197494728-8-5-2021-30-CC-SGAN-C5LTJH-20210805144621

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494728
Report Date: 06/25/2021
Date Signed: 08/05/2021 02:46:33 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:	BUMO - CENTURY CITY		FACILITY NUMBER:	197494728
ADMINISTRATOR:	NGUYEN, JOAN		FACILITY TYPE:	830
ADDRESS:	10250 SANTA MONICA BLVD #2860		TELEPHONE:	(424) 500-8556
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90012
CAPACITY:	12	CENSUS: 0	DATE:	06/25/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Kristine Manley/Director		TIME COMPLETED:	02:00 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	On 6/25/2021 at 10:00 am, Licensing Program Analyst (LPA), Silva Garibyan made an announced visit to Bumo-Century City for the purpose of conducting a pre-licensing visit. LPA Garibyan met with director Kristine Manley and assistant director Haley Blair. The facility is located on the second floor of Westfield Century City Shopping Mall. LPA Garibyan toured the facility. The applicant is requesting an Infant license for a capacity of 12 children. Requested hours of operation Sunday-Wednesday 9:00 AM - 6:00 PM, Thursday 9:00 AM - 9:00 PM, Friday-Saturday 9:00 AM-10 PM. An approved fire clearance was conducted by Fire Inspector Herbert Reddick from the LA City Fire Department Institution Unit on 6/24/2021. Indoor Measurements: (17.7 x 21.9) + (5.9 x 8.9) - ( 1.5 x 2) = 437.14sq.ft/35 = 12 infants Outdoor measurement: 17.5 x 25 = 437.5 sq.ft/75 = 6 children The outdoor play area is located directly across from the Bumo entrance and is enclosed behind 4 foot wooden fencing with a locked and coded gate. The children will be escorted to the outdoor area by a minimum of two staff members. The storefront is comprised of floor to ceiling windows leaving a clear view of the outdoor play area from the lobby and workspace. Page 1 of 6

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Silva Garibyan	TELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:	DATE: 06/25/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2021

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: BUMO - CENTURY CITY	FACILITY NUMBER: 197494728
	VISIT DATE: 06/25/2021

NARRATIVE

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The crib room contains 7 cribs. The classroom contains a changing table within arms reach of a sink. There is a refrigerator for Infant milk and meal storage. Crib bedding will be washed by the center daily. Labels will identify each child's crib.
Parents will provide lunch, snack, baby food or milk for infants enrolled in this program. First aid supplies are available in all classrooms.

Facility is equipped with a sprinkler system and fire alarm system. Fire Extinguishers and Carbon monoxide detectors were observed in all classrooms. Facility has central heating and air. Trash cans were observed with appropriate lids. First aid kits were observed to have: bandages, adhesive tape, scissors, tweezers, and antiseptic solution.

A separate isolation room and bathroom will be used for isolation of ill children. Required postings were observed in the hall way for public viewing. Facility has a working phone land line available ( 909-648-6954).

The facility will use the education platform, ProCare by Kinderlime, for signing children in and out. The parents will be assigned a 4 digit PIN code that will be used to drop-off and/or pick-up children. In addition, a signature will be required each time , using the iPad kiosk located at the front desk.

Director understands that Infant teachers must have Infant/toddler units. Minimum staffing ratios are 1 teacher to every 4 infants. 1 teacher and 1 aide may supervise up to 8 infants.

Applicant is also aware of Infants Needs and Services Plans and the requirement to conduct meetings as needed with infant families to update the Needs and Services Plans. Logs will be kept in the classroom for staff to document Infant feedings and diaper changes. Page 2 of 6

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Silva Garibyan	TELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:	DATE: 06/25/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2021

LIC809 (FAS) - (06/04)

Page: 2 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: BUMO - CENTURY CITY	FACILITY NUMBER: 197494728
	VISIT DATE: 06/25/2021

NARRATIVE

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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.

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 Immunization's
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SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Silva Garibyan	TELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:	DATE: 06/25/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2021

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: BUMO - CENTURY CITY	FACILITY NUMBER: 197494728
	VISIT DATE: 06/25/2021

NARRATIVE

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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

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. Page 4 of 6

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Silva Garibyan	TELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:	DATE: 06/25/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2021

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: BUMO - CENTURY CITY	FACILITY NUMBER: 197494728
	VISIT DATE: 06/25/2021

NARRATIVE

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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.
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
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SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Silva Garibyan	TELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:	DATE: 06/25/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2021

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: BUMO - CENTURY CITY	FACILITY NUMBER: 197494728
	VISIT DATE: 06/25/2021

NARRATIVE

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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 items are pending prior to licensure to be completed by:

Waiver request to allow infants and preschoolers to share the outdoor play area on a scheduled basis and to allow preschoolers and infants to use the outdoor play area on a staggered outdoor schedule.

A copy of this report will be electronically mailed to the applicant for review and signature

A read receipt shall confirm as receipt of the electronically delivered report.

Applicant shall print and sign the report and mail the report to the licensing office, with an original signature.

If there are any questions or concerns, please contact the department at (424) 301-3077

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SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Silva Garibyan	TELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:	DATE: 06/25/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2021

LIC809 (FAS) - (06/04)

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