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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493784
Report Date: 12/21/2023
Date Signed: 12/21/2023 02:42:33 PM

Document Has Been Signed on 12/21/2023 02:42 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:KID'S CLUB PROGRAMSFACILITY NUMBER:
197493784
ADMINISTRATOR:ROBERTS, TONYFACILITY TYPE:
840
ADDRESS:23838 KITTRIDGE STREETTELEPHONE:
(818) 591-2582
CITY:WEST HILLSSTATE: CAZIP CODE:
91307
CAPACITY: 52TOTAL ENROLLED CHILDREN: 52CENSUS: DATE:
12/21/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Tony RobertsTIME COMPLETED:
03:00 PM
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On 12/21/2023 Licensing Program Analysts (LPA) Jillinda Chandler, Doris Whitmore, and Laticia Thompson made an announced visit to Kids Club for the purpose of conducting a Case Management - Licensee Initiated inspection. The licensee is requesting a room change. Licensee is surrendering rooms 1 and 2 to a Preschool that is sharing the same campus. (Shepherd of the Valley Preschool and Church-197414470) and moving to rooms 5, 6, and 7( nearest to the church chapel) LPA inspected and measured the three classrooms. The center is located on the property of Shepherd of the Valley Preschool and Church. There is an approved fire clearance on file conducted by Cindy Struck of the LA City Fire Prevention Bureau of the Public Safety Valley Unit.
The following was observed:
Age-appropriate furniture, equipment, and toys.
Fire Extinguisher 2A10BC, last inspected 04/17/2023, Carbon Monoxide, Trash Cans with tight fitted lids, First Aid Kit was observed with the required supplies. Cubbies were observed for children’s belongings. Isolation Area is located in the main office using the staff restroom. Parents will sign in at the entrance using their original signature. Center will use pitchers and cups as a water source.
There were no hazardous conditions in the outdoors area, cushioning was observed under all climbing apparatus, cushioning was in good condition. Water Fountains are made readily available.
Indoor Measurements equals 2140.62, which will accommodate the requested capacity.
Outdoor Measurements equals 5715.44, which will accommodate the requested capacity.
The licensee has a shared outdoor activity waiver on file to share the space with Shepherd Preschool
LPA inspected the rest rooms, and the following was observed:
6 toilets
6 sinks
Licensee also observed koala changing tables in each restroom. Restrooms were gender identified.
Based on today’s inspection the facility shall be granted a room addition based on observations and measurements. Page 1
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Doris Whitmore
LICENSING EVALUATOR SIGNATURE: DATE: 12/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/21/2023
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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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: KID'S CLUB PROGRAMS
FACILITY NUMBER: 197493784
VISIT DATE: 12/21/2023
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Applicant was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.

LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep, as an additional resource. LPA also informed applicant of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at: https://www.cpsc.gov/, and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.



This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A 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, available at: http://www.ada.gov/childqanda.htm.

Applicant was informed of the MyChildCarePlan.org site, 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.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 receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication. Lead Testing was conducted 04/18/2023 for the entire church.


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SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Doris Whitmore
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2023
LIC809 (FAS) - (06/04)
Page: 3 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: KID'S CLUB PROGRAMS
FACILITY NUMBER: 197493784
VISIT DATE: 12/21/2023
NARRATIVE
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The following corrections are needed before licensure will be considered. Corrections are due by 012/26/2023:

Required Postings shall be placed in a prominent area for viewing by parents and other authorized individuals.

SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Doris Whitmore
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3