197493895-10-1-2024-30-CC-JLAO-D9MJ2S-20241001064025

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197493895
Report Date: 09/30/2024
Date Signed: 10/01/2024 06:40:34 AM

Document Has Been Signed on 10/01/2024 06:40 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:	UNTITLED NO.1 SCHOOL		FACILITY NUMBER:	197493895
ADMINISTRATOR:	TASLIMI, LAILA		FACILITY TYPE:	850
ADDRESS:	2953 DELAWARE AVENUE		TELEPHONE:	(310) 264-1664
CITY:	SANTA MONICA	STATE: CA	ZIP CODE:	90404
CAPACITY:	20	CENSUS: 14	DATE:	09/30/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Erika "Ziggy" Membreno, Director		TIME COMPLETED:	12:30 PM

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On 09/30/2024 Licensing Program Analysta (LPA)s Judy Laureano and Brittany Lovest conducted an unannounced 3 Year Required Inspection at Untitled No. 1 School. LPAs were greeted by Erika Membreno/Ziggy Luna, Facility director.

Facility operates Monday through Friday from 7:50 a.m. to 5:00 p.m. LPAs toured the preschool classrooms and preschool’s outdoor yard. LPAs observed 14 children and 3 staff members and director providing care and supervision. Facility is licensed to care for children ages 30 months to entry to First Grade for a max capacity of 20 children.

Staff was observed operating within proper ratios. Classrooms were observed and inspected. Classrooms were observed with age-appropriate materials and a variety of manipulatives. Classrooms were observed to have fine and gross motor activities centers. Children’s cubbies were observed outside the bathroom. Furniture and equipment are in good condition, free of sharp, loose or pointed parts.

Facility is open to enroll children that might need incidental medical services. Medication, if needed, is stored in the director’s office, in the emergency bag pack inaccessible to the children in care. LPAs reviewed medication storage and LIC required forms with director. LPAs reminded facility to ensure that all medication is stored with all necessary LIC forms. All prescription and nonprescription medication shall be centrally stored in accordance with the following requirements: medication shall be kept in a safe place inaccessible to the children in care and each container shall have an unaltered label.

Teachers are responsible for the day-to-day cleaning. Disinfectants, cleaning solutions and other hazardous items are stored in the top cabinet of the closet next to the director’s office and in the kitchen, away from the children in care.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy Laureano	TELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2024

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: UNTITLED NO.1 SCHOOL	FACILITY NUMBER: 197493895
	VISIT DATE: 09/30/2024

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Furniture and equipment are in good condition, free of sharp, loose or pointed parts. 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.

Facility provides meals and snacks to children and LPAs observed food preparation area and food storage area. All food is protected against contamination and any contaminated food is discarded immediately. LPAs advised, copies of the menus as served shall be dated and kept on file for at least 30 days. Menus shall be made available for review by the child's authorized representative and the Department upon request. Director stated that parents received menu information via StoryPark, online application.

Water is readily available to children in care. LPAs observed water jug that provides water to the children. Children bring their own refillable water bottles and water bottles are available for children both indoors and outdoors and teachers assist children in refilling their water bottles.

LPAs observed all toilets and hand washing facilities. LPAs observed toilets and sinks to accommodate the facility’s capacity. Toilets flush properly, toilets and sinks are reachable by the children in care. Floors in the facility are clean and safe. Solid waste storage containers have tight-fitting covers and are in good repair.

Parent board was observed with all necessary posting in the library area of the facility.

The facility is free of flies, insects and rodents. 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.

Fire extinguishers, working fire alarm and carbon monoxide detector were observed in the space. All electrical outlets were observed to be covered.

Prior to working or volunteering in a licensed childcare facility, all individuals subject to a criminal record review have received a criminal record clearance or exemption. Upon notification from the Department, the licensee will comply and act immediately to terminate the employment of, remove from the facility or bar from entering the facility for any person it is deemed necessary while the Department considers granting or denying an exemption.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy Laureano	TELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2024

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: UNTITLED NO.1 SCHOOL	FACILITY NUMBER: 197493895
	VISIT DATE: 09/30/2024

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Capacity and limitations as specified on the license are being maintained during today’s inspections.

At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at offsite activities. Director’s Pediatric CPR and Pediatric First aid training was taken on 3/31/2023. LPA discussed the importance of making sure all Pediatric CPR and Pediatric First Aid training is EMSA approved.

LPAs reviewed 6 staff files and observed files to be complete with immunization records, mandated reporter training certificate and educational qualifications. LPAs reviewed a sample of children’s files and observed 10 files complete with immunization record and all necessary CCL documents. LPAs provided director with copies of the LIC 311A and LIC 125 to use as a reference when auditing files.

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. The person who signs the child in/out of the facility shall use their full legal signature and record the time of day. Facility uses an electronic sign in/out system; Brightwheel, online app. LPAs discussed the importance of ensuring the person who brings the child to , and removes the child from, the center shall sign in the child in/out. Director confirmed that hard copies of sign in/out sheets are available for LPA’s review.

All children are under supervision, including visual supervision, of a teacher at all times. Facility maintains a ratio of one teacher supervising no more than 12 children in care.

Facility representative 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.

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.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy Laureano	TELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2024

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: UNTITLED NO.1 SCHOOL	FACILITY NUMBER: 197493895
	VISIT DATE: 09/30/2024

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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/.

Facility representative Erika Membreno/Ziggy Luna was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them child care providers and Resource and Referral Agencies (R&Rs) throughout California.

No deficiencies were cited during today’s visit in accordance to the California Code of Regulations Title 22, Division 12, Chapter 1.

Upon on receipt of this report, the Director/Licensee shall post the Notice of Site Visit. The Notice of Site Visit shall be posted for 30 consecutive days. Failure to maintain posting as required, will result in an immediate $100 civil penalty.

An exit interview was conducted, and report was reviewed with Director Erika Membreno/Ziggy Luna.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy Laureano	TELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2024

LIC809 (FAS) - (06/04)

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