197419606-4-28-2022-30-CC-LJCS-CDWNNK-20220428103654

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197419606
Report Date: 04/28/2022
Date Signed: 04/28/2022 10:36:59 AM

Document Has Been Signed on 04/28/2022 10:36 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	PACE - YOUNG INNOVATOR		FACILITY NUMBER:	197419606
ADMINISTRATOR:	ARAKELYAN, ANUSH		FACILITY TYPE:	850
ADDRESS:	3740 DON FELIPE DRIVE		TELEPHONE:	(323) 389-8470
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90008
CAPACITY:	40	CENSUS: 20	DATE:	04/28/2022
TYPE OF VISIT:	Case Management - COVID-19	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Ruzanna Datvian		TIME COMPLETED:	10:45 AM

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On 4/28/2022, Licensing Program Analyst (LPA) Lillian Casillas conducted an unannounced Case Management – COVID-19 inspection to follow up on reported positive cases of COVID-19. Upon arrival, LPA met with the Site Director, Ruzanna Datvian. LPA conducted a risk assessment and toured the inside and outside of the facility. LPA observed 20 children and 6 staff.

According to the Unusual Incident Report LIC 624 submitted on 2/15/2022- 6 children tested positive for COVID-19. Site Director stated that all children who tested positive for COVID-19 isolated and were cleared to return to the facility. No additional children or staff have tested positive for COVID-19 since.

During visit, LPA observed COVID-19 related signs/posters throughout the facility. The entrance and classrooms include sanitation areas with hand sanitizer and touchless thermometers. LPA observed all bathrooms fully stocked with soap and paper towels. The children classroom materials and supplies are kept separate in plastic containers with their names on it. LPA observed floor markers and tape on tables to maintain social distancing.

During the visit LPA and Director discussed the following best practices:

Arrival Procedures - Site Director confirmed children and staff complete temperature checks and wellness checks every morning before entering the facility.

Face Masks - Although face masks are not required, the practice remains recommended.

Isolation area - Isolation area is located in the office area. A designated staff will stay with the child until the parent arrives.

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SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Lillian J Casillas	TELEPHONE: (424) 301-3097
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2022

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: PACE - YOUNG INNOVATOR	FACILITY NUMBER: 197419606
	VISIT DATE: 04/28/2022

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Cleaning and Disinfecting - The outdoor play area and classrooms are sanitized daily using a spray sanitation gun. High-touch surface areas are sanitized throughout the day.

Reporting Requirements – Site Director follows reporting requirement to report all COVID-19 positives cases to Department of Public Health. In addition, facility must report all positives cases and closure of facility or classrooms to Community Care Licensing. When reporting Unusual Incidents, call CCLD within 24 hours and submit Unusual Incident Report within 7 days.

No deficiencies are cited, per Title 22, Division 12, Chapter 3, of the California Code of Regulations.

An exit interview was conducted and a copy of this report (LIC 809) and Notice of Site Visit were provided to Site Director.

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Lillian J Casillas	TELEPHONE: (424) 301-3097
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2022

LIC809 (FAS) - (06/04)

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