197494574-4-29-2021-30-CC-DLOE-C2JN3E-20210429100610

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494574
Report Date: 04/28/2021
Date Signed: 04/29/2021 10:06:43 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:	DEVONSHIRE PRESCHOOL		FACILITY NUMBER:	197494574
ADMINISTRATOR:	MERADITH GRABLE		FACILITY TYPE:	850
ADDRESS:	21203 DEVONSHIRE STREET		TELEPHONE:	(818) 700-2821
CITY:	CHATSWORTH	STATE: CA	ZIP CODE:	91311
CAPACITY:	60	CENSUS: 26	DATE:	04/28/2021
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	07:53 AM
MET WITH:	Marian Ratnayake		TIME COMPLETED:	08:40 AM

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 4/28/2021 at 7:53 am Licensing Program Analyst (LPA), Deborah Lowe and LPA Silva Garibyan met with Licensee Marian Ratnayake for a case management visit. LPA Lowe informed Licensee the purpose of the visit is to remeasure the facility and define the classroom numbers. LPA Lowe defined classroom space and room numbers with Licensee and LPA Garibyan measured the classrooms. The measurements are as follows: Preschool Indoor: Classroom #1 ( Blue Carpet) : 13 x 19.5 = 253.5 sq. ft Classroom #2: ( 18.5 x 17.5) + ( 30.5 x 10) - ( 4.9 x 8.5) - ( 2.8 x 2.6) = 579.82 sq. ft Classroom #3: ( 16.3 x 11.9) + ( 11 x 11.6) + ( 11.4 x 11.1) = 448.11 sq. ft. Classroom #4: ( 11.1 x 11.1) + ( 6.1 x 11.3) + ( 7.5 x 10.4) + ( 11.6 x 13) + ( 4.5 x 4.9) = 442.99 sq. ft. Classroom #5: 8.3 x 20 = 166 sq. ft. Classroom #6: 17 x 13.9 = 236. 3 sq. ft. Total indoor measurement for preschool : 2,126.2 sq ft. / 35 = 60 preschool children Classroom #1 LPA Lowe and LPA Garibyan observed to have 1 child table, full size copy machine, wooden bench, 1 table with 2 adult chairs, and 2 pieces of adult furniture. Room was not observed to be set up for child care. Classrooms # 5 & 6 were observed for COVID-19 waiver request to care for 10 school age children. Classroom #5 was observed to be set up for social distancing for 5 children. Classroom #6 was not set up for social distancing. Accessible bathroom for school age children is located in classroom #6. Bathroom was observed to be for single use, 1 toilet and 1 sink with a door for privacy. Page 1 of 2

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (434) 301-3069
LICENSING EVALUATOR NAME: Deborah Lowe	TELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2021

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 2

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: DEVONSHIRE PRESCHOOL	FACILITY NUMBER: 197494574
	VISIT DATE: 04/28/2021

NARRATIVE

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Outside space for school age children was observed through an exit door in classroom #6 to be a concrete area with tables and bench sitting for the children, and activity space.

LPA Lowe and LPA Garibyan advised Licensee of the following corrections:

* clean out classroom #1 and set up room up for child care, email picture to show completed
* label classrooms with room numbers, email picture to show completed
* amend facility sketch to show 6 designated classrooms, email amended facility sketch to show completed
* outside area off of classroom #6 clean the tables and sweep up debris
* classrooms vacuum carpeted areas

Advisory on regulation of bathroom usage for school age children:

101539 Fixtures, Furniture, Equipment and Supplies

(a) In addition to Section 101239, the following shall apply:

(b) Toilets used by school-age children shall provide individual privacy.

(1) Toilet facilities shall not be used simultaneously by children of both sexes.

Exit interview was conducted with Marian Ratnayake, Licensee over the phone on 4/28/2021.

Page 2 of 2

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (434) 301-3069
LICENSING EVALUATOR NAME: Deborah Lowe	TELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2021

LIC809 (FAS) - (06/04)

Page: 2 of 2