197419197-2-2-2024-58-CC-SGAN-D23QS9-20240202112511

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197419197
Report Date: 02/02/2024
Date Signed: 02/02/2024 11:25:21 AM

Document Has Been Signed on 02/02/2024 11:25 AM - 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:	A MOTHER GOOSE ACADEMY		FACILITY NUMBER:	197419197
ADMINISTRATOR:	CARDENAS, CAREN		FACILITY TYPE:	850
ADDRESS:	11849 BURBANK BLVD.		TELEPHONE:	(818) 980-0118
CITY:	VALLEY VILLAGE	STATE: CA	ZIP CODE:	91607
CAPACITY:	41	CENSUS: 20	DATE:	02/02/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Caren Cardenas/Director		TIME COMPLETED:	11:55 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	On 02/02/2024 at 8:30 am, Licensing Program Analyst (LPA) Silva Garibyan conducted an unannounced Required inspection visit. LPA met with Jacqueline Caren Cardenas, Director and toured the facility. Facility is currently licensed for a capacity of 41 children. LPA observed 20 children and three staff present at the time of the visit. Parents and authorized adults use an electronic sign in and out devise (Brightwheel App), The devise is capable of printing sign in/out sheets upon request of licensing representative or other enforcement agencies. All children are under supervision, including visual supervision of a teacher at all times. Capacity and limitations as specified on the license are being maintained. The facility consists of 5 classrooms (4 classrooms in the main building structure and 1 classroom in the rear building). The children's bathroom is located in the center of the facility along the left side. The facility operates from 7:30 a.m. to 5:00 p.m. 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 and other hazardous items are made inaccessible. A walk through of the classrooms was conducted, the classrooms were found to be clean and free from any potential hazards. Furniture was found to be in good repair and age appropriate. There is adequate heating, lighting and ventilation. Page 1

SUPERVISOR'S NAME: Betty Bell	TELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Silva Garibyan	TELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2024

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

FACILITY NAME: A MOTHER GOOSE ACADEMY	FACILITY NUMBER: 197419197
	VISIT DATE: 02/02/2024

NARRATIVE

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The bathroom was inspected. LPA observed toilets and sinks to accommodate the facility’s capacity. Facility is equipped with four toilets and two sinks in the bathroom, three sinks in the classrooms. Toilets flush properly, toilets and sinks are reachable by the children in care. The bathroom has adequate toilet paper and paper towels available. LPA observed the hot water to be turned off. The bathroom was found to be clean. There is adequate lighting/ventilation in the bathroom area. 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. Floors in the facility are clean and safe. The classrooms were equipped with working telephones.
School provides breakfast, lunch, and snacks for the children in care. There is a full service kitchen on site. The kitchen is equipped with a refrigerator, freezer, stove, sink and microwave oven. The kitchen has cold and hot running water. Labeled containers were observed to store opened foods. LPA observed locks on the cabinets making detergents and toxins inaccessible to children. Water pitchers were observed for dispensing water in classrooms and outdoors. Trash cans used for solid or soiled waste were observed with tight fitting lids.

The outdoor area is fully enclosed. Age appropriate toys and equipment was observed. No hazardous conditions or equipment was observed during today’s visit. Shading and benches were observed. Pitchers are available for drinking water. Licensee was reminded that children are to be visually supervised at all times and no child should ever be left alone.

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SUPERVISOR'S NAME: Betty Bell	TELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Silva Garibyan	TELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2024

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: A MOTHER GOOSE ACADEMY	FACILITY NUMBER: 197419197
	VISIT DATE: 02/02/2024

NARRATIVE

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There are cubbies for children's belongings in the classrooms. LPA observed a sufficient quantity of cots available for napping children. The bedding is stored separately and properly.
Children are inspected for illnesses as they arrive. A review of medication policy indicated that Medication is administered by the director, who documents the date, time and dosage onto a log. Medications are stored securely and inaccessible to children. There is a separate area for isolation and care of ill children in the office. There is a cot available for each ill child. An isolated toilet and sink are available for ill children by utilizing the staff bathroom.

Center has devised an Incidental Medical Service plan to provide to parents of children with allergies (epi-pen), asthmatic (inhalers), and children needing G-tube feeding

The facility is equipped with a working smoke detectors and Carbon Monoxide detector. LPA observed four fire extinguishers (3A 40BC) located throughout the facility with service date of 02/10/2023. First Aid Kit was observed to be complete. Fire Drill log was observed to be complete and current.

The facility has sufficient cots for napping. Each cot is occupied by only one child at time. LPA reviewed a sample of children’s files and observed files were complete. LPA reviewed a sample of staff files and observed files were complete. CPR, Pediatric First Aid (Director completed on 12/23/2022), and Mandated Reporter Training certificates ( Director completed on 12/19/2023) were observed to be current. The name of the child care center director or fully qualified teacher designated to act in the director’s absence has been reported to the Department. Page 3

SUPERVISOR'S NAME: Betty Bell	TELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Silva Garibyan	TELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2024

LIC809 (FAS) - (06/04)

Page: 3 of 5

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: A MOTHER GOOSE ACADEMY	FACILITY NUMBER: 197419197
	VISIT DATE: 02/02/2024

NARRATIVE

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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.
Director 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.

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 4.

SUPERVISOR'S NAME: Betty Bell	TELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Silva Garibyan	TELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2024

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: A MOTHER GOOSE ACADEMY	FACILITY NUMBER: 197419197
	VISIT DATE: 02/02/2024

NARRATIVE

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LPA discussed the safe sleep regulations with Director 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.
Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) 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/.

Director 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.

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

Exit interview conducted and report was reviewed with the director Caren Cardenas.

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SUPERVISOR'S NAME: Betty Bell	TELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Silva Garibyan	TELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2024

LIC809 (FAS) - (06/04)

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