197419915-10-24-2022-58-CC-SORS-CKHV3D-20221024160435

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197419915
Report Date: 10/24/2022
Date Signed: 10/24/2022 04:04:44 PM

Document Has Been Signed on 10/24/2022 04:04 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:	31ST DISTRICT PTSA CREATIVE KIDS		FACILITY NUMBER:	197419915
ADMINISTRATOR:	MARLENE ORTIZ		FACILITY TYPE:	840
ADDRESS:	17551 MIRANDA STREET		TELEPHONE:	(818) 360-4203
CITY:	ENCINO	STATE: CA	ZIP CODE:	91316
CAPACITY:	72	CENSUS: 36	DATE:	10/24/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:31 PM
MET WITH:	MARLENE ORTIZ- Director		TIME COMPLETED:	04:30 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	On 10/24/2022 Licensing Program Analyst (LPA) Suzette Ornelas conducted an unannounced Annual Required Inspection for the facility. LPA met with Marlene Ortiz, Director, and toured the facility indoors and outdoors. Days and hours of operation are Monday through Friday in the morning from 6:30 AM - 8:15 AM. Afternoon Monday through Friday 1:00 PM to 6:30 PM. The program uses Room 18 and Room 19. *Center does not operate during the summer break.* Children Sign-In According to the Site Director: The sign in on Monday through Friday at 7:00 AM by parents and are signed out by staff when they are released to their class. Upon return to the program after school the staff signs them in and parents sign them out at pick up time. LPA observed all required postings in a prominent area. Due to school being in session at the time of the inspection, no children were observed. 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. A walk through of the classroom area was conducted. LPA observed 2 licensed classrooms on the premises. RM 19: (K-1st Grade), RM 18 (2nd - 5th Grade) All areas identified on the Facility Sketch were inspected. RM 18: 0 children with a ratio of 2 teachers RM 19: 0 children with a ratio of 2 teachers

SUPERVISOR'S NAME: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Suzette Ornelas	TELEPHONE: 424-301-3008
LICENSING EVALUATOR SIGNATURE:	DATE: 10/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 3

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: 31ST DISTRICT PTSA CREATIVE KIDS	FACILITY NUMBER: 197419915
	VISIT DATE: 10/24/2022

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
26
27
28
29
30
31
32

Upon arrival, director stated that Room 5 and Room 18 were in use due to school changes caused by enrollment and availability. LPA informed director that the facility is only licensed to provide care in rooms 17, 18 and 19. Director obtained permission to use room 19 and ceased use of room 5 immediately. LPA provided director a copy of the the Reporting Requirements Regulation 101212(c) and information on submitting LIC200A and updated facility sketch to the department to ensure regulation requirement is met. A declaration was obtained from the director stating room 5 will not be used until clearance is granted and instead room 19 and outdoor covered table area will be used.

A walk through of the classroom room space was conducted, the space was 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. Isolation area for sick students is located in a rug area inside the classroom. LPA observed adequate arrangements for isolation and care of ill children.

The bathroom and toileting areas were inspected, LPA observed toilets and sinks to accommodate the facility’s capacity. There is a girls restroom (4 toilets, 2 sinks) and a boys restroom (2 toilets, 2 sinks, 2 urinals) located in an outdoor bungalow by the play area. Toilets flush properly, toilets and sinks are reachable by the children in care. The restrooms have adequate toilet paper and paper towels available. The bathrooms were found to be clean. There is adequate lighting/ventilation in the bathroom area.

Playground equipment is in safe condition and free of hazards. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. Areas around high climbing equipment, swings and slides have cushioning material to absorb falls. All food preparation and storage areas are clean and safe. Per Director, program provides daily snacks for children. Solid waste storage containers have tight-fitting covers and are in good repair. Drinking water is readily available both indoors and outdoors. The facility is equipped with a working smoke detector and carbon monoxide detector in both classrooms. LPA observed a fire extinguisher (2A 10BC) located in both classrooms. 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. No poisons were observed during the inspection.

SUPERVISOR'S NAME: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Suzette Ornelas	TELEPHONE: 424-301-3008
LICENSING EVALUATOR SIGNATURE:	DATE: 10/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2022

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: 31ST DISTRICT PTSA CREATIVE KIDS	FACILITY NUMBER: 197419915
	VISIT DATE: 10/24/2022

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
26
27
28
29
30
31
32

LPA reviewed a sample of children’s files and observed files were complete. Prior to working or volunteering in a licensed child care facility, all individuals subject to a criminal record review have received a criminal record clearance or exemption. At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at off site activities. The name of the child care center director or fully-qualified teacher(s) designated to act in the director’s absence has been reported to the Department. LPA reviewed a sample of staff files and observed files were complete. LPA provided Administrator with a copy of the Disaster and Mass Casualty Plan regulation and information on ensuring the plan follows regulating requirements, to be maintained at the facility moving forward.

Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

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

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

SUPERVISOR'S NAME: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Suzette Ornelas	TELEPHONE: 424-301-3008
LICENSING EVALUATOR SIGNATURE:	DATE: 10/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2022

LIC809 (FAS) - (06/04)

Page: 3 of 3