197418307-3-10-2020-30-CC-DADS-BMKUPC-20200310154520

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197418307
Report Date: 03/10/2020
Date Signed: 03/10/2020 03:45:34 PM

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:	STONER AVENUE ELEMENTARY SCHOOL CSPP		FACILITY NUMBER:	197418307
ADMINISTRATOR:	STAPLETON,JAMES		FACILITY TYPE:	850
ADDRESS:	11735 BRADDOCK DRIVE- ROOM 2		TELEPHONE:	(310) 390-3396
CITY:	CULVER CITY	STATE: CA	ZIP CODE:	90230
CAPACITY:	23	CENSUS: 13	DATE:	03/10/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:40 AM
MET WITH:	Principal Maria		TIME COMPLETED:	03:50 PM

NARRATIVE

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3/10/20 Licensing Program Analyst Dalicia Adkins conducted an unannounced visit for the purpose of annual inspection. LPA met with principal Maria Garcia- Haro who guided LPA on a tour throughout the center. This is a Day Preschool Day Care Center/Los Angeles Unified School District -Early Childhood Education serving children ages 3-4.5 years old.

LPA inspected physical plant, reviewed child records, reviewed staff records. LPA observed AM Preschool Room #2: 13 students , 1 teacher and 2 aides. There are two sessions AM from 7:50am to 10:50am and session 2 from 11:35 to 2:35pm.

LPA observed posting requirements: Emergency Disaster Plan (LIC 610A), Earthquake Preparedness Checklist, Notification of Parents Rights (LIC PUB 394), Parents Rights (LIC 9148), Facility License (LIC 203) , Personal Rights (LIC 613A), Weekly Menu, Child Passenger Restraint System (PUB 269) and Daily Activity Schedule.

LPA Observed General Requirements: fully charged fire extinguisher -2A:10BC ,Carbon Monoxide Detector, Smoke Detectors , Working Landline , Sign in and out sheets. Facility observed to be well ventilated and adequate lighting. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are locked in storage cabinet.

First Aid Kit: stored in zipped closed bag near the front door entrance.

Kitchen: OFF LIMITS

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SUPERVISOR'S NAME: Victor Bautista	TELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Dalicia Adkins	TELEPHONE: (424) 301-3064
LICENSING EVALUATOR SIGNATURE:	DATE: 03/10/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2020

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

FACILITY NAME: STONER AVENUE ELEMENTARY SCHOOL CSPP	FACILITY NUMBER: 197418307
	VISIT DATE: 03/10/2020

NARRATIVE

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Kitchen: OFF LIMITS

CLASSROOM #2: 1teacher /2 assistants/ 13 children (4-5 years old). LPA observed safe and age appropriate toys, furniture is in good repair and age appropriate. I sink with running facet and drinking faucet. Children in classroom #2 Classroom #1 utilizes bathroom #1: 1 bathroom stall for girls, 1 bathroom stall for boys and one shared sink for washing hands.

PLAY YARD : LPA observed one large play/climbing structure securely anchored to the ground with adequate cushioning underneath. Play yard fence is at least four feet high and adequate shade provided by large trees. LPA observed available drinking water; 1 sink with faucet and drinking faucet. Play toys age appropriate. LPA observed on playyard; storage containers stacked, piles of debris from landscaping, large toy stored near gate ( covered with spider webs and dust/dirt).

Incidental Medical Services Plan of Operation: Per Director and Teacher no children are required to medication. No medication was stored at center for preschool children. When needed, a cabinet located in main office is available to store medication.

Exit interview conducted and the following topics discussed:

SIDS: New proposed Safe Sleep Regulations and Best Practices, link http://safetosleep.nih.gov
MANDATED REPORTING: must stay current and renew every two years, www.mandatedreportereporterca.com
IMS/ Americans with Disability Act (ADA): Disability rights laws prohibit child care providers from excluding children solely because they have a disability-related need for medication. As a child care provider you must have an individualized plan included in plan of operation submitted to the department.
Child Care Advocate Program: promotes the delivery of quality child care, link childcareadvocatesprogram@dss.ca.gov
CHILD CARE QUARTERLY NEWSLETTER: advised to sign up and provided, www.ccld.ca.gov
UNUSUAL INCIDENT/INJURY REPORTING: A report shall be made to the department by telephone or fax during the department’s normal business hours before the close of the next working day (1) following the occurrence during the operation of Family Day Care Home of the event. Health and Safety Code Section 1597.467(b)(2). In addition to verbal or fax report ,a written report shall be submitted to the department within seven (7) days. LIC 924 www.ccld.ca.gov
Effects of Lead Exposure: www.cdph.ca.gov/programs/clppb.
Never Shake a Baby http://www.dontshake.org

The facility was found to be

This report was reviewed with Principal Maria and copy was furnished. A copy of site visit was also furnished.

SUPERVISOR'S NAME: Victor Bautista	TELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Dalicia Adkins	TELEPHONE: (424) 301-3064
LICENSING EVALUATOR SIGNATURE:	DATE: 03/10/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2020

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

FACILITY NAME: STONER AVENUE ELEMENTARY SCHOOL CSPP	FACILITY NUMBER: 197418307
	VISIT DATE: 03/10/2020

NARRATIVE

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CLASSROOM #2: 1 teacher /2 assistants/ 13 children (3 - 4.5 years old). LPA observed safe and age appropriate toys, furniture is in good repair and age appropriate. I sink with running facet and drinking faucet. Children in classroom #2 Classroom #1 utilizes bathroom #1: 1 bathroom stall for girls, 1 bathroom stall for boys and one shared sink for washing hands.
PLAY YARD : LPA observed one large play/climbing structure securely anchored to the ground with adequate cushioning underneath. Play yard fence is at least four feet high and adequate shade provided by large trees. LPA observed available drinking water; 1 sink with faucet and drinking faucet. Play toys age appropriate. LPA observed broken play toy (climbing boat), storage containers and debris on play ground. These conditions pose minimal hazard to children in care. ADVISORY NOTE- Technical Violation issued, No type A or B violations issued during today's visit 3/10/20 facility evaluation. (see technical violation)

Exit interview conducted and the following topics discussed:

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SUPERVISOR'S NAME: Victor Bautista	TELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Dalicia Adkins	TELEPHONE: (424) 301-3064
LICENSING EVALUATOR SIGNATURE:	DATE: 03/10/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2020

LIC809 (FAS) - (06/04)

Page: 4 of 4

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: STONER AVENUE ELEMENTARY SCHOOL CSPP	FACILITY NUMBER: 197418307
	VISIT DATE: 03/10/2020

NARRATIVE

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UNUSUAL INCIDENT/INJURY REPORTING: A report shall be made to the department by telephone or fax during the department’s normal business hours before the close of the next working day (1) following the occurrence during the operation of Family Day Care Home of the event. Health and Safety Code Section 1597.467(b)(2). In addition to verbal or fax report ,a written report shall be submitted to the department within seven (7) days. LIC 924 www.ccld.ca.gov
Effects of Lead Exposure: www.cdph.ca.gov/programs/clppb.
Never Shake a Baby http://www.dontshake.org

With verbal authorization: this report was reviewed with Sandra Buen-Abad - School Administrative Assistant. A copy of this report, notice of site visit and copy of technical violation was furnished.

LPA exited the facility at 12pm and returned at 2pm.

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SUPERVISOR'S NAME: Victor Bautista	TELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Dalicia Adkins	TELEPHONE: (424) 301-3064
LICENSING EVALUATOR SIGNATURE:	DATE: 03/10/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2020

LIC809 (FAS) - (06/04)

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