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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494787
Report Date: 05/27/2021
Date Signed: 06/15/2021 12:38:36 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:HUNTLEY PRESCHOOL INCFACILITY NUMBER:
197494787
ADMINISTRATOR:ANGELA EILLSFACILITY TYPE:
850
ADDRESS:803 NORTH ALFRED STREETTELEPHONE:
(310) 721-1402
CITY:LOS ANGELESSTATE: CAZIP CODE:
90069
CAPACITY:20CENSUS: 19DATE:
05/27/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Angela Ellis/LicenseeTIME COMPLETED:
05:30 PM
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On 5/27/2021 at 3:00 pm, Licensing Program Analyst (LPA), Silva Garibyan made an announced visit to Huntley Preschool for the purpose of conducting a change of ownership ( from individual to profit corporation) pre-licensing visit. LPA Garibyan met with Licensee Angela Ellis. LPA Garibyan toured the facility. The applicant is requesting a Preschool license for a capacity of 20 children. Requested hours of operation are Monday - Friday 8:00 am - 6:00 pm. This is a facility housed in a single family residence structure that has been granted the appropriate permits to operate as a Child Care Center. The front gate has a coded entry. At the time of the visit there were 19 children present with the director and two teachers. The children have access to all of the facility with the exception of the staff restroom, storage area & office/kitchen.
An approved fire clearance was conducted by Fire Inspector Steve Porras from the LA City Fire Department Institutions Unit on 5/25/2021.
Indoor Measurements
Preschool classrooms are Play Room/Circle Room, Classroom #1 and Classroom #2.
Play Room/Circle Room: (10.5 x 11) + ( 14.1 x 21.6) = 115.5 + 304.56 = 420.06 sq. ft/35= 12 children
Classroom #1: (16.3 x 18) - ( 7.8 x 8.3 ) = 293.4 - 64.74 = 228.66 sq. ft/35 = 6 children
Classroom #2: 11.9 x 13.4 = 159.46 sq. ft/35 = 5 children
Total indoor measurement for preschool : 808.18 sq ft. / 35 = 23 preschool children

Outdoor measurement:

Back Yard: ( 39.1 x 48.9) - ( 12.9 x 19.8) - ( 19.8 x 22.9) = 1,911.99 - 255.42 - 453.42 = 1,203 .15 sq. ft/75 = 16 children
Front Yard: 18.8 x 50.7 = 953.16 sq.ft./75 = 12 children
Total outdoor measurement: 1,203.15 + 953.16 = 2,156.31 sq.ft/75 = 28 children
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SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Silva GaribyanTELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:

DATE: 05/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2021
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 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: HUNTLEY PRESCHOOL INC
FACILITY NUMBER: 197494787
VISIT DATE: 05/27/2021
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Restrooms:
The Classroom #2 was observed with one bathroom containing 2 toilets and 2 sinks. Bathroom calculations - 2 toilets = 1 toilet per 15 children for a total of 30 and 2 sinks = 1 sink per 15 children for a total of 30. There is a separate staff bathroom which will also be used by sick children.
Director's office will be used for isolation of ill children. Required postings were observed in classroom for public viewing. Parent / guardian sign in and out is at front of facility for all children to be signed in with original signature. Facility has a working phone land line available ( 323-782-0909).
Indoor Activity Space:
LPA Garibyan observed indoor activity space to have age appropriate furniture and toys in good repair, including tables, chairs, and cots.
The patio area was observed with cubby storage for the children's personal belongings. Two water dispensers were observed with disposable cups for drinking water.

Fire extinguisher was observed with an inspection date of 4/15/2021. Facility is equipped with smoke and Carbon monoxide detectors. 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.

All medications will be stored in the director's office and when needed in refrigerator located in director's office. Food Service:
The food preparation area was inspected for their equipment and protection against contamination. Disposal of food/debris were discussed. Per the director the children bring their lunches and the facility provides the morning and evening snack. Storage area was inspected for toxins/cleaning compounds inaccessibility.

Outdoor equipment was inspected for cushioning material, age appropriateness and good repair. LPA observed that the play yard is sloped heading toward a long fence which is latched and secure. There is a sand box with a wooden play structure and slide on the play yard. In the patio area there is a shaded area for children to rest, the area has tables and chairs, the front yard has picnic benches, wooden house club house, and tire swing. LPA also observed drinking water availability, and fencing were inspected. Play area was inspected for safety, potential hazards and accessibility to bodies of water. There were no bodies of water at time of visit.
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SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Silva GaribyanTELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:

DATE: 05/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2021
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: HUNTLEY PRESCHOOL INC
FACILITY NUMBER: 197494787
VISIT DATE: 05/27/2021
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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
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).

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SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Silva GaribyanTELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:

DATE: 05/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2021
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: HUNTLEY PRESCHOOL INC
FACILITY NUMBER: 197494787
VISIT DATE: 05/27/2021
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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.


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

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SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Silva GaribyanTELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:

DATE: 05/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2021
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: HUNTLEY PRESCHOOL INC
FACILITY NUMBER: 197494787
VISIT DATE: 05/27/2021
NARRATIVE
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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
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 90405 Page 5 of 6

SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Silva GaribyanTELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:

DATE: 05/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2021
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: HUNTLEY PRESCHOOL INC
FACILITY NUMBER: 197494787
VISIT DATE: 05/27/2021
NARRATIVE
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The following is required to continue the processing of the application for capacity of 60 children:

1) Final file review by LPA



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 RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Silva GaribyanTELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:

DATE: 05/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2021
LIC809 (FAS) - (06/04)
Page: 6 of 6