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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
197493214
Report Date:
10/11/2023
Date Signed:
10/11/2023 03:30:58 PM
Document Has Been Signed on
10/11/2023 03:30 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:
PLUMMER ELEMENTARY CSPP
FACILITY NUMBER:
197493214
ADMINISTRATOR:
IBIA M. GOMEZ
FACILITY TYPE:
850
ADDRESS:
9340 NOBLE AVE
TELEPHONE:
(818) 895-8481
CITY:
NORTH HILLS
STATE:
CA
ZIP CODE:
91343
CAPACITY:
22
CENSUS:
14
DATE:
10/11/2023
TYPE OF VISIT:
Required - 1 Year
UNANNOUNCED
TIME BEGAN:
09:00 AM
MET WITH:
Esther Leon, Principal
TIME COMPLETED:
03:40 PM
NARRATIVE
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Licensing Program Analyst (LPA) Lilia Hernandez conducted an unannounced annual inspection to the above facility on 10/11/2023. LPA arrived at the facility at 9:00AM, identified self and met with Esther Leon, Principal who guided analyst on a tour of the facility. LPA provided Principal with a copy of the LIC 125 Entrance Checklist to help facilitate the inspection. This is a preschool program which consists of 1 classroom located in Room 4. Facility operation hours are Monday to Friday from 8:00 AM to 2:23 PM.
All areas identified on the Facility Sketch were inspected.
There were 14 children and 2 staff present when LPA arrived. The facility was observed to be within the license capacity and limitations.
Criminal record clearance was not reviewed. However, per condition of employment with the Los Angeles Unified School District, all individual’s present have obtained a criminal record clearance or criminal record exemption.
The following was observed during the tour of the facility:
Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. All floors were observed to be clean and safe. All materials accessible to children were observed to be toxic free.
LPA observed teachers’ belongings stored in the area where children play. LPA observed items stored in boxes in the areas where children play. ---Page 1 of 5
SUPERVISOR'S NAME:
Rita Ramos
TELEPHONE:
(424) 301-3061
LICENSING EVALUATOR NAME:
Lilia Hernandez
TELEPHONE:
424-301-3071
LICENSING EVALUATOR SIGNATURE:
DATE:
10/11/2023
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/11/2023
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
9
Document Has Been Signed on
10/11/2023 03:30 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:
PLUMMER ELEMENTARY CSPP
FACILITY NUMBER:
197493214
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
10/11/2023
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238.4(a)
Storage Space
(a) The licensee shall ensure that each child has an individual permanent or portable storage space for his/her clothing, personal belongings and/or bedding.
This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in LPA observed children's jackets and sweaters hanging on a child sized coat rack overlapping. which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
10/25/2023
Plan of Correction
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Per principal, an order for cubbies will be placed and proof of purchase and a photo of the shelves will be sent to LPA via email by POC due.
Type B
Section Cited
CCR
101239.1(c)(2)
Napping Equipment
(c) Each cot or mat shall be equipped with a sheet to cover the cot or mat and, depending on the weather, a sheet and/or blanket to cover the child. (2) Bedding shall be individually stored so that each child's bedding is identifiable and no child's used bedding comes into contact with other bedding.
This requirement is not met as evidenced by:
Deficient Practice Statement
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4
Based on observation, the licensee did not comply with the section cited above in LPA observed matts stored in a corner of the classroom stacked inside a box and not individually stored. which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
10/25/2023
Plan of Correction
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Per principal, classroom space will be evaluated and make space to store matts in individualized plastic bag. Proof of correction will be sent to LPA via email by the POC due date.
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:
Rita Ramos
TELEPHONE:
(424) 301-3061
LICENSING EVALUATOR NAME:
Lilia Hernandez
TELEPHONE:
424-301-3071
LICENSING EVALUATOR SIGNATURE:
DATE:
10/11/2023
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/11/2023
LIC809
(FAS) - (06/04)
Page:
2
of
9
Document Has Been Signed on
10/11/2023 03:30 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:
PLUMMER ELEMENTARY CSPP
FACILITY NUMBER:
197493214
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
10/11/2023
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
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Based on observation, interview, and record review the licensee did not comply with the section cited above due to principal disclosing that they have never taken the AB 1207 Mandated Reporter training which poses a potential health, safety and personal rights risk to children in care.
POC Due Date:
10/25/2023
Plan of Correction
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Per Principal, copies of certificates will be emailed to LPA and will be submitted by POC due date.
Type B
Section Cited
CCR
101212(b)
Reporting Requirements
(b) The name of the child care center director, and any fully qualified teacher(s) designated to act in the child care center director's absence, shall be reported to the Department within 10 days of a change of child care center director or designee(s).
This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above in LPA did not observe an LIC308 posted with the designee name. Per principal, a complete LIC308 is not available which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
10/25/2023
Plan of Correction
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Per principal, copies of the LIC308 will be submitted for principal and assistant principal to LPA via email by the POC due date.
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:
Rita Ramos
TELEPHONE:
(424) 301-3061
LICENSING EVALUATOR NAME:
Lilia Hernandez
TELEPHONE:
424-301-3071
LICENSING EVALUATOR SIGNATURE:
DATE:
10/11/2023
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/11/2023
LIC809
(FAS) - (06/04)
Page:
3
of
9
Document Has Been Signed on
10/11/2023 03:30 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:
PLUMMER ELEMENTARY CSPP
FACILITY NUMBER:
197493214
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
10/11/2023
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(f)
Personnel Requirements
(f) At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities.
This requirement is not met as evidenced by:
Deficient Practice Statement
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3
4
Based on observation and interview, the licensee did not comply with the section cited above in LPA did not observe any personnel files to. Per principal, there is no staff files with current CPR/First Aid certificates which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
10/25/2023
Plan of Correction
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Per principal, proof of a staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid will be emailed to LPA by POC due date.
Type B
Section Cited
CCR
101229.1(a)(1)
Sign In and Sign Out
(a) In addition to the sign-in procedure requirement of Section 101226.1(b), the licensee shall develop, maintain and implement a written procedure to sign the child in/out of the child care center that shall, at a minimum, include the following: (1) The person who signs the child in/out shall use his/her full legal signature and shall record the time of day.
This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, LPA observed sign in/out sheets for 14 of 14 children to have Staff #1 signature and no time of day of drop off or pick up which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
10/25/2023
Plan of Correction
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Per principal, child's authorized representative will be informed immediately (10/11/2023) to sign in and sign out their own child and document time of drop off and pick up. A copy of the sign in/out sheets will be submitted to LPA via email by POC due date. Sign in/out sheets that include dates 10/12/2023 through 10/24/2023 will be submitted.
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:
Rita Ramos
TELEPHONE:
(424) 301-3061
LICENSING EVALUATOR NAME:
Lilia Hernandez
TELEPHONE:
424-301-3071
LICENSING EVALUATOR SIGNATURE:
DATE:
10/11/2023
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/11/2023
LIC809
(FAS) - (06/04)
Page:
4
of
9
Document Has Been Signed on
10/11/2023 03:30 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:
PLUMMER ELEMENTARY CSPP
FACILITY NUMBER:
197493214
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
10/11/2023
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
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Based on interview, the licensee did not comply with the section cited above due to principal stating that there are no copies of staff immunization's on file which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
10/25/2023
Plan of Correction
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Per Principal, proof of immunization will be filed in the DSS folder at the facility and proof of immunization's will be emailed to LPA by the POC date.
Type B
Section Cited
HSC
1596.954
Every licensed child day care center shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections.
This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on observation and interview, the licensee did not comply with the section cited above due to LPA observing that there is no carbon monoxide detector. Per Staff 1 and Assistant Principal, there is no carbon monoxide detector install in Room 4 which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
10/25/2023
Plan of Correction
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2
3
4
Per Principal, a picture of the installed correction will be emailed to LPA and will be submitted by POC due date.
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:
Rita Ramos
TELEPHONE:
(424) 301-3061
LICENSING EVALUATOR NAME:
Lilia Hernandez
TELEPHONE:
424-301-3071
LICENSING EVALUATOR SIGNATURE:
DATE:
10/11/2023
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/11/2023
LIC809
(FAS) - (06/04)
Page:
5
of
9
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:
PLUMMER ELEMENTARY CSPP
FACILITY NUMBER:
197493214
VISIT DATE:
10/11/2023
NARRATIVE
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LPA observed children's belongings stored in a shelf near the classroom entrance. LPA also observed children's jackets and sweaters hanging on a child sized coat rack overlapping.
Linens are provided for each child enrolled. Linens are washed weekly by school district.
Per staff #1, matts are not provided for each child enrolled.
Per Staff #1, there are only 6 matts available for the 16 children enrolled. Children who do not have a matt to rest on sit at the table with quiet activities.
LPA observed matts stored in a corner of the classroom stacked inside a box. (Photo taken)
Age-appropriate sinks and toilets were inspected for availability and good repair in the restrooms. Room 4 also has an additional sink for hand washing. General sanitation was observed.
Availability of indoor drinking water was not observed in classrooms. Per principal, children bring their own water bottle daily and drinking water is available outdoors for children who need water refills.
Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Principal states that poisons are locked in the hopper room.
LPA did not observe a carbon monoxide detector installed in Room 4.
Per Staff 1 and Assistant Principal, there is no carbon monoxide detector install in Room 4.
All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish, rodents, and/or any other vermin. All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids or solid waste bags shall be discarded immediately after each meal. ---Page 2 of 5
SUPERVISOR'S NAME:
Rita Ramos
TELEPHONE:
(424) 301-3061
LICENSING EVALUATOR NAME:
Lilia Hernandez
TELEPHONE:
424-301-3071
LICENSING EVALUATOR SIGNATURE:
DATE:
10/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/11/2023
LIC809
(FAS) - (06/04)
Page:
6
of
9
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:
PLUMMER ELEMENTARY CSPP
FACILITY NUMBER:
197493214
VISIT DATE:
10/11/2023
NARRATIVE
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LPA observed 3 children's tricycles with missing bar grips and exposed sharp metal.
LPA observed play structure off limits and taped off for repair. Padding under play structure is pending replacement.
Per Principal, no date for repair completion is available.
There is a large tree in the play yard that provides adequate shade. Availability of outdoor drinking water was observed. LPA advised that no children shall be left without the supervision of a teacher at any time.
Per Principal, there are no firearms stored on the premises. LPA did not observe pools or bodies of water at the facility.
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. PIN 22-05-CCP.
Children’s Records were reviewed. Inspection of required forms was made and documented on the LIC 857.
Children's roster was reviewed and is current. Sign-In and Sign-Out sheets were reviewed. LPA observed sign in/out sheets to have all children present signed by Staff #1 and no time of day of drop off or pick up indicated.
LPA did not observe any personnel files to review.---Page 3 of 5
SUPERVISOR'S NAME:
Rita Ramos
TELEPHONE:
(424) 301-3061
LICENSING EVALUATOR NAME:
Lilia Hernandez
TELEPHONE:
424-301-3071
LICENSING EVALUATOR SIGNATURE:
DATE:
10/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/11/2023
LIC809
(FAS) - (06/04)
Page:
7
of
9
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:
PLUMMER ELEMENTARY CSPP
FACILITY NUMBER:
197493214
VISIT DATE:
10/11/2023
NARRATIVE
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Per principal, there is currently no staff files with mandated reporter training certificates, immunization records, and current CPR/First Aid certificates.
LPA did not observe an LIC308 with the designee’s information.
Per principal, a complete LIC308 is not available.
Disaster drill log was available, last drill was conducted on 9/28/2023 and on 9/19/2023.
Menus are posted one month in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request. The facility provides breakfast, lunch, and hot supper to children. Food is prepared in the main elementary cafeteria.
First Aid supplies were observed in the classroom. According to Principal, medication is only administered to a child when accompanied with a doctor's note and is stored in the office. The facility was observed to be equipped with an isolation area for any child who becomes ill and it is located in the nurse office.
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/
.
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
.
---Page 4 of 5
SUPERVISOR'S NAME:
Rita Ramos
TELEPHONE:
(424) 301-3061
LICENSING EVALUATOR NAME:
Lilia Hernandez
TELEPHONE:
424-301-3071
LICENSING EVALUATOR SIGNATURE:
DATE:
10/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/11/2023
LIC809
(FAS) - (06/04)
Page:
8
of
9
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:
PLUMMER ELEMENTARY CSPP
FACILITY NUMBER:
197493214
VISIT DATE:
10/11/2023
NARRATIVE
1
2
3
4
5
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Principal 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.
The following deficiencies listed on the attached deficiencies page are being cited in accordance with California Code of Regulations Title 22.
A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with Esther Leon, Principal.
---Page 5 of 5
SUPERVISOR'S NAME:
Rita Ramos
TELEPHONE:
(424) 301-3061
LICENSING EVALUATOR NAME:
Lilia Hernandez
TELEPHONE:
424-301-3071
LICENSING EVALUATOR SIGNATURE:
DATE:
10/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/11/2023
LIC809
(FAS) - (06/04)
Page:
9
of
9