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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494348
Report Date: 07/07/2021
Date Signed: 07/07/2021 03:36:57 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:BRELLA PLAYA VISTA PRESCHOOLFACILITY NUMBER:
197494348
ADMINISTRATOR:KENNER RAKOVFACILITY TYPE:
850
ADDRESS:12746 W JESFFERSON BL. #3-3100TELEPHONE:
(213) 300-5962
CITY:PLAYA VISTASTATE: CAZIP CODE:
90094
CAPACITY:43CENSUS: 52DATE:
07/07/2021
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
07:35 AM
MET WITH:Melanie Wolff, Co-OwnerTIME COMPLETED:
03:40 PM
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On 7/07/2021 at 7:30 am, Licensing Program Analysts (LPA), Deborah Lowe and LPA Claudia Escobedo made an announced visit to Brella Playa Vista for the purpose of conducting a pre-licensing visit for a capacity increase. LPA Lowe and LPA Escobedo met with Owner Melanie Wolff. LPA Lowe and LPA Escobedo toured the facility. The facility is requesting an increase to the preschool license with toddler option for a capacity of 66 children from current capacity of 44 preschool children.
Co-Owner Darien Williams and Director Kenner Rakoz were present at facility for visit.

An approved fire clearance was conducted with the Los Angeles City Fire Department on 5/25/2021.

Indoor Measurements
Rooms Facility is requesting to add to their license are rooms 1 and rooms 6.

Room 1 (29.83 x 26.92) = 803.02 encumbered space (2.05 x 3.83) 7.85, 803.02 - 7.85= 795.17

Room 6 (21.33 x 32) = 682.56

During visit Co-Owner Melanie Wolff requested to change the designated toddler room. Facility requesting to switch the toddlers from room 2 (previously titled Creative Room) with the preschool room 4 (previously titled library).

Room 4 (26.92 x 14.25) = 383.61
Room 2 (21.5 x 8.33) = 179.10, (14.58 x 22.42) = 326.88 179.10 + 326.88 = 505.98

Total indoor measurements 795.17 + 682.56 + 383.61 + 505.98 = 2,367.32 divided by 35 sq feet = 67
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SUPERVISOR'S NAME: Karren StarksTELEPHONE: (434) 301-3069
LICENSING EVALUATOR NAME: Deborah LoweTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2021
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 6
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: 07/07/2021
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Outdoor Measurement of Garden

(47.17 x 5.42) = 255.661, (12.25 x 13.67) = 83.729, (11 x 11.58) = 127.38, (3.58 x 9.58) = 34.296, (9.33 x 1.25) = 11.662, (9.33 x 1.50) = 13.995, (6.50 x 10.25) = 66.625, (8.33 x 10.25) = 85.382

Total outdoor measurement of garden = 678.73 divided by 75 sq feet = 9 children.

Indoor Play Space Measurement

Indoor play space has a retractable room partition with room 6. Retractable room door will need to remain closed during hours of operation for room 6 to remain independent from from play space.

(30.83 x 32) = 986.56 divided by 60 sq feet = 16 children

Based on previously approved waiver for indoor activity space the space is measured at 60 square feet per child.

Art Studio

During visit Owner stated facility would like to use room 3 (art studio) as a shared activity space for art and science activities not as a preschool classroom.

(19.50 x 21.50) = 419.25 divided by 35 sq feet = 11 children

Toddler and preschool children may not commingle in the shared space, room usage schedule should be placed on door.

Restrooms:


Two restrooms were observed. Restroom in play space area was observed to have 4 toilets and trough style sink with 4 faucets, changing table was also observed. Restroom in room 6 was observed to have 1 toilet, 1 sink. Bathroom calculations require 1 toilet per 15 children, facility has 5 toilets therefore facility can accommodate 75 children. Sink calculation requires 1 sink per 15 children, facility has 5 sinks therefore facility can accommodate 75 children.
Indoor activity space
LPA Lowe and LPA Escobedo observed indoor activity space to have age appropriate furniture and toys in good repair, including tables, and chairs. Page 2 of 6
SUPERVISOR'S NAME: Karren StarksTELEPHONE: (434) 301-3069
LICENSING EVALUATOR NAME: Deborah LoweTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2021
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: 07/07/2021
NARRATIVE
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Fire extinguisher was observed with a service date of 9/12/2019. Facility is equipped with a sprinkler system and fire alarm system. Carbon monoxide and smoke detectors were not observed in facility, Facility stated they have an integrated fire system that includes carbon monoxide and smoke detectors. Facility has central heating and air. First aid kits are stored in each classroom.

Directors office will be used for isolation of ill children. Required postings were observed in front lobby for public viewing. Facility is using an electronic sign in / out program. Parent / guardian sign in using an app called Brightwheel. Facility has a working phone land line available.
Medications are stored in classroom upper cabinet inaccessible to children.

Food Service:
Children will bring their own lunch from home and facility will provide prepackaged food parents may purchase if home lunch is not brought. Refrigerator was observed in hallway along with cabinets storage. Refrigerator was observed to be clean and in good working order. Water is provided with the use of a filtered water system, staff fill water pictures and take to classrooms.

Napping
Children nap in their classrooms. Napping cribs were observed to be vinyl material. Owner stated cots are disinfected daily. Facility provides sheets for cots, Owner stated sheets are cleaned daily.

The following was discussed with the applicant:

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.html.

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SUPERVISOR'S NAME: Karren StarksTELEPHONE: (434) 301-3069
LICENSING EVALUATOR NAME: Deborah LoweTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2021
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: 07/07/2021
NARRATIVE
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Required Postings/Licensee shall have posted in the Child Care Center at all times the following:
Facility license.
Personal Rights form (LIC 613A).
Menus.
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).
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.

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
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).
Appropriate driver's license for person(s) transporting children.

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.
Website: www.mandatedreporterca.com
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SUPERVISOR'S NAME: Karren StarksTELEPHONE: (434) 301-3069
LICENSING EVALUATOR NAME: Deborah LoweTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2021
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: 07/07/2021
NARRATIVE
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Senate Bill (SB) 792: This bill, commencing September 1, 2016, 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.

Senate Bill (SB) 277 New Immunization Requirement: 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.

SIDS & SHAKEN BABY SYNDROME INFORMATION: LPA discussed safe sleep for infants with applicant: Infants must be placed on their backs and must be physically checked every 15 minutes to gauge temperature and ensure they are breathing. Applicant reviewed both items provided and understands the guidance of safe sleep practices. LPA discussed flyer given today (Never Shake a Baby) Applicant reviewed flyer and understands the preventive practices of shaken baby syndrome and abusive head trauma.



Safe Sleep Links:
AAP: https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/A-Parents-Guide-to-Safe-Sleep.aspx
NIH: https://safetosleep.nichd.nih.gov/safesleepbasics/environment/room/text_alternative

Safe to Sleep Campaign: https://safetosleep.nichd.nih.gov/materials

Licensee shall maintain Administrative Records which shall have the following:


Administrative Records
Written inspection procedures for accepting children on a daily basis.
Sign-in/sign-out sheets kept for current 30 days, or approved waiver to use 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.
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SUPERVISOR'S NAME: Karren StarksTELEPHONE: (434) 301-3069
LICENSING EVALUATOR NAME: Deborah LoweTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2021
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: 07/07/2021
NARRATIVE
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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 six months. Documentation of drills shall be maintained for at least one year.Up-to-date list of qualified teacher substitutes.
Documentation of exceptions and waivers: 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).

The applicant was informed 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 is as followed: Phone number: (916) 654-1541.
Email Address: childcareadvocatesprogram@dss.ca.gov

Appeal Process: A licensee may file an appeal, in writing 15 business days from the date of receiving the penalty assessment. All appeals must be sent to:

California Department of Social Services | Community Care Licensing Division 300 N. Continental Blvd. Suite, 290-A El Segundo, CA 90245

The following corrections are needed before a capacity increase will be considered:

1. Review of requested outdoor space and indoor activity space waivers

2. Service fire extinguisher

3. Verify that carbon monoxide and smoke detectors are installed at facility.

Exit interview conducted Exit interview was conducted with Melanie Wolff, Co-Owner, Darien Williams, Co-Owner and Kenner Rakoz, Director. Page 6 of 6

SUPERVISOR'S NAME: Karren StarksTELEPHONE: (434) 301-3069
LICENSING EVALUATOR NAME: Deborah LoweTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2021
LIC809 (FAS) - (06/04)
Page: 6 of 6