197494312-8-7-2019-30-CC-HESA-BETR47-20190807124104

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494312
Report Date: 08/07/2019
Date Signed: 08/07/2019 12:41:19 PM

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:	MANHATTAN COUNTRY CLUB PRESCHOOL		FACILITY NUMBER:	197494312
ADMINISTRATOR:	PAKZAD, CHRISTINA		FACILITY TYPE:	850
ADDRESS:	1330 PARKVIEW AVE		TELEPHONE:	(310) 698-1844
CITY:	MANHATTAN BEACH	STATE: CA	ZIP CODE:	90266
CAPACITY:	8	CENSUS: 0	DATE:	08/07/2019
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Rose Colette - Regional Family Director		TIME COMPLETED:	01:00 PM

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	On 8/7/19, Licensing Program Analyst (LPA) Helen Estrella arrived at 1330 Parkview Ave, Manhattan Beach CA 90266 and met with Regional Family Director Rose Colette for the purpose of a pre-licensing inspection. The facility is housed at Bay Club - Manhattan Beach Country Club. The facility is requesting a capacity of 43 preschool children from ages two to five years. The program will operate Monday to Friday from 9:00 AM to 12:30 PM. The facility was granted a fire clearance from Manhattan Beach Fire Department on 7/25/19. The facility will be utilizing classroom #1 and #2 located upstairs next to the ballroom. The facility was observed with age appropriate chairs, tables, and children's equipment. Since the program will operate half-day only on a daily basis, children will not be napping. However, the facility does have a mat and bed linens should a child become restless and/or ill prior to the 12:30 PM pick up. The outdoor space that is being utilized is "Court 12" that is adjacent to additional tennis courts and eating area. Isolation are will be in Director's office down the hall. Access to the Facility Parents will park in the parking space provided by the property. Parents will enter through the front of the property to get to the entrance of the building and classrooms that are located upstairs. Sign in and sign out Applicant to ensure that the authorized person who signs the child in/out shall use his/her full legal signature and shall record the time of day. The main sign in/out will be inside the classroom.

SUPERVISOR'S NAME: Jennie Ferreira	TELEPHONE: (424) 301-3073
LICENSING EVALUATOR NAME: Helen Estrella	TELEPHONE: (424) 301-3073
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2019

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: MANHATTAN COUNTRY CLUB PRESCHOOL	FACILITY NUMBER: 197494312
	VISIT DATE: 08/07/2019

NARRATIVE

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The following was discussed with the applicant:
Update on Incidental Medical Services: Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing 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 Emptying an Ileostomy Bag.

All adults employed and/or assisting with childcare and working in facility must be fingerprinted and cleared prior to entering/working at the facility. The applicant was informed that the presence of adults in the center without Criminal Record Clearance or Exemption will be cited and civil penalty assessed for $100 per day. The applicant may find additional information and forms on the DSS website at www.ccld.ca.gov including information on the Live Scan application (LIC 9163). Appointments can be made for Live Scan at 1-800-315-4507.

Licensee was made aware of The Child Care Advocate Program (CCAP) that is administered from within the Community Care Licensing Division. CCAP participates in many community activities and special projects in order to disseminate information on the State’s licensing role, provide information to the public and parents on child care licensing, and provide many other helpful resources to the licensees and the public. CCAP’s direct contact information: (916) 654-1541 Email Address: childcareadvocatesprogram@dss.ca.gov

Senate Bill 792: Commencing September 1, 2016, SB 792, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles. LPA discussed the influenza waiver during the inspection.

SUPERVISOR'S NAME: Jennie Ferreira	TELEPHONE: (424) 301-3073
LICENSING EVALUATOR NAME: Helen Estrella	TELEPHONE: (424) 301-3073
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2019

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: MANHATTAN COUNTRY CLUB PRESCHOOL	FACILITY NUMBER: 197494312
	VISIT DATE: 08/07/2019

NARRATIVE

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Employee/Volunteer Files shall also be maintained and shall contain the following: Health Screening Report - Facility Personnel (LIC 503) and TB Clearance, Proof of Immunizations, Mandated Reporter Training Certificate of Completion, TB Clearance and "Good Health" statement from volunteers, Personnel Record (LIC 501) or application/resume, Evaluation of Director Qualifications (LIC 9096), Evaluation of Teacher Qualifications (LIC 9095).

For each aide under age 18, verification of high school graduation or current participation in an occupational program conducted by an accredited high school or college. Criminal Record Statement (LIC 508) for staff subject to fingerprint requirements. Fingerprint clearances - Proof of clearance (Criminal Record, FBI and Child Abuse).

Licensee shall maintain Administrative Records which shall have the following:
Administrative Records: Written inspection procedures for accepting children on a daily basis, Sign-out sheets kept for current 30 days; or to use of electronic pin system. Admission policies, including admission criteria, ages of children who will be accepted; medical assessment requirements; program activities, supplemental services, if any; field trip provisions, transportation arrangements, food service, if any.

Designation of Facility Responsibility (LIC 308), Personnel Report (LIC 500) showing current roster, Licensee affidavit regarding persons exempt from fingerprint requirements (Use back of LIC 500), Emergency Disaster Plan (LIC 610) (a posting requirement; see below) with verification that disaster drills are conducted every month. Documentation of drills shall be maintained for at least one year. Up-to-date list of qualified teacher substitutes, Documentation of exceptions and waivers (if any): Facility Waiver Request (LIC 956) and Exception/Exemption Request (LIC 971), Annual licensing reports and substantiated complaints from the last three years (must be available at the center for public review). and a Child Care Facility Roster (LIC 9040).

Based on today's inspection the facility shall be recommended for licensure pending submission of facility's administrative documents and management review. An exit interview was conducted and a copy of this report was provided to Rose Colette.

SUPERVISOR'S NAME: Jennie Ferreira	TELEPHONE: (424) 301-3073
LICENSING EVALUATOR NAME: Helen Estrella	TELEPHONE: (424) 301-3073
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2019

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: MANHATTAN COUNTRY CLUB PRESCHOOL	FACILITY NUMBER: 197494312
	VISIT DATE: 08/07/2019

NARRATIVE

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New Immunization Requirement: Law enacted by SB 277, beginning January 1, 2016, personal beliefs exemptions will no longer be an option for the vaccines that are currently required for entry into child care or school in California. Personal beliefs exemptions already on file will remain valid until the child reaches the next immunization checkpoint.

Mandated Reporter: Beginning on January 1, 2018, AB 1207, requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. The OCAP modules are free of cost and available at: http://www.mandatedreporterca.com/.

The applicant was informed Fire/Disaster drills are to be conducted once every month and log must be kept. Applicant also informed children records and facility roster must be kept for 3 years and advised all public reports must be kept for review. Forms and Regulations available at: www.ccld.ca.gov.

The applicant was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hot line at 1-800-540-4000. Applicant was informed to call the Community Care Licensing office within 24 hours of the Unusual Incident and follow up with a written Unusual Incident/Injury Report (LIC 624B) within 7 business days.

Licensee shall have the following posted in the Child Care Center at all times: Facility license, Personal Rights form (LIC 613A), Cafe Menu/Snacks for parents view option to purchase, Child passenger restraint system poster (PUB 269), Daily activity schedule, Emergency Disaster Plan (LIC 610) and Earthquake Preparedness Checklist (LIC 9148), Parent’s Rights Poster (PUB 393), Notice of Site Visit (LIC 9213), and any licensing report documenting a type”A” citation must be posted for 30 days. Any licensing report or other document verifying compliance or non-compliance with the Department’s order to correct a Type A deficiency must be posted for 30 days.

SUPERVISOR'S NAME: Jennie Ferreira	TELEPHONE: (424) 301-3073
LICENSING EVALUATOR NAME: Helen Estrella	TELEPHONE: (424) 301-3073
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2019

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: MANHATTAN COUNTRY CLUB PRESCHOOL	FACILITY NUMBER: 197494312
	VISIT DATE: 08/07/2019

NARRATIVE

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Indoor Activity Space
Based on the measurements obtained, the indoor space allows the requested capacity of 56 children. LPA observed furniture and equipment to be in good condition, free of sharp, loose, or pointed parts. Children’s bathrooms are located in classrooms #1, #2 and down the hall. There are a total of (3) toilets and (3) sinks, which is sufficient for the capacity requested. There is dispensable soap and paper towels in each bathroom. The staff bathroom is located on the opposite side of the children's classrooms. The Isolation area is in the Director's office down the hall. Overhead lighting provides the majority of the light in each classroom, but sunlight comes through the windows. There are storage hooks in the entrance of the classroom for all children's belongings. LPA observed drinking water available for the children as well (inside and outside).

Outdoor Activity Space
Based on the measurements obtained, the outdoor space allows the requested capacity of 74 children. The facility will utilize an enclosed tennis court that is not actively in use (paddle tennis). The applicant states will use this area with mobile equipment and remove the tennis mesh when children are utilizing this space. The play equipment is stored in storage area adjacent to court when not in use. The surface of the outdoor activity space is maintained in safe conditions and free of hazards. All areas appear to have cushioning material to absorb a fall. There is drinking water available in the court area.

Medication/First Aid Kits/Snacks
The applicant states the facility will not be administering medication to children and will be sent to the Director's office for parent's to be contacted. At this time, the facility does not provide Incidental Medical Services (IMS). Applicant was advised that children should be screened every day for illness and/or unusual marks. First Aid supplies are stored in the each classroom and in the general adult areas. The children will bring a lunch and the parents, if they choose, have the option to order a lunch from the facility restaurant. The facility will post the list of children with food allergies as required. The classroom observed with a mini refrigerator and microwave. The Center will administer medicine only when specific instructions are provided by a medical professional. All food/snacks shall be protected against contamination, advised to always place open food items in zip lock bags or plastic containers. LPA observed all storage containers for solid waste, it was advised that moveable bins have tight-fitting covers and that they are kept on, and in good repair. LPA observed all areas that are accessible to the children were toxic free and applicant was advised to take measures to keep the facility free of flies, other insects and rodents. The facility is to maintain a medical log. The facility will administer an epi-pen and asthma inhaler as required. The Director shall ensure that staff are properly trained.

SUPERVISOR'S NAME: Jennie Ferreira	TELEPHONE: (424) 301-3073
LICENSING EVALUATOR NAME: Helen Estrella	TELEPHONE: (424) 301-3073
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2019

LIC809 (FAS) - (06/04)

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