197418307-4-29-2024-58-CC-LHEZ-D4SS7K-20240429133739

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197418307
Report Date: 04/29/2024
Date Signed: 04/29/2024 01:37:55 PM

Document Has Been Signed on 04/29/2024 01:37 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
EL SEGUNDO CC NORTH, 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: 14	DATE:	04/29/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	08:39 AM
MET WITH:	Maria Garcia-Haro, Principal		TIME COMPLETED:	01:50 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 Analyst (LPA) Lilia Hernandez conducted an unannounced annual inspection to the above facility on 04/29/2024. LPA arrived at the facility at 8:39AM, identified self and met with Maria Garcia-Haro, Principal, who guided analyst on a tour of the facility. LPA provided Principal with a copy of the LIC 125 Entrance Checklist to help facilitate the inspection. This is a preschool program which consists of one classroom, Room 2 located on the grounds of an elementary school. Facility operation hours are Monday to Friday from 8:00 AM to 2:35 PM. All areas identified on the Facility Sketch were inspected. There were 14 children and 2 staff present when LPA arrived. The facility was observed to be within the license capacity and limitations. Criminal record clearance was not reviewed. However, per condition of employment with the Los Angeles Unified School District, all individual’s present have obtained a criminal record clearance or criminal record exemption. The following was observed during the tour of the facility: Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Carbon monoxide detectors were not observed in the facility. Children have their own cubby to store their belongings. LPA did not observe children belongs touching. Mats and linens are provided for each child enrolled. Linens are washed weekly by school district. LPA observed mats stored stacked in a bin near the children’s bathroom. Mats were observed stored with bedding kept on. Mats and bedding were observed stored in a way that did not prevent mats and bedding to come in contact with each other. (photo taken) During nap time, LPA observed napping equipment to be placed right next to one another with no walkway in between mats. LPA also observed children walking over each others mats. ---Page 1 of 4

SUPERVISOR'S NAME: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia Hernandez	TELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:	DATE: 04/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2024

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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Document Has Been Signed on 04/29/2024 01:37 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: STONER AVENUE ELEMENTARY SCHOOL CSPP	FACILITY NUMBER: 197418307
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/29/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.954

Licensure Requirements

Every licensed child day care center shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in LPA did not observe a carbon monoxide detector in the facility which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/13/2024
	Plan of Correction
1 2 3 4	Per Principal, a carbon monoxide detector will be install in the facility. Photo of carbon monoxide install in the facility will be submitted to LPA via email by POC die date.

Type B

Section Cited

CCR

101239.1(c)(2)

Napping Equipment

(c) Each cot or mat shall be equipped with a sheet to cover the cot or mat and, depending on the weather, a sheet and/or blanket to cover the child. (2) Bedding shall be individually stored so that each child's bedding is identifiable and no child's used bedding comes into contact with other bedding. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in LPA observed mats and bedding stored in a way that did not prevent mats and bedding to come in contact with each other which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/13/2024
	Plan of Correction
1 2 3 4	Per Principal, written statement and photo of how mats and bedding will be stored will be submitted to LPA via email by POC due date.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia Hernandez	TELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:	DATE: 04/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 04/29/2024 01:37 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: STONER AVENUE ELEMENTARY SCHOOL CSPP	FACILITY NUMBER: 197418307
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/29/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101239.1(d)

Napping Equipment

(d) Napping equipment shall be arranged so that each child has access to a walkway without having to walk on or over the cots or mats of other children. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in LPA observed napping equipment to be placed right next to one another with no walkway in-between mats. LPA also observed children walking over each others mats which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/13/2024
	Plan of Correction
1 2 3 4	Per Principal, written statement and photo of how mats and bedding will be arranged during napping will be submitted to LPA via email by POC due date.

Type B

Section Cited

CCR

101239(f)(1)

Fixtures, Furniture, Equipment and Supplies

(f) Solid waste shall be stored, located and disposed of in a manner that will not transmit communicable diseases or odors, create a nuisance, or provide a breeding place or food source for insects or rodents. (1) All containers used for storage of solid wastes, including moveable bins, shall have a tightfitting cover that is kept on; shall be in good repair; and shall be leakproof and rodent-proof. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in LPA observed trash can for solid waste without a tight fitted lid which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/13/2024
	Plan of Correction
1 2 3 4	Per Principal, trash cans for solid waste with tight fitted lids will be obtained and photo of correction will be submitted via email to LPA by POC due date.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia Hernandez	TELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:	DATE: 04/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2024

LIC809 (FAS) - (06/04)

Page: 3 of 8

Document Has Been Signed on 04/29/2024 01:37 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: STONER AVENUE ELEMENTARY SCHOOL CSPP	FACILITY NUMBER: 197418307
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/29/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 3 of 3 staff (Principal, Teacher, Aide) are missing AB1207 mandated reporter training certificate which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/13/2024
	Plan of Correction
1 2 3 4	Per Principal, copies of the certificates for the completed training will be submitted to LPA via email by POC due date.

Type B

Section Cited

HSC

1596.7995(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 2 of 3 staff (Principal, Aide) are missing immunization against measles and pertussis and 3 of 3 staff (Principal, Teacher, Aide) is missing immunization against influenza which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/29/2024
	Plan of Correction
1 2 3 4	Per Principal, proof of immunization's will be submitted to LPA via email by POC due date.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia Hernandez	TELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:	DATE: 04/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 04/29/2024 01:37 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: STONER AVENUE ELEMENTARY SCHOOL CSPP	FACILITY NUMBER: 197418307
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/29/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101220(a)

Child's Medical Assessments

(a) Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child. This medical assessment enables the licensee to assess whether the center can provide necessary health-related services to the child. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above 1 of 5 child files reviewed is missing LIC701 with TB risk factors which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/29/2024
	Plan of Correction
1 2 3 4	Per Principal, a copy of the completed LIC701 form with TB risk factors will be submitted to LPA via email by POC due date.

Type B

Section Cited

CCR

101227(a)(6)

Food Service

(6) Menus shall be in writing and shall be posted at least one week in advance in an area accessible for review by the child's authorized representative. Copies of the menus as served shall be dated and kept on file for at least 30 days. Menus shall be made available for review by the child's authorized representative and the Department upon request. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in LPA did not observe menu's for state preschool posted which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/13/2024
	Plan of Correction
1 2 3 4	Per Principal, menu's will be posted in an area accessible for review by the child's authorized representative to view. A photo of the correction will be submitted via email to LPA by POC due date.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia Hernandez	TELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:	DATE: 04/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2024

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

FACILITY NAME: STONER AVENUE ELEMENTARY SCHOOL CSPP	FACILITY NUMBER: 197418307
	VISIT DATE: 04/29/2024

NARRATIVE

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All floors were observed to be clean and safe. All materials accessible to children were observed to be toxic-free Per Principal, there are no firearms stored on the premises. Age-appropriate sinks and toilets were inspected for availability and good repair in the restrooms. Each classroom also has an additional sink for handwashing. General sanitation was observed. Availability of indoor drinking water was observed in classrooms.

Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Principal states that poisons are locked in the hopper room.

LPA did not observe menu’s for state preschool posted. Per Cafeteria Manager, menu’s have not been provided to state preschool for posting. Menus for the past 30 days are available upon request. The facility provides breakfast and lunch to children. Food is prepared in the elementary cafeteria.
All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish, rodents, and/or any other vermin. 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 or solid waste bags shall be discarded immediately after each meal. LPA observed trash can for solid waste without a tight fitted lid.

Outdoor playground equipment is in a 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, slides, and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard. LPA observed play yard to have trees that provided shade. Availability of outdoor drinking water was observed. LPA advised that no children shall be left without the supervision of a teacher at any time. LPA observed no pools or bodies of water at the facility.

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 child care 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).
LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. ---Page 2 of 4

SUPERVISOR'S NAME: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia Hernandez	TELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:	DATE: 04/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2024

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

FACILITY NAME: STONER AVENUE ELEMENTARY SCHOOL CSPP	FACILITY NUMBER: 197418307
	VISIT DATE: 04/29/2024

NARRATIVE

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LPA reviewed staff records. The review of Staff records was documented on the LIC 859. There is at least one person trained in CPR and Pediatric First Aid present during this inspection. 3 of 3 staff are missing AB1207 mandated reporter training certificate. 2 of 3 staff are missing immunization against influenza, measles and pertussis. 1 of 3 staff is missing immunization against influenza.

Children’s Records were reviewed. Inspection of required forms was made and documented on the LIC 857. 1 of 5 child files reviewed is missing LIC701 with TB risk factors. Children's roster was reviewed and is current. Sign-In and Sign-Out sheets were reviewed. Children present were signed in.

Disaster drill logs were available. The last fire drill was conducted on 04/18/2024 and the last earthquake drill was conducted on 4/21/2024.

First Aid supplies were observed in the nurse’s office. According to Principal, medication is only administered to a child when accompanied with a doctor's note. Medication is stored in the elementary school nurse’s office. The school nurse and trained staff administers the medications which are stored in a locked cabinet. The facility was observed to be equipped with an isolation area for any child who becomes ill and it is located in the nurse’s office.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication, 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/.

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. ---Page 3 of 4

SUPERVISOR'S NAME: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia Hernandez	TELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:	DATE: 04/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2024

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

FACILITY NAME: STONER AVENUE ELEMENTARY SCHOOL CSPP	FACILITY NUMBER: 197418307
	VISIT DATE: 04/29/2024

NARRATIVE

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

The following deficiencies listed on the attached deficiencies page are being cited in accordance with California Code of Regulations Title 22.

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

Exit interview conducted and report was reviewed with Maria Garcia-Haro, Principal.

---Page 4 of 4

SUPERVISOR'S NAME: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia Hernandez	TELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:	DATE: 04/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2024

LIC809 (FAS) - (06/04)

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