197494434-2-18-2020-30-CC-VWHY-BLWRTJ-20200218121824

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494434
Report Date: 02/14/2020
Date Signed: 02/18/2020 12:18:32 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:	BLOOM PRESCHOOL		FACILITY NUMBER:	197494434
ADMINISTRATOR:	PIPER, KAWAILANI		FACILITY TYPE:	850
ADDRESS:	13560 HAWTHORNE BLVD		TELEPHONE:	(310) 908-4551
CITY:	HAWTHORNE	STATE: CA	ZIP CODE:	90250
CAPACITY:	30	CENSUS: 0	DATE:	02/14/2020
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Kawailani Piper		TIME COMPLETED:	12:45 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	Licensing Program Analyst (LPA), V. Wheatley conducted a prelicensing inspection for a new license. LPA met with the applicant Ms. Piper at 9:20am. The applicant is requesting 30 capacity. LPA toured and inspected the facility according to the facility sketch. The child care center is located on the premises of Calvary Presbyterian Church. The church is off limits and the preschool has its own area. The applicant has a lease agreement and will be the director. LPA inspected a total of two classrooms. Furniture and equipment were inspected for age appropriateness and good repair. LPA observed age appropriate toys and educational materials. The telephone service, heating, lighting, and ventilation is adequate. The classrooms have screened wall heaters. The heater in Classroom 2 does not work. There are portable air conditioners. The electrical outlets are inaccessible. LPA observed cubbies for children's belongings and first aid kit. LPA observed trash bins with lids and drinking water in every classroom. LPA observed mats for napping. The bedding will be supplied and laundered by staff. The staff understand the bedding cannot touch another child's bedding. LPA inspected a food preparation area inside of Classroom #3 which is equipped with a refrigerator and a sink. The staff will serve two snacks from two food groups. LPA observed snack menus posted. The juice served will be 100% and milk 1%. LPA also observed a full kitchen that is available to cook food in the future. The church does not allow any storing of preschool food or materials. There will be additional food on the premises for emergencies. The food allergies will be posted in the classroom and in the kitchen. The detergents and chemicals will remain separate from the food.

SUPERVISOR'S NAME: Sharalyn Jenkins-Sweeten	TELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Veronica Wheatley	TELEPHONE: (424) 301-3051
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2020

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: BLOOM PRESCHOOL	FACILITY NUMBER: 197494434
	VISIT DATE: 02/14/2020

NARRATIVE

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Classroom Measurements:

Classroom 2 (middle classroom) = 8 capacity
Classroom 3 (near the hallway to the restrooms) 16 = capacity
Total Capacity = 24

Outdoor equipment was inspected for health, safety, cushioning material, good material, good repair and age appropriateness. LPA observed an age appropriate play structure with three slides. There is a round garden and a vegetable garden. The children will ride the bikes around this area in one direction. No running allowed in this area. LPA observed a patio for shade and chairs for rest. Drinking water will be brought outside for children to freely drink. There are no bodies of water on the premises.

Outdoor Play Area Measurement
Playground measured sq. ft = 32 capacity

LPA observed one restroom for children with 3 toilets and 2 sinks. There is one sink in Classroom 3 which equals 3 sinks total.
Total capacity for toilets and sinks =45 capacity

LPA discussed supervision, ratios, educational requirements, earthquake/fire drill emergency procedures, discipline policies, adult immunization's and mandatory training for mandated reporters. The staff will use the men's restroom in building near the kitchen. The parent board has all of the required documents posted. The applicant/director has health and safety/CPR/first aid which expires September 2021.

SUPERVISOR'S NAME: Sharalyn Jenkins-Sweeten	TELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Veronica Wheatley	TELEPHONE: (424) 301-3051
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2020

LIC809 (FAS) - (06/04)

Page: 3 of 3

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: BLOOM PRESCHOOL	FACILITY NUMBER: 197494434
	VISIT DATE: 02/14/2020

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The applicant will submit a plan of operation for Incidental Medical Services when required.
IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A 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, at http://www.ada.gov/childqanda.htm

A fire department clearance has been approved and received.

A license will be granted for 24 capacity when the following corrections are submitted.

1. Heater in Classroom #2 repaired and proof of operation
2. Bell for door in Classroom #2 for alarm
3. Cover 6 poles on the playground with safe material
4. Signs on the first restroom for children and other for staff
5. Child proof gate at the entrance of hallway and bottom of stairs
6. Make the white headboard inside the classroom secure and safe
7. Sample menu
8. Update the Parents Handbook
9. Update the Staff / Personnel Handbook
10. Update the Emergency Disaster Plan
11. Submit director qualifications & Mandated Reporter Training

Exit interview. A copy of the report was provided.

SUPERVISOR'S NAME: Sharalyn Jenkins-Sweeten	TELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Veronica Wheatley	TELEPHONE: (424) 301-3051
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2020

LIC809 (FAS) - (06/04)

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