197420027-8-25-2022-58-CC-SORS-CHMRPV-20220825131235

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197420027
Report Date: 08/25/2022
Date Signed: 08/25/2022 01:12:47 PM

Document Has Been Signed on 08/25/2022 01:12 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:	GAN MALIBU, ECC		FACILITY NUMBER:	197420027
ADMINISTRATOR:	CUNIN, SARAH		FACILITY TYPE:	830
ADDRESS:	22933 PACIFIC COAST HWY		TELEPHONE:	(310) 456-6573
CITY:	MALIBU	STATE: CA	ZIP CODE:	90265
CAPACITY:	7	CENSUS: 0	DATE:	08/25/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	CUNIN, SARAH- DIrector		TIME COMPLETED:	01:15 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 08/25/2022 Licensing Program Analyst (LPA), Suzette Ornelas conducted an unannounced Annual Required Inspection for the infant license. LPA met with Director, Sarah Cunin, and toured the facility indoors and outdoors. Days and hours of operation are Monday through Friday 8a to 5p. Center has preschool license (197420027) on the premises. LPA observed all required postings in a prominent area. There are no children present on the premises. Children are signed in/out virtually via application Brightwheel. 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 a child restroom which included 1 toilet, 1 sink and an infant changing table. Infant changing tables have a padded surface and are covered with washable vinyl or plastic and have raised sides at least three inches high. Floors in the facility are clean and safe. Furniture and equipment are in good condition, free of sharp, loose or pointed parts. 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. Per director, parents provide daily meals. Solid waste storage containers have tight-fitting covers and are in good repair. Drinking water is available both indoors and outdoors. The facility is free of flies, insects and rodents. The facility is equipped with a smoke detector and fire extinguisher (2A 10BC). There is no carbon monoxide detector on the premises due to the facility not having a gas line, the property uses electricity. 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. The facility has sufficient cribs, cots or mats for infant napping. Each crib, mat or cot is occupied by only one infant at time and cribs are kept free from all loose articles including blankets and pillows and there are no objects hanging above or attached to the crib.

SUPERVISOR'S NAME: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Suzette Ornelas	TELEPHONE: 424-301-3008
LICENSING EVALUATOR SIGNATURE:	DATE: 08/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2022

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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Document Has Been Signed on 08/25/2022 01:12 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: GAN MALIBU, ECC	FACILITY NUMBER: 197420027
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/25/2022

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 observation, interview, record review, the licensee did not comply with the section cited above in 3 infant teachers did not have a mandated reporter training certificate which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/09/2022
	Plan of Correction
1 2 3 4	Director will provide proof of completion for 3 infant teachers via email to LPA.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Suzette Ornelas	TELEPHONE: 424-301-3008
LICENSING EVALUATOR SIGNATURE:	DATE: 08/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2022

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: GAN MALIBU, ECC	FACILITY NUMBER: 197420027
	VISIT DATE: 08/25/2022

NARRATIVE

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Infants are not swaddled while in care. Staff physically checks on sleeping infants every fifteen minutes and documents any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Documentation for infants up to 12 months includes sleeping position if it is other than on their back. Individual Infant Sleeping Plan is completed and in file for each infant up to 12 months of age. LPA provided licensee with a copy of the Infant Needs and Services Plan Regulation and Responsibility for Providing Care and Supervision for Infants Staff-infant ratio.Requirements are being met while infants are sleeping. 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 offsite 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 incomplete. LPA observed 3 staff missing Mandated Reporter training certificate. Licensee was provided with a copy of the Mandated Reporter Regulation and will provide proof to LPA via email once documents are obtained.

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, the following deficiency is being cited: (see next page, 809 D) Type B: Health and Safety Code 1596.8662(b)(1)

Licensee was provided a copy of their appeal rights.

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: 08/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2022

LIC809 (FAS) - (06/04)

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