed on 02/22/2024 12:46 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	LEXINGTON AVENUE PRIMARY CENTER CSPP		FACILITY NUMBER:	197416805
ADMINISTRATOR:	KURILICH, PAULA G.		FACILITY TYPE:	850
ADDRESS:	4564 W. LEXINGTON AVE. ROOM 1		TELEPHONE:	(323) 644-2884
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90029
CAPACITY:	24	CENSUS: 12	DATE:	02/22/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Principal, Mariam Kupalian		TIME COMPLETED:	01:00 PM

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On 02/22/24 licensing Program Analyst (LPAs) Staicy Perry and Nolan Tcheng conducted an unannounced annual inspection. Upon arrival at 9:30 am LPAs met with Mona Abou Mosleh, School Administrator Assistant. Principal Mariam Kupalian was not here due to being in a meeting. LPAs were led on a tour of the facility. This is an LAUSD state preschool program located in RM 1 on the premises of Lexington Ave Primary Center Elementary School. This program consists of 1 classroom. The facility also has a waiver on file for PALS (Preschool for All Learners). Waiver indicates the sharing of the bathroom and outdoor play space. Per Mona, there are currently 12 enrolled in the program. Hours of operation for this facility are Monday, Wednesday, Thursday and Friday from 8:00am-2:30pm and Tuesdays are from 8:00am-1:30pm for early dismissal. LPAs observed PALS with 6 children and 3 teachers in the Classroom 1. At 11:13am Principal Mariam Kupalian arrived and took over.

Licensing staff observed all required forms/publications to be posted by the front entrance. Snack menus were reviewed to ensure that they are being posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request. Facility provides breakfast, lunch and snacks.

PHYSICAL PLANT: All areas were identified on the Facility Sketch were inspected. The following classrooms were inspected: Classroom #1: 12 children and 2 staff. Teacher-child ratios were observed to be in accordance with Title 22 regulations. The Licensee is within the conditions, limitations, and capacity specified on the license. All children were observed to be under visual supervision of a teacher during tour. Napping equipment (mats/cots) and bedding were inspected for good condition, appropriate storage, and cleanliness.

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SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Staicy Perry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 02/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2024

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: LEXINGTON AVENUE PRIMARY CENTER CSPP	FACILITY NUMBER: 197416805
	VISIT DATE: 02/22/2024

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LPAs observed napping mats labeled in a bag with each child’s name on it and a ziploc bag labled with their names which have their sheet and blankets. Children take their blankets home to wash weekly. Storage for children's belongings were inspected. All toilets and washing facilities are in safe and sanitary operating conditions. First Aid supplies are available and complete. Drinking water was readily available indoors. All children bring in their water bottles labeled with their names and extra water is available if needed.

At this time, the Nurses office located in the main office is used as an isolation area, there is a bed available for an ill child to rest and a restroom if needed. Per Mona school has a nurse that comes in once a week. LPAs observed that the facility has carbon monoxide detector which was tested and is in operable condition.

Licensing staff observed disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Classroom furniture and equipment are in good condition, free of sharp, loose, or pointed parts. All floors are clean and safe. All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids. The facility was observed to be free of flies, other insects, and rodents.

Licensing staff observed the valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 2/1/24, as indicated on service tag. Per State Fire Marshall standards, fire extinguishers shall be serviced annually. Facility has a functioning carbon monoxide and smoke detector that meets statutory requirements. Director states there are no weapons, firearms, or bodies of water on the premises.

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SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Staicy Perry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 02/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2024

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: LEXINGTON AVENUE PRIMARY CENTER CSPP	FACILITY NUMBER: 197416805
	VISIT DATE: 02/22/2024

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OUTDOORS: Licensing staff reviewed the outdoor play area. Outdoor 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. All areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard. There is one outside play space that has two play structures, swing set, and playhouses for children in care. Another outside play space observed for tricycles and ball play. Drinking water is readily available outdoors. LPAs advised teacher Melain that the children need to be within the direct care and supervision at all times. Children take their water bottles when they go outside to play.

FACILITY RECORDS: Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. Disaster drills have been conducted at least every six months. Last drill conducted was on 2/16/24.

There is at least one person trained in CPR and Pediatric First Aid present during this inspection. LPAs did not review staff files during the inspection due to the staff files being stored at the administrative office. LPAs will review staff files at a later time and date. If staff files were to be incomplete during the time and date that LPA reviews files, a case management inspection will occur at the facility to reflect the incomplete file. Children’s Records were reviewed for completeness; Inspection of required forms was made and documented on the LIC 857.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. 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/.
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SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Staicy Perry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 02/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2024

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: LEXINGTON AVENUE PRIMARY CENTER CSPP	FACILITY NUMBER: 197416805
	VISIT DATE: 02/22/2024

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Licensing staff discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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 childcare 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).
Testing was conducted and results were provided to LPAs. Licensing staff referred Principal Mariam Kupalian to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

Principal Mariam Kupalian 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.

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SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Staicy Perry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 02/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2024

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: LEXINGTON AVENUE PRIMARY CENTER CSPP	FACILITY NUMBER: 197416805
	VISIT DATE: 02/22/2024

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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.

Miriam was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative.

Exit interview conducted and report was reviewed with the licensee Principal Mariam Kupalian.

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SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Staicy Perry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 02/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2024

LIC809 (FAS) - (06/04)

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