197418048-12-4-2020-54-CC-AJLO-BVYTCF-20201204133637

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197418048
Report Date: 12/03/2020
Date Signed: 12/04/2020 01:37:13 PM

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:	CII/WESTERN HEAD START STATE PRESCHOOL		FACILITY NUMBER:	197418048
ADMINISTRATOR:	MARGARITA PARRA		FACILITY TYPE:	850
ADDRESS:	4277 S. WESTERN AVENUE		TELEPHONE:	(213) 252-4380
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90062
CAPACITY:	68	CENSUS: 7	DATE:	12/03/2020
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Antonia Gutierrez, Site Supervisor & Rosa Mariscal, HS Manager		TIME COMPLETED:	09:05 AM

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	This was a Case Management Inspection conducted by A. Lucero, Licensing Program Analyst (LPA). Due to COVID-19 and precautionary measures, this inspection was conducted with Site Supervisor Antonia Gutierrez and HS Manager Rosa Mariscal via a tele-inspection by use of FaceTime. A physical inspection to the facility was conducted on 11/12/2020 for the purpose of measuring the facility’s classrooms and playgrounds. Also present at the physical inspection was LPA J. Estrada. On the date of the physical inspection, LPAs observed six children present with three staff. During this tele-inspection, LPA on a video tour of the facility. LPA observed seven children in care during the tele-inspection with two staff; tour commenced at 8:37am. Facility is currently licensed for 68 children. Licensee is requesting a capacity decrease from 68 children to 40 children. Specifically, Licensee is requesting for eight toddler children ages 18 months to 3 years and 32 preschool children ages 3 years to 5 years old. A granted fire clearance was received by the licensing department. At 8:37am, it was stated to LPA that the Toddlers are currently distant learning and not present at the facility. The programs will operate Monday through Friday from 8:00am to 4:30pm. All indoor and outdoor areas identified on the facility sketch were toured during this inspection and on the physical inspection dated 11/12/2020. Measurements were taken and noted of the Toddler Classroom, Classroom HS 1 and Classroom HS 2. Measurements were also taken of the Toddler playground and of the preschool playground and noted. A tour of the playground was conducted at 8:45am on the date of the tele-inspection. A first aid kit was observed in the classrooms on the date of the physical inspection. Carbon monoxide detectors were tested on the date of the physical inspection and in operable condition. Smoke detectors are present and are hardwired through the facility. Fire extinguishers have been serviced in March 2020.

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Armando J Lucero	TELEPHONE: (323) 981-3435
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2020

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: CII/WESTERN HEAD START STATE PRESCHOOL	FACILITY NUMBER: 197418048
	VISIT DATE: 12/03/2020

NARRATIVE

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The applicant states that the director's office will be used as the ill isolation area and children will use the staff restroom. The facility will provide hot lunch, AM and PM snack. The facility will administer prescription and non-prescription medications. Medications will be stored in the director's office, unless refrigeration is needed. In this case, medication will be stored in the kitchen. At 9:01am, LPA observed cleaning compounds locked.

Sign in/out procedures will be implemented at the entrance to the facility. LPA observed sufficient storage space for children’s belongings. There is water available indoors and outdoors. Containers used to discard food have tight fitting lids. Cleaning compounds and any poisons are locked inaccessible to children.

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. There is cushioning material under the play equipment. There is outside shade in the playgrounds. The outdoor area is completely fenced. No bodies of water were observed during this visit.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A 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/childqanda.htm

COVID-19 Technical Assistance was provided on the date of the physical inspection. Facility was provided with a Self-Assessment Guide, posters, and information on COVID-19. Technical Assistance was also provided on the date of the tele-inspection at 8:39am. LPA Lucero discussed protocol in place regarding COVID-19. Staff stated protocol in place is not having parents fully enter the facility and sign-in/out will take place at the front entrance. The child care are is big enough to meet the six feet distance. Staff will evaluate children for any symptoms such as fever, running nose, cough or child's behavior and will inform authorized representative child cannot stay if any symptoms related to COVID-19; or if symptoms appear during the day, staff will isolate the child and call authorized representative for immediate pick-up. Children will wash their hands during arrival, entering from outdoor play, meal times, covering their cough, and from using the restroom. LPA Lucero observed hand-washing posters posted in the restrooms and it was stated that the staff of the facility are aware of cleaning, disinfecting, sanitizing and the importance of constant hand-washing.

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Armando J Lucero	TELEPHONE: (323) 981-3435
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2020

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: CII/WESTERN HEAD START STATE PRESCHOOL	FACILITY NUMBER: 197418048
	VISIT DATE: 12/03/2020

NARRATIVE

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The following was discussed with the Applicant/Licensee/Representative:
Rooms that are off-limits need to be made inaccessible during operating hours. Smoking is prohibited. The Applicant/Licensee/Representative was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care.

The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and Carbon Monoxide detectors should be checked and batteries replaced as needed. Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your location.

Mandatory Forms for the children’s files and staff files, requirements for fire drills, earthquake drills and documentation were discussed. Role and responsibilities of being a Mandated Reporter were reviewed. The Applicant/Licensee/Representative was advised how to access forms and Regulations online at www.ccld.ca.gov. Applicant/Licensee/Representative was made aware that it is his/her responsibility to know the regulations as well as anyone who assists in providing care.

LPA advised Applicant/Licensee/Representative that all adults 18 years of age and older providing Care & Supervision and/or have continuous presence in the facility shall adhere to a criminal background clearance with the Department of Justice, FBI and Child Abuse Index Check. The Applicant/Licensee/Representative was also advised of the requirement to report Unusual Incidents and/or injuries to the parent/guardian and to CCL within the time frame specified by the regulation. Applicant/Licensee/Representative advised that indoor and outdoor supervision required at all times. If outdoor area not adequately fenced, provider must be with children at all times when outdoors.

LPA will submit facility’s request for capacity decrease from 68 children to 40 children (eight toddlers and 32 preschool children) for approval.

There were no deficiencies cited during today's visit in accordance to the California Code of Regulations Title 22, Division 12, Chapter 1. Exit interview was conducted with Site Supervisor, via tele-inspection, during which appeal rights were explained. This report along with a copy of the appeal rights will be sent to the Applicant via email with a read receipt or confirmation of receipt of email, which will act as the Applicants signature.

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Armando J Lucero	TELEPHONE: (323) 981-3435
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2020

LIC809 (FAS) - (06/04)

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