197492957-10-4-2022-30-CC-JCHR-CJVPTJ-20221004113601

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197492957
Report Date: 10/04/2022
Date Signed: 10/04/2022 11:38:14 AM

Document Has Been Signed on 10/04/2022 11:38 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:	WEST LA EXTENDED DAY		FACILITY NUMBER:	197492957
ADMINISTRATOR:	JOLENE DOUCETTE		FACILITY TYPE:	840
ADDRESS:	6550 W. 80TH STREET		TELEPHONE:	(310) 642-8386
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90045
CAPACITY:	90	CENSUS: 0	DATE:	10/04/2022
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	09:53 AM
MET WITH:	Jolene Doucette - director		TIME COMPLETED:	10:44 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 10/4/2022 Licensing Program Analyst (LPA) made an announced visit to the West L.A Extended Day after-school program. During todays visit LPA met with director Jolene Doucette. Licensee is requesting to add two additional classrooms to the existing after school, school age license. The program currently exist in rooms 21 and 22 on the Wish Charter Elementary (LAUSD) campus. There is also a middle school -Orville Wright Middle school on the premises.The licensee is requesting to increase the capacity from 90 to 180 by adding the two additional classrooms. Two classrooms number 23 and 24 were inspected for health and safety compliance. There is an approved fire clearance on file conducted by Inspector Sivaborvoran of the L.A City Fire Department- Institutions Unit. During todays visit the after school program was not in session, the program hours are 2:00 P.M - 6:00 P.M; Monday- Friday LPA observed the following: The essential first aide supplies, bandages,ointments, tweezers, thermometer Working telephones inside the classrooms Fire Extinguisher last inspected 12/1/2021 Room temperature set at a comfortable setting for the current days weather Furniture and equipment was age appropriate in fair condition. The director office and the handicap restroom are used for isolation of ill children Class rooms were exempt from Title 22's square footage requirement per Health and Safety Code Section 1596.806

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Jillinda Chandler	TELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2022

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: WEST LA EXTENDED DAY	FACILITY NUMBER: 197492957
	VISIT DATE: 10/04/2022

NARRATIVE

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The program provides pre packaged snacks, LPA did not observe a prepping area. A refrigerator is located in room 22 for perishable items. Water is provided by a filtered water dispenser, children use their personal water containers or paper cups.

Children use restrooms located on the school premises, restrooms are directly outside of rooms 23 and 2 and in the hallway. Restrooms are gender identified with privacy stalls with operable toilets and sinks.
The program is exempt from sink and toilet requirement per Health and Safety Code Section 1596.806

LPA observed the outdoors activity area this area was fully gated with a 5 foot or taller gate. The surface of the outdoor activity area was observed to be asphalt LPA did not observe any climbing equipment. Operable water fountains were observed with broad based stepping stools to assist in accessing the fountain.
LPA did not observe any hazardous conditions during todays inspection.
The program is exempt from Title 22's square footage requirement per Health and Safety Code Section 1596.806.

Based on todays inspection the program shall be granted an increase of capacity for an additional 90 children and a total capacity of 180 children. The program shall be licensed pending the receipt of an amended Proposition 39, that reflects the usage of the 4 classrooms.

This report was discussed with licensee Jolene Doucette, an exit interview was conducted. A copy of this report shall be provided to licensee via email due to a printer error.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Jillinda Chandler	TELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2022

LIC809 (FAS) - (06/04)

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