197493925-7-19-2019-30-CC-PFLS-BE8MYS-20190719100200

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197493925
Report Date: 07/19/2019
Date Signed: 07/19/2019 10:02:07 AM

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:	CCRC HEAD START - LOKRANTZ		FACILITY NUMBER:	197493925
ADMINISTRATOR:	MARINE KARAQULYAN		FACILITY TYPE:	850
ADDRESS:	19451 WYANDOTTE STREET		TELEPHONE:	(818) 717-1000
CITY:	RESEDA	STATE: CA	ZIP CODE:	91335
CAPACITY:	17	CENSUS: 0	DATE:	07/19/2019
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Shawntel Williams - Early Learning Supervisor		TIME COMPLETED:	10:15 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	Licensing Program Analyst (LPA), Peter Flores conducted an announced Pre-Licensing Inspection for increase of capacity. LPA Flores met with Shawntel Williams, Early Learning Supervisor, who guided LPA Flores on a tour of the facility inside and outside. The facility was previously measured and granted a capacity of 17. The previous measurements for the classroom accommodates 20 Children. The play yard accommodates 156 children. The facility will operate Monday through Friday, from 7:00 AM to 6:00 PM, serving children from 2 years old to entry to kindergarten. The following measurements were observed during the inspection: The preschool program will be conducted out of Room 21 and 22: Room 21: 22 x 32.3 = 710.6 '/. 35 = 20.3 (20 children) - Previously measured on 08-09-18 Room 22: 32 x 23.2 = 742.4 '/. 35 = 21.1 (21 children) TOTAL INDOOR CAPACITY: 41 preschoolers Pre-School Play yard: 139.4 x 84.3 = 11,751.42 / 75 = 156.68 (156 Children) - Previously measured on 08-09-18 TOTAL OUTDOOR CAPACITY: 156 preschoolers

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Peter Flores	TELEPHONE: (424) 301-3063
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2019

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: CCRC HEAD START - LOKRANTZ	FACILITY NUMBER: 197493925
	VISIT DATE: 07/19/2019

NARRATIVE

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The following toilets and sinks were observed during the inspection:
4 sinks and 6 toilets. There is enough sinks and toilets for the requested capacity of 40.

Total indoor and outdoor capacity is observed to accommodate 49 preschool children. Fire Department granted a capacity of 40 on 07/02/2019.

At this time the facility does not provide Incidental Medical Services. (IMS)

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (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

Incidental Medical Services Include: Blood-Glucose Monitoring for Diabetic Children, Administering Inhaled Medication, Administering EpiPen Jr. and EpiPen or other Epinephrine Auto-Injectors, Glucagon Administration, Gastrostomy Tube Care (G-tube care), Insulin Injections Administration, Anti-Seizure Administration, and Carrying out medical orders when the child’s physician has determined that a layperson can be trained and safely carry out the orders.

The capacity requested for Capacity of 40 will be granted.

An exit interview was conducted an a copy of this report was given to Shawntel Williams, Early Learning Supervisor

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Peter Flores	TELEPHONE: (424) 301-3063
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2019

LIC809 (FAS) - (06/04)

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