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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493416
Report Date: 12/12/2023
Date Signed: 12/12/2023 05:49:15 PM


Document Has Been Signed on 12/12/2023 05:49 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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:PRIME TIME SPORTS CAMP@GRAND VIEW ELEM.SCHOOLFACILITY NUMBER:
197493416
ADMINISTRATOR:SAWYERS, REBECCAFACILITY TYPE:
840
ADDRESS:3951 GRAND VIEW BLVD.TELEPHONE:
(310) 838-7872
CITY:LOS ANGELESSTATE: CAZIP CODE:
90066
CAPACITY:90CENSUS: 21DATE:
12/12/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:KAELYN GSELLMAN, DIRECTORTIME COMPLETED:
06:15 PM
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Licensing Program Analyst (LPA) Lisa Clayton arrived Grand View Elementary School unannounced to conduct the Required 3-year inspection for the Prime Time Sports Camp afterschool program. LPA met with Program Director Kaelyn Gsellman. LPA Clayton observed 21 children being supervised and cared for appropriately by 3 staff.

The facility serves children from UTK (4 years) to 5th grade (Transitional-Kindergarten and Elementary School Age). According to the site director, the facility’s hours of operation are from 2:43 PM- 5:30 PM, Monday, Wednesday-Friday and 1:43 PM-5:30 PM on Tuesday. A late lunch is provided by the school and kept in the school cafeteria. The after-school program provides a snack and water.

The Children are picked up from their classroom by the program “coach” and signed in at that time. Parents sign children out at pick up.

The afterschool program is conducted in Bungalow B (the Prime Time Room) and has access to the play yard on the Southwest end of the school campus. Isolation area for sick students is located in the classroom.

All toilets and hand washing facilities are in safe and sanitary operating condition. Floors in the facility are clean and safe. LPA Clayton inspected the classrooms and observed age-appropriate toys, books and furnishings. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. There is adequate heating, lighting and ventilation.

Playground equipment is in safe condition, free of sharp, loose, or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards.

SUPERVISOR'S NAME: Karren StarksTELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME: Lisa ClaytonTELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:
DATE: 12/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/12/2023
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 12/12/2023 05:49 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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245


FACILITY NAME: PRIME TIME SPORTS CAMP@GRAND VIEW ELEM.SCHOOL
FACILITY NUMBER: 197493416

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/12/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
HSC
1596.871(c)(1)(A)
Administration of Child Day Care Licensing
Subsequent to initial licensure, a person specified in subdivision (b) who is not exempt from fingerprinting shall obtain either a criminal record clearance or an exemption from disqualification, pursuant to subdivision (f) of this section or Section 1522.7, from the State Department of Social Services prior to employment, residence, or initial presence in the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA Claytons observation the licensee did not comply with the section cited above in as the staff fingerprint clearances are not visible in Guardian, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 12/18/2023
Plan of Correction
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 Program Director to contact Guardian and correct staff fingerprint issues no later than December 18, 2023
Type A
Section Cited
CCR
101170(j)
Criminal Record Clearance
(j) The licensee shall maintain documentation of criminal record clearances or criminal record exemptions of volunteers that require fingerprinting.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA Claytons observation the licensee did not comply with the section cited above as the staff fingerprint clearances are not visible in Guardian, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 12/18/2023
Plan of Correction
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 Program Director to contact Guardian and correct staff fingerprint issues no later than December 18, 2023
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: Karren StarksTELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME: Lisa ClaytonTELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:
DATE: 12/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/12/2023
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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: PRIME TIME SPORTS CAMP@GRAND VIEW ELEM.SCHOOL
FACILITY NUMBER: 197493416
VISIT DATE: 12/12/2023
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There are no swimming pools, ponds, 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. All poisons are kept in a locked cabinet area.

LPA observed a fully charged 2- A10 B:C Fire Extinguisher, 2 fully stocked first aid kits in the classroom. The carbon monoxide and smoke detector were not tested but are wired to the Fire Alarm system. The last fire drill was conducted in September 2023.

LPA reviewed a total of 4 staff files. LPA Clayton provided the Program Director with an updated LIC311A (Records To Be Maintained At The Facility) and instructed Director to bring the staff files into compliance upon return from holiday break (January 8, 2024).

LPA reviewed 5 children files and they were found to be in compliance including consent for Emergency Medical Treatment and Emergency Contacts.

Program Director Kaelyn was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.



Incidental Medical Services (IMS) are not being provided at this time. 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/

Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.
SUPERVISOR'S NAME: Karren StarksTELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME: Lisa ClaytonTELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2023
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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: PRIME TIME SPORTS CAMP@GRAND VIEW ELEM.SCHOOL
FACILITY NUMBER: 197493416
VISIT DATE: 12/12/2023
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LPA Clayton reminded Director to access the Community Care Licensing website www.ccld.ca.gov for 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. Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms.


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.

Per Title 22, Health and Safety Codes deficiencies were cited today (see LIC 9099D).


Exit interview conducted, and report was reviewed with Director Kaelyn Gsellman. Appeal Rights and a Notice of Site Visit was provided and must remain posted for 30 days.
SUPERVISOR'S NAME: Karren StarksTELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME: Lisa ClaytonTELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2023
LIC809 (FAS) - (06/04)
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