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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494348
Report Date: 11/21/2019
Date Signed: 11/21/2019 10:49:01 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:BRELLA PLAYA VISTA PRESCHOOLFACILITY NUMBER:
197494348
ADMINISTRATOR:MELANIE WOLFFFACILITY TYPE:
850
ADDRESS:12746 JEFFERSON BLVD, #3-3100TELEPHONE:
(213) 300-5962
CITY:PLAYA VISTASTATE: CAZIP CODE:
90068
CAPACITY:43CENSUS: 4DATE:
11/21/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:38 AM
MET WITH:Kathryn J. Mayer, DirectorTIME COMPLETED:
11:00 AM
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Licensing Program Analysts (LPAs) Shandra Powell, Silva Garibyan, and Keyona Scott conducted an announced case management inspection to the above facility. LPAs met with Director Kathyn Mayer. The facility has a Infant license attached (197494347) at the time of inspection 3 toddlers and 1 preschooler were present.

The purpose of the inspection was to follow-up on a waiver request to evaluate and take measurements of the outdoor park area named Randy Johnson Bluff Creek Children's Playground for facility to use in lieu of not having any outdoor play area located at the facility.

Director Kathryn Mayer explained what the outdoor route the children will take to the alternate outdoor play area. Department Representatives walked on Runway Road east towards Village Drive. Children will cross the street at Village Drive and Runway Road. There are two drive ways the children will cross on the route to the play area (Sea Spray Place and Sea Beach Place) There are two street lights the children will cross during the walk (Millenium Drive and Bluff Creek Drive). The Randy Johnson Bluff Creek Children's Playground is a public outdoor area approximately 1000 feet away from the facility and approximately 1350 feet away from the facility to the gated playground at the park where children will play. According to the Center Director, the children will only use the part of the park that is gated with age appropriate play structures (photos taken). The playground is equipped with appropriate cushioning and fall zones. There is a shaded area with a bench. There are four rest rooms with a sink and soap dispenser located at the park the playground to the restrooms is approximately 126 ft. Based on measurements taken the total outdoor square footage allows 77 children ( 2,709 sq. ft.)

The Department will further evaluate the facility request to use the alternate outdoor play area


There were no deficiencies cited during today's visit.
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Shandra PowellTELEPHONE: (323) 981-3383
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2019
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: BRELLA PLAYA VISTA PRESCHOOL
FACILITY NUMBER: 197494348
VISIT DATE: 11/21/2019
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The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit made by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Kathryn Mayer, Director, including, but not limited to Appeal Rights and Agency's consultative role.
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Shandra PowellTELEPHONE: (323) 981-3383
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2019
LIC809 (FAS) - (06/04)
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