<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494317
Report Date: 01/28/2020
Date Signed: 01/28/2020 04:34:30 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:FUTURE STARS ACADEMYFACILITY NUMBER:
197494317
ADMINISTRATOR:OLSHANSKY, IRENEFACILITY TYPE:
830
ADDRESS:4946 W. 20TH STREETTELEPHONE:
(323) 938-5995
CITY:LOS ANGELESSTATE: CAZIP CODE:
90016
CAPACITY:8CENSUS: 0DATE:
01/28/2020
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Irene Olshansky/Marina OlshnaskyTIME COMPLETED:
05:00 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
1/28/2020 at 1:00pm Licensing Program Analyst (LPA’s) Dalicia Adkins, Jeanette Estrada, Claudia Escobedo and Antonio Almanza conducted an announced pre-licensing visit for the purpose of inspection of change of ownership/addition of infant program. LPA met with administrators/owners Irene Olshansky and Marina who guided LPA’s on a tour throughout the center. In accordance with California Code of Regulations , Title 22 , Division 12 Chaper 3, LPA’s conducted observation and evaluation of : PHYSICAL PLANT, ROOMS, POSTING REQUIREMENTS, INFANT EQUIPMENT, MEASUREMENT OF INDOOR AND OUTDOOR SPACE.

Applicant is applying for an infant program with requested capacity of 8 infants from 0-2 years old. Operation hours will be Monday - Friday from 6:30am to 6:00pm. Applicant is reconsidering the infant program and may remove it and will submit new application requesting older infants from 9 months to 2 years.

FUTURE STARS ACADEMY INFANT PROGRAM is located at 4946 W. 20th St. Los Angeles Ca 90016. This is one of the four facilities that will be located on premises under Ocean Sky-A California corporation. .Parent will enter the gated parking lot on 20th and drop off children at front door, parents will be given code to unlock front door. Sing and out sheet will be located in older preschool (2-5 years) room, building 4946. Parent will walk through this room, exit back door, down six steps and enter through attached gate. Another gate leads to infant center; will not be used and will remain locked. A code is required to open this gate. There is available gated parking on premises or available street parking in front of center (20th street).

PAGE 1

SUPERVISOR'S NAME: Victor BautistaTELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Dalicia AdkinsTELEPHONE: (424) 301-3064
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 5
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: FUTURE STARS ACADEMY
FACILITY NUMBER: 197494317
VISIT DATE: 01/28/2020
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
26
27
28
29
30
31
32
Infant room/nursery, bathrooms, kitchen and playground Inspected: all areas accessible to infants thoroughly inspected. Center observed to be safe, sanitary and in good repair. Infants will utilize the infant room and infant play yard located next to infant room. Entire area is utilized, no off limits area.

Required posting : Per director parent board will be posted on the wall to the right of the front door entrance. Per licensing these forms shall be posted : (facility license (LIC203) emergency disaster plan (LIC 610A) earthquake preparedness checklist (LIC 9148) notification of parents right (LIC 995), personal rights form (613A), Menu( one weed in advance) Child Passenger restraint system poster and valid facility license.

INFANT ROOM/NURSERY LPA observed infant furniture to be age/developmentally appropriate and in good repair. Toys are safe age/developmentally appropriate. Toys are free of small parts that could be pulled of and swallowed. Adequate storage for children belonging, 8 available cubbies. LPA did not observe any baby walkers, bouncers or jumpers, and are not permitted on premises.


Napping Equipment and Space: LPA observed 5 cots, 4 mats and 3 cribs. Mats and LPA’s observed separate storage space for children bedding and adequate storage for children’s personal belonging.

Indoor measure: measurement: 253.78/35 ft = 7 capacity (based on 1/28/20 measurement and current layout of 3 cribs )

Feeding/ feeding furniture: Feeding tables are study with broad legs and plastics seats (3) are in good repair. Per Director parents are responsible for bringing prepared formula in bottles. Food/bottle preparation area inaccessible, area adequately equipped, clean and free of hazards. LPA observed one seating table with 4 chairs. Operating clean refrigerator (38 degrees)/ freezer located in near prep area. Cleaning supplies stored separately and are inaccessible.

PAGE 2
SUPERVISOR'S NAME: Victor BautistaTELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Dalicia AdkinsTELEPHONE: (424) 301-3064
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2020
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: FUTURE STARS ACADEMY
FACILITY NUMBER: 197494317
VISIT DATE: 01/28/2020
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
26
27
28
29
30
31
32
DIAPER CHANGING/ AREA: LPA observed wooden changing table. Per director will pad the side and changing table with at least inch thick padding covered with washable vinyl or plastic. Sides at minimum 3 inches and sink within arm’s reach ( double sinks) . Parents will provide diapers and wipes, center will have wipes and diapers available for purchase if needed.

INFANT PLAY YARD: Outdoor play area is free from of debris, defects or dangerous conditions. Play equipment is securely anchored according to ground and area is has adequate resilient artificial grass material providing adequate cushioning underneath play equipment. LPA’s observed 1plastic tunnel, plastic block structure, one plastic rocker, and play cars. LPA’s observed trees which provided adequate shading and some shaded area provided some shade for preschool shaded area . Playground equipment is in good repair and is age/developmentally appropriate. Fence is at least four feet high and entire play area is gated. LPA’s observed one drinking water dispenser, 2 storage bins.

Outdoor measurement: 655.8= 8 capacity

Health Related Services: First aid bag with first aid supplies will be stored in floating cabinet on wall near changing table. Teachers will conduct a health check during morning drop off.

Incidental Medical Services Plan of Operation: Staff will be trained to administer inhaled medications and EpiPen’s.. Director or assigned staff will administer medication, provided that parents signed consent form, medication is labeled with instructions by physician , and parents train staff on how to administer medication. Medication shall be properly labeled and stored in original container.

PAGE 3

SUPERVISOR'S NAME: Victor BautistaTELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Dalicia AdkinsTELEPHONE: (424) 301-3064
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2020
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: FUTURE STARS ACADEMY
FACILITY NUMBER: 197494317
VISIT DATE: 01/28/2020
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
26
27
28
29
30
31
32
Exit interview conducted and the following topics discussed:
SIDS: New proposed Safe Sleep Regulations and Best Practices, link http://safetosleep.nih.gov
MANDATED REPORTING: must stay current and renew every two years, www.mandatedreportereporterca.com
IMS/ Americans with Disability Act (ADA): Disability rights laws prohibit child care providers from excluding children solely because they have a disability-related need for medication. As a child care provider you must have an individualized plan included in plan of operation submitted to the department.
Child Care Advocate Program: promotes the delivery of quality child care, link childcareadvocatesprogram@dss.ca.gov
CHILD CARE QUARTERLY NEWSLETTER: advised to sign up and provided, www.ccld.ca.gov
EFFECTS OF LEAD EXPOSURE: California Lead Poisoning Prevention Branch’s website at www.cdph.ca.gov/programs/clppb, or call (510) 620-5600.
PREVENTING SHAKEN BABY SYNDROME: find ways to cope with crying and understand long term effects of shaking an infant www.dontshake.org
UNUSUAL INCIDENT/INJURY REPORTING: A report shall be made to the department by telephone or fax during the department’s normal business hours before the close of the next working day (1) following the occurrence during the operation of Family Day Care Home of the event. Health and Safety Code Section 1597.467(b)(2). In addition to verbal or fax report ,a written report shall be submitted to the department within seven (7) days. LIC 924 www.ccld.ca.gov
PAGE 4
SUPERVISOR'S NAME: Victor BautistaTELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Dalicia AdkinsTELEPHONE: (424) 301-3064
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2020
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: FUTURE STARS ACADEMY
FACILITY NUMBER: 197494317
VISIT DATE: 01/28/2020
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
26
27
28
29
30
31
32
Topics Discussed:
Cot storage
Cover entire changing service with padding and shall be attached/mounted to the wall
Diaper Genie
Provide LPA informational printout describing berries on tree in the play yard
Bathroom toileting program
Isolation area for ill children
Where medication will be stored
cover metal 3 seater with cushion and pad corners

PAGE 5
SUPERVISOR'S NAME: Victor BautistaTELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Dalicia AdkinsTELEPHONE: (424) 301-3064
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2020
LIC809 (FAS) - (06/04)
Page: 5 of 5