197494761-10-27-2021-30-CC-VWHY-C884TW-20211027192350

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494761
Report Date: 10/26/2021
Date Signed: 10/27/2021 07:24:01 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:	GOOD SHEPHERD CATHOLIC SCHOOL		FACILITY NUMBER:	197494761
ADMINISTRATOR:	KARIN JACOBSON		FACILITY TYPE:	840
ADDRESS:	148 S LINDEN DRIVE		TELEPHONE:	(310) 671-4400
CITY:	BEVERLY HILLS	STATE: CA	ZIP CODE:	90212
CAPACITY:	30	CENSUS: 0	DATE:	10/26/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Marlyn Alas		TIME COMPLETED:	04:30 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 met with applicant Marlyn Alas for the purpose of conducting a prelicensing inspection for a new license. The applicant is requesting a school aged license for 30 school aged children. The program is located on the premises of Good Shepherd Catholic School. The hours will be Monday through Thursday 3PM to 5:30PM and Friday 12:30PM to 5:30PM. This is an after school program. LPA Wheatley toured the entire premises indoors and outdoors. The facility has adequate lighting and ventilation. There is central heating and air conditioning inside of the classrooms. The parents will enter from the rear of the building into the campus. The children for Good Sports Plus Ltd program will already be on the premises. The parents are not allowed on the premises at this time due to Covid-19. The required signs will be posted for the parents to view. LPA observed age appropriate equipment and safe equipment inside of the classroom however the applicant states their children will not be utilizing the play equipment inside of the classroom. The children will work on their homework and enrichment. Obrayn Hall will be off limits and the door will remain closed and locked at all times. The program equipment will be stored in a cabinet inside of the Teacher's Lounge. There is a staff restroom inside of this lounge. LPA observed a sink, microwave and refrigerator. This lounge is off limits to children. LPA measured the Classroom #1 near the principal's office = 638 square feet. The total capacity for Classroom #1 is 18 capacity/children.

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Veronica Wheatley	TELEPHONE: (424) 301-3051
LICENSING EVALUATOR SIGNATURE:	DATE: 10/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2021

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: GOOD SHEPHERD CATHOLIC SCHOOL	FACILITY NUMBER: 197494761
	VISIT DATE: 10/26/2021

NARRATIVE

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LPA measured the outdoor area which is very large = 6,650 square feet = 89 capacity / children.
LPA observed several individual tables with umbrella coverings for shade and rest.
Drinking water will be provided outside for children to freely drink.

There are no bodies of water on the premises.

There are only two restrooms for the school aged children. The girls restroom is located near the outdoor area on the south end of the school and the entrance is covered. There are 9 toilets and 4 sinks.
Capacity = 60

The boys restroom is located upstairs. There are 5 toilets, 6 urinals and 4 sinks. Capacity = 60.

LPA Wheatley observed a covered area near the main office that will be used for isolation of an ill child.

The facility was inspected by the Los Angeles City Fire Department and granted a fire clearance. The facility is equipped with fire extinguishers. The staff will conduct fire drills and earthquake drills on a regular basis. The drills will be logged.

The equipment must be arrange to accommodate the children to be 3 feet apart according to Los Angeles County Public Health Department. The Covid-19 signs must be posted at the entrance for parent to view when dropping off and picking up their children. There must be face masks, cleaning supplies, disinfectant and a touch-less thermometer on the premises. There must be age appropriate toys outside for children to play individually due to Covid-19. The drinking fountains are made inaccessible and not used during this time.

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Veronica Wheatley	TELEPHONE: (424) 301-3051
LICENSING EVALUATOR SIGNATURE:	DATE: 10/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2021

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: GOOD SHEPHERD CATHOLIC SCHOOL	FACILITY NUMBER: 197494761
	VISIT DATE: 10/26/2021

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A license may be granted for 18 capacity/children when the following corrections are submitted:
1. Post Covid-19 signs at the entrance and hand sanitizer station.
2. Hand washing signs for all sinks.
3. Carbon monoxide detector.
4. Fire extinguisher.
5. Caddy with Covid-19 supplies (thermometer, masks, gloves, wipes, spray, hand sanitizer, etc.,
6. Emergency kits and emergency food.
7. Electrical outlets covered or inaccessible
8. First aid kit for classroom.
9. Paint or replace toilet seats
10. Sink #3 in boys restroom does not work, repair.
11. Bulletin Board for Covid-19 Signs for Parents to view

The applicant will complete the corrections within two weeks.

A copy of this report will be emailed to the applicant and a read response is required.

Exit interview.

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Veronica Wheatley	TELEPHONE: (424) 301-3051
LICENSING EVALUATOR SIGNATURE:	DATE: 10/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2021

LIC809 (FAS) - (06/04)

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