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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494865
Report Date: 07/16/2021
Date Signed: 07/16/2021 01:17:50 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:WISEBURN PRESCHOOL ENRICHMENTFACILITY NUMBER:
197494865
ADMINISTRATOR:KAREN CHAPKHANEHFACILITY TYPE:
850
ADDRESS:12501 ISIS AVENUETELEPHONE:
(310) 748-8834
CITY:HAWTHORNESTATE: CAZIP CODE:
90250
CAPACITY:156CENSUS: 0DATE:
07/16/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Karen Chapkhaneh - Site SupervisorTIME COMPLETED:
01:30 PM
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On 07/16/2021 at 8:00 a.m. Licensing Program Analysts (LPA) Deborah Lowe and Claudia Escobedo met with Site Supervisor - Karen Chapkhaneh. The purpose of the visit was an announced pre-licensing inspection at the facility to ensure that health, safety and personal rights as required by Title 22 and Health and Safety Regulations governing California Child Care Centers will be met. No children were present during this inspection. This is an application for 156 children, ages 3 years to 5 years old. The child care center will operate Monday – Friday 7:30 a.m. – 5:30 p.m. The fire clearance was approved on 06/25/2021.

The facility holds 6 classrooms and 2 outdoor play areas. Additionally, the staff restrooms, director's office, staff lounge, occupational therapy room, speech therapy room and assessment room are housed within a separate bungalow behind Rooms 5 and 6.

LPAs Lowe and Escobedo toured and measured the on-limits areas and classrooms located at the facility. The facility has a total of 6 classrooms. Children will have access to 12 sinks, 10 toilets and 1 urinal. Rooms 1-4 have locked doors that lead to a K-8th grade school.

Classroom measurements are:

· Room #1:

Classroom Space = (28.92 x 29 = 838.68) + (4.42 x 2.25 = 9.95) = 848.63 square feet

Total Encumbered Space = 40.2 square feet

Total Space = 848.63 - 40.2 = 808.43 square feet divided by 35 square feet = 23 children

Continue on LIC 809-C

SUPERVISOR'S NAME: Peter FloresTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2021
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: WISEBURN PRESCHOOL ENRICHMENT
FACILITY NUMBER: 197494865
VISIT DATE: 07/16/2021
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· Room #2 :

Classroom Space = (28.67 x 29 = 831.43) + (4.42 x 2.75 = 12.16) = 843.59 square feet

Total Encumbered Space = 42.68 square feet

Total Space = 843.59 - 42.68 = 800.91 square feet divided by 35 square feet = 22 children

· Room #3:

Classroom Space = (28.75 x 29 = 833.75) + (2.42 x 7.92 = 19.17) = 852.92 square feet

Total Encumbered Space = 30.45 square feet

Total Space = 852.92 - 30.45 = 822.47 square feet divided by 35 square feet = 23 children

· Room #4:

Classroom Space = (28.58 x 29 = 828.82) + (7.92 x 2.42 = 19.17) = 847.99 square feet

Total Encumbered Space = 29.25 square feet

Total Space = 847.99 - 29.25 = 818.74 square feet divided by 35 square feet = 23 children

· Room #5:

Classroom Space = (22.42 x 19.42 = 435.40) + (8.75 x 7 = 61.25) = 496.65 square feet

Total Encumbered Space = 30.83 square feet

Total Space = 496.65 - 30.83 = 465.82 square feet divided by 35 square feet = 13 children

Continued on LIC 809-C

SUPERVISOR'S NAME: Peter FloresTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2021
LIC809 (FAS) - (06/04)
Page: 2 of 8
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: WISEBURN PRESCHOOL ENRICHMENT
FACILITY NUMBER: 197494865
VISIT DATE: 07/16/2021
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· Room #6:

Classroom Space = (21.75 x 9.42 = 204.89) + (10.92 x 7.25 = 79.17) = 284.06 square feet


Total Encumbered Space = 26.87 square feet

Total Space = 284.06 - 26.87 = 257.19 square feet divided by 35 square feet = 7 children

Outdoor Play measurements are:
  • Grass Area:

Total Area: 44.17 x 71.67 = 3,165.66 square feet divided by 75 square feet = 42 children

  • Black Top Area:

Area Near 6 = 20.5 x 13.5 = 267.75 square feet

Area in front of Rooms 5 & 6 = 86.17 x 19.05 = 1,641.54 square feet

Area in front of Rooms 3 & 4 = 4.05 x 113.17 = 458.33 square feet

Total Area: 267.75 + 1,641.54 + 458.33 = 2,367.62 square feet divided by 75 square feet

= 31 children

Total Outdoor Measurements = 3,165.66 + 2,376.62 = 5,542.28 divided by 75 square feet

= 73 children

The facility has a total of 10 toilets, 1 urinal and 12 sinks.

Total Indoor Capacity = 111 children

Total Outdoor Capacity = 73 children

Continued on LIC 809-C

SUPERVISOR'S NAME: Peter FloresTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2021
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: WISEBURN PRESCHOOL ENRICHMENT
FACILITY NUMBER: 197494865
VISIT DATE: 07/16/2021
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All outdoor and indoor passageways, stairways, inclines, ramps, open porches and other areas of potential hazard are kept free of obstruction. The child care center is and shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. Floors of all rooms have a surface that is safe and clean. A comfortable temperature for children shall be maintained at all times. Furniture and equipment is and shall be maintained in good condition, free of sharp, loose or pointed parts. Tables and chairs are and shall be provided to meet the needs of the children. All play equipment and materials used by children are and shall be age-appropriate. The facility provides individual permanent storage space for children's clothing, personal belongings and/or bedding. All materials and surfaces accessible to children, including toys, are and shall be free of toxic substances. Drinking water is available both indoors and in the outdoor activity area. Children will bring water bottles from home and facility will provide drinking water.

The licensee shall take measures to keep the center free of flies, other insects, and rodents. All containers used for storage of solid wastes, including moveable bins have and shall have a tight-fitting cover that is kept on; shall be in good repair; and shall be leakproof and rodent-proof.

Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. LPAs Lowe and Escobedo observed disinfectant wipes, air freshener and/or Goo Gone in 6 of 6 classrooms. Storage areas for poisons shall be locked.

The licensee shall maintain the following first-aid supplies in a location accessible to staff but inaccessible to children: A current edition of a first-aid manual, sterile first-aid dressings, bandages or roller bandages, adhesive tape, scissors, tweezers, thermometer and, antiseptic solution. The isolation room is located in the Director's Office and is equipped with a mat to be used by an ill child. The ill child will use the staff restroom located near the Director's Office.

LPAs Lowe and Escobedo observed fire extinguishers in each room. The service date on the fire extinguishers were June 2020 and December 2020. LPAs Lowe and Escobedo did not observe a carbon monoxide detector.

All child care centers shall have working telephone service on the premises. Each classroom has working telephones.

Sign-In/Sign-Out procedures shall include the full legal signature and time of day. The person who brings the child to, and removes the child from, the center shall sign the child in/out. The sign-in and sign-out sheets

Continued on LIC 809-C

SUPERVISOR'S NAME: Peter FloresTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2021
LIC809 (FAS) - (06/04)
Page: 4 of 8
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: WISEBURN PRESCHOOL ENRICHMENT
FACILITY NUMBER: 197494865
VISIT DATE: 07/16/2021
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with the signatures required, shall be kept for one month and shall be available at the center for review by the Department. In addition to the sign-in procedure requirement, the licensee shall be responsible for ensuring that children with obvious symptoms of illness including, but not limited to, fever or vomiting, are not accepted.

Smoking is prohibited on the premises of a child care center as specified in Health and Safety Code Section 1596.795(b).

A baby walker shall not be allowed on the premises of a child care center in accordance with Health and Safety Code Sections 1596.846(b) and (c).

Foldable mats for napping are and shall be maintained in a safe condition and constructed of foam at least 3/4 inch thick are covered with vinyl. Mats are colored so that the sleeping side can be distinguished from the floor side. Mats will be wiped with a detergent/disinfectant weekly or when soiled or wet. Each cot or mat will be equipped with a sheet to cover the cot or mat. The facility will provide mat covers to each child and parents will take mat covers home weekly for washing.

LPAs Lowe and Escobedo observed a variety of age-appropriate equipment, toys and materials in good condition and in sufficient quantity to allow children present to fully participate in planned activities.

All toilets and handwashing facilities were observed to be in safe and sanitary operating condition. Room 5 has 1 toilet and 2 sinks located in the classroom. Room 6 has 1 toilet and 2 sinks located in the classroom.

There shall be one toilet and one handwashing fixture, separate from and in addition to the number of toilets and handwashing fixtures required above, designated for use by children who are ill, for use by staff, and for emergency use. This toilet and handwashing fixture shall be conveniently located in relation to the isolation area.

Common towels or washcloths are prohibited.

There is a shaded rest area for the children located in the grass area. Outdoor play area is free of hazards including, holes, broken glass and other debris, and dry grasses that pose a fire hazard. LPAs Lowe and Escobedo observed 2 tricycles with exposed handle bars with sharp edges. As a condition of licensure, the

Continued on LIC 809-C

SUPERVISOR'S NAME: Peter FloresTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2021
LIC809 (FAS) - (06/04)
Page: 5 of 8
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: WISEBURN PRESCHOOL ENRICHMENT
FACILITY NUMBER: 197494865
VISIT DATE: 07/16/2021
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areas around and under high climbing equipment, swings, slides and other similar equipment shall be cushioned with material that absorbs falls. Site Supervisor Chapkhaneh states that an outdoor play structure will be installed in the black top area in September 2021. The playground is enclosed by a fence to protect children and to keep them in the outdoor activity area. The fence is at least four feet high.

Medications shall be kept in a safe place inaccessible to children. These medications will be stored in the locked storage closet located in the child's classroom. A refrigerator shall be used to store any medication that requires refrigeration. The refrigerator located in the staff lounge will be used to store medications that require refrigeration. The licensee shall develop and implement a written plan to record the administration of prescription and nonprescription medications and to inform the child's authorized representative daily when such medications have been given.

All food shall be safe and of the quality and in the quantity necessary to meet the needs of the children. All food shall be selected, stored, prepared and served in a safe and healthful manner. Children will bring snacks and lunch from home. The facility will have snacks available to children who did not have a snack from home. All foods or beverages capable of supporting the rapid and progressive growth of microorganisms that can cause food infections or food intoxications shall be stored in covered containers at 45 degrees F (7.2 degrees C) or less. Soaps, detergents, cleaning compounds or similar substances shall be stored in areas separate from food supplies.

The license shall post in a prominent, publicly accessible location in the center the following item, LPAs Escobedo and Lowe observed the LIC 613A (9/96), PUB 393 (8/02) Child Care Center Notification of Parents' Rights Poster, LIC 610 and LIC 9148 in a prominent and public accessible area in the center.

The following was discussed:

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.

Continued on LIC 809-C

SUPERVISOR'S NAME: Peter FloresTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2021
LIC809 (FAS) - (06/04)
Page: 6 of 8
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: WISEBURN PRESCHOOL ENRICHMENT
FACILITY NUMBER: 197494865
VISIT DATE: 07/16/2021
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Employee/Volunteer Files shall also be maintained and shall contain the following
Health Screening Report - Facility Personnel (LIC 503) and TB Clearance.
Proof of Immunizations
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.

Items to be corrected include:

Continued on LIC 809-C

SUPERVISOR'S NAME: Peter FloresTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2021
LIC809 (FAS) - (06/04)
Page: 7 of 8
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: WISEBURN PRESCHOOL ENRICHMENT
FACILITY NUMBER: 197494865
VISIT DATE: 07/16/2021
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  • Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children.
  • Carbon Monoxide detectors shall be installed.
  • All storage room doors shall be equipped with latches or locks.
  • Room 3 air vent has a loose and falling screw
  • Fire Extinguisher need to be serviced.
  • Remove items that may fall from the tops of cabinets/cubbies including pencil sharpener
  • Tricycles with sharp edges to be repaired.

An outdoor space waiver will be submitted.

An exit interview was conducted with the above items discussed and a copy of this report was provided to the Applicant. Final license determination will be made upon review by the Licensing Program Manager and correction of the above issues. Applicant to correct items by 07/31/2021.

SUPERVISOR'S NAME: Peter FloresTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2021
LIC809 (FAS) - (06/04)
Page: 8 of 8