197417847-1-28-2022-30-CC-LPHS-CB4PZP-20220128104550

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197417847
Report Date: 01/26/2022
Date Signed: 01/28/2022 10:46:13 AM

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:	BLUE OAK CREATIVE SCHOOLHOUSE		FACILITY NUMBER:	197417847
ADMINISTRATOR:	SAMIRA HERRERA		FACILITY TYPE:	850
ADDRESS:	12719 WASHINGTON PLACE		TELEPHONE:	(310) 390-4111
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90066
CAPACITY:	34	CENSUS: 31	DATE:	01/26/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	LISA PERTTULA		TIME COMPLETED:	01:30 PM

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On 1/26/2022 Licensing Program Analyst (LPA) Loyce Phillips, conducted an unannounced Annual Required Inspection for the Preschool Program. LPA met with Licensee, Lisa Perttula and toured the facility indoors and outdoors. Days and hours of operation are Monday through Friday 8:00am to 5:30pm. LPA observed 2 classrooms. Classroom 1 (Willow) had 15 children with 3 staff members. Classroom 2 (Maple) had 16 children with 2 staff members.

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, medication, poisons and other hazardous items are made inaccessible. No poisons or hazardous items were observed during the inspection.

Furniture and equipment are in good condition, free of sharp, loose or pointed parts. 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 toilets and hand washing facilities are in safe and sanitary operating condition. 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 and any contaminated food is discarded immediately. The solid waste storage containers all have tight fitted lids. Drinking water is available both indoors and outdoors. Areas around high climbing equipment and slides have material to absorb falls. The facility is free of flies, insects and rodents.

The Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. Prior to working or volunteering in a licensed child care facility, all individuals are subjected to a criminal record review and have received a criminal record clearance or exemption. Upon notification from the Department, the facility 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: Peter Flores	TELEPHONE: (424) 301-3063
LICENSING EVALUATOR NAME: Loyce Phillips	TELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2022

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: BLUE OAK CREATIVE SCHOOLHOUSE	FACILITY NUMBER: 197417847
	VISIT DATE: 01/26/2022

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Capacity and limitations as specified on the license are being maintained. At least one person is trained in CPR and Pediatric First Aid is present when children are at the facility or at off site activities. The person who signs the child in/out of the facility shall use their full legal signature and record the time of day. 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 12 children in care. LPA reviewed a sample of children and staff files and observed files were complete.

Incidental Medical Services (IMS) policy was discussed. For IMS information See Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqandanda.htm

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.

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 atwww.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.
Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited.

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

An exit interview conducted and report was reviewed with Licensee, Lisa Perttula.

SUPERVISOR'S NAME: Peter Flores	TELEPHONE: (424) 301-3063
LICENSING EVALUATOR NAME: Loyce Phillips	TELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2022

LIC809 (FAS) - (06/04)

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