197494866-9-10-2021-30-CC-DLOE-C6R2QY-20210910173644

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494866
Report Date: 09/10/2021
Date Signed: 09/10/2021 05:37:04 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:	WILSHIRE BLVD TEMPLE-UNIVERSITY CAMPUS		FACILITY NUMBER:	197494866
ADMINISTRATOR:	CAROL BOVILL		FACILITY TYPE:	850
ADDRESS:	11960 SUNSET BLVD		TELEPHONE:	(310) 472-0603
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90049
CAPACITY:	169	CENSUS: 0	DATE:	09/10/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Carol Bovill, Director		TIME COMPLETED:	05:30 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

On 09/10/2021 at 8:15 a.m. Licensing Program Analysts (LPA) Deborah Lowe met with Director Carol Bovill. The purpose of the visit was an announce pre-licensing inspection for a change in ownership at the facility to ensure that health, safety and personal rights as requires 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 169 children with a toddler option, ages 18 months to 6 years old. The child care center will operate Monday – Friday 7:30 a.m. – 5:00 p.m. The fire clearance was approved on 09/02/2021. Fire extinguishers were observed with a service date of 2/23/2021.

LPA Lowe toured facility with Director Carol Bovill, Site Supervisor April Schafer, Associate Executive Director Douglas Lynn and Toby Berkow. Facility has an Armed Security Guard at entrance to property. All visitors have to pass the security gate and check in before entry to facility and parking areas. Applicant is submitting a waiver for the Armed Security on the property.

LPA Lowe measured the on-limits areas and classrooms located at the facility. The facility has a total of 12 classrooms. Preschool children will have access to 16 sinks, 22 toilets, and 8 urinals. Toddler Option children will have access to 1 toilet and 1 sink.

Toddler Option Classroom measurements are:

· Room #102 = (18 x 14.58) = 262.44 + (9.58 x 17) = 162.86 room total 262.44 + 162.86 = 425.30

· Room #122 = (12.83 x 21.05) = 270.07

Total classroom measurements for Toddler Option are: 425.30 + 270.07 = 695.37 divided by 35 sq feet = 19 Toddler children. Due to available toilets and sinks for Toddlers total capacity would be 15 Toddler children.

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (434) 301-3069
LICENSING EVALUATOR NAME: Deborah Lowe	TELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2021

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 10

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: WILSHIRE BLVD TEMPLE-UNIVERSITY CAMPUS	FACILITY NUMBER: 197494866
	VISIT DATE: 09/10/2021

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
26
27
28
29
30
31
32

Preschool Classroom measurements are:

· Room #101 = (20.05 x 33.42) = 670.07 Encumbered space: wall air units (3.50 x .67) = 2.35, (3.50 x .75) = 2.63 and adult use cabinets (1.42 x 2.67) = 3.79 x 3 cabinets = 16.35 of total encumbered space. Total room measurement: 670.07 – 16.35 = 653.72

· Room #103 = (19.17 x 25.17) = 482.51 – (3.58 x .83) = 2.97, total room measurement: 479.54

· Room #105 = (18.92 x 27.17) = 514.06

· Room #106 = (18.33 x 43.58) = 798.82 Encumbered space: Pillars (1.25 x 1.75) = 2.19, (1 x 2) = 2, (0.92 x 1.67) = 1.54, (1 x 1.83) = 1.83 and adult use cabinet (2 x 1.75) = 3.5 = 11.06 of total encumbered space. Total room measurement: 798.82 – 11.06 = 787.76

· Room #107 = (27.17 x 13.92) = 378.21 + (18.67 x 4.42) = 82.52 – (3.50 x .67) = 2.35. Total room measurement: 378.21 + 82.52 – 2.35 = 458.38

· Room #108 = (22.83 x 24.58) = 561.16 + (22.33 x 4.58) = 102.27 – (4.0 x 2.0) = 8.0 – fire hose (3.0 x .67) = 2.01. Total room measurement: 561.16 + 102.27 – 8.0 – 2.01 = 653.42

· Room #112 = (22.83 x 30.50) = 696.32

· Room #202 upper level = (21.58 x 20.33) = 438.72 – (2.58 x 1.50) = 3.87. Total classroom measurement: 438.72 – 3.87 = 434.85

· Room #204 upper level = (21.58 x 19.67) = 424.48

· Room #206 upper level = (22.42 x 20.75) = 465.22 – (2.58 x 1.0) = 2.58. Total classroom measurement: 465.22 – 2.58 = 462.64

Total classroom measurements are: 653.72 + 479.54 + 514.06 + 458.38 + 653.42 + 787.76 + 696.32 + 434.85 + 424.48 + 462.64 = 5,565.17 divided by 35 sq feet = 159 children. Applicant request is for 151 preschool age children.

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (434) 301-3069
LICENSING EVALUATOR NAME: Deborah Lowe	TELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2021

LIC809 (FAS) - (06/04)

Page: 2 of 10

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: WILSHIRE BLVD TEMPLE-UNIVERSITY CAMPUS	FACILITY NUMBER: 197494866
	VISIT DATE: 09/10/2021

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
26
27
28
29
30
31
32

Outdoor Play measurements are: Facility has 1 designated Toddler outdoor space for the toddler option component and 3 designated outdoor space yards for the preschool program.

Toddler Play Yard located outside of Lobby and Directors office: (21.50 x 55.58) = 1,194.97 + (3.17 x 1.75) = 4.92. Total Toddler outdoor activity space: 1,194.97 + 4.92 = 1,199.89 divided by 75 sq feet = 15 children within the toddler option component.

Preschool Outdoor areas:

· Playground #2 “Sand Yard”: (52.33 x 63.67) = 3,331.85 – (7.75 x 7.67) = 59.44. Total measurement 3,331.85 – 59.44 = 3,272.41

· Playground #3 “Ruby Garden”: (62.33 x 84.67) = 5,277.48 – (3.42 x 8.0) = 27.36. Total measurement 5,277.48 – 27.36 = 5,250.12

· Playground #4 “Outdoor Garden”: (26.33 x 16.67) = 438.92 + (24.25 x 14.17) = 343.62. Total measurement: 438.92 + 343.62 = 782.54

Total preschool outdoor measurements are: 3,272.41 + 5,250.12 + 782.54 = 9,305.07 divided by 75 sq feet = 124 children.

Indoor/Children’s Area:

LPA Lowe observed all outdoor and indoor passageways, stairways, inclines, ramps, open porches and other areas of potential hazard to be free of obstruction. The child care center was observed be clean, safe, sanitary and in good repair to ensure the safety and well-being of children, employees and visitors. Floors of all rooms were observed to have a surface that is safe and clean. A comfortable temperature for children was observed with use of air units in each room. Furniture and equipment were observed to be maintained in good condition, free of sharp, loose or pointed parts. Tables and chairs were observed to meet the needs of the children. All play equipment and materials used by children were observed to be age-appropriate. LPA Lowe advised licensee shall ensure that each child has an individual permanent or portable storage space for his/her clothing, personal belongings. All materials and surfaces accessible to children, including toys, were observed to be free of toxic substances.

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (434) 301-3069
LICENSING EVALUATOR NAME: Deborah Lowe	TELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2021

LIC809 (FAS) - (06/04)

Page: 3 of 10

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: WILSHIRE BLVD TEMPLE-UNIVERSITY CAMPUS	FACILITY NUMBER: 197494866
	VISIT DATE: 09/10/2021

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
26
27
28
29
30
31
32

Drinking water was observed to be available with use of water coolers place throughout the facility. Water cooler was observed to have a cold and room temperature spout. Applicant stated they have pest control contract to assist in keeping facility free of flies, other insects, and rodents. All containers used for storage of solid wastes, including moveable bins, were observed to have a tightfitting cover; in good repair. No fireplaces or open-faced heaters were observed at facility. Window screens were not observed.

Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children were observed to be stored where inaccessible to children. LPA Lowe advised 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: LPA observed a current edition of a first-aid manual, sterile first-aid dressings, bandages or roller bandages, adhesive tape, scissors, tweezers, thermometer, and antiseptic solution.

Applicant stated they are equipped to isolate and care for any child who becomes ill during the day within the directors office. LPA Lowe advised isolation area shall be located to afford easy supervision of children by center staff. The isolation area was observed to be equipped with a mat. LPA Lowe advised isolation area shall not be located in the kitchen area or the general-use toilet area.

Every licensed child day care center shall have one or more carbon monoxide detectors in the facility. LPA Lowe observed carbon monoxide detector located on the lower level in hallway and upper level in room 204. Maintenance staff tested carbon monoxide detector and LPA Lowe was able to hear the test showing the carbon monoxide detector was in good working condition. Facility was observed to have working telephone in each classroom.

In addition to the sign-in procedure requirement of Section 101226.1(b), the licensee shall develop, maintain, and implement a written procedure to sign the child in/out of the child care center that shall, at a minimum, include the following: Facility is using the BrightWheel app for children sign in and out applicant attested they can print any documents requested.

LPA Lowe observed a check in station to conduct an assessment of children before entering facility ensuring children with obvious symptoms of illness including, but not limited to, fever or vomiting, are not accepted.

LPA Lowe advised smoking is prohibited on the premises of a child care center as specified in Health and Safety Code Section 1596.795(b), and 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).

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (434) 301-3069
LICENSING EVALUATOR NAME: Deborah Lowe	TELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2021

LIC809 (FAS) - (06/04)

Page: 4 of 10

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: WILSHIRE BLVD TEMPLE-UNIVERSITY CAMPUS	FACILITY NUMBER: 197494866
	VISIT DATE: 09/10/2021

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
26
27
28
29
30
31
32

There shall be at least 35 square feet of indoor activity space per child based on the total licensed capacity.

Based on the total licensed capacity, one toilet and one handwashing fixture shall be maintained for every 15 children, or fraction thereof.

Napping:

Mats were observed to be used for napping and were observed to be maintained in a safe condition. Constructed of foam at least 3/4 inch thick. Covered with vinyl or similar material that can be wiped. Marked or colored so that the sleeping side can be distinguished from the floor side. Wiped with a detergent/disinfectant weekly or when soiled or wet. LPA Lowe advised mats need to be maintained in a safe condition with no exposed foam.

Each cot or mat shall be equipped with a sheet to cover the cot or mat and, depending on the weather, a sheet and/or blanket to cover the child. Applicant stated children will bring their own bedding.

The licensee shall provide 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.

Preschool Program with Toddler Component

LPA Lowe advised licensees serving preschool-age children may create a special program component for children who are between 18 months and 36 months of age. The provisions of Sections 101151 through 101239.2 shall apply for children over 24 months, in addition to those specified in Health and Safety Code section 1596.955. The provisions of Sections 101351 through 101439.1 shall apply for children between the ages of 18 and 24 months participating in a preschool toddler component, in addition to those specified in Health and Safety Code section 1596.955.

LPA Lowe advised the maximum group size, with two teachers, or one fully qualified teacher and one aid, does not exceed 12 toddlers.

LPA Lowe advised the toddler program is to be conducted in areas separate from those used by older or younger children. Plans to alternate use of outdoor play space may be approved to achieve separation.

Restrooms:

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (434) 301-3069
LICENSING EVALUATOR NAME: Deborah Lowe	TELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2021

LIC809 (FAS) - (06/04)

Page: 5 of 10

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: WILSHIRE BLVD TEMPLE-UNIVERSITY CAMPUS	FACILITY NUMBER: 197494866
	VISIT DATE: 09/10/2021

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
26
27
28
29
30
31
32

All toilets, handwashing and bathing facilities were observed to be maintained in safe and sanitary operating condition. Additional equipment, aids and/or conveniences shall be provided as needed in centers that serve children with physical disabilities.

Hot water temperature controls shall be maintained to automatically regulate temperature of hot water delivered to plumbing fixtures used by children to attain a hot water temperature of not less than 105 degrees F (40.5 degrees C) and not more than 120 degrees F (48.8 degrees C). Notwithstanding (e) and (e)(1) above, handwashing fixtures shall not be required to deliver hot water.

LPA Lowe advised there shall be one toilet and one handwashing fixture, separate from and in addition to the number of toilets and handwashing fixtures required in (h) 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. All staff restrooms are on the upper level of facility.

LPA Lowe advised common towels or washcloths are prohibited. Urinals may be used to meet the requirements of this section provided they are low enough for children to reach them, or broad-based platforms or anchored steps are provided to enable children to reach them.

There shall be at least two toilets for each urinal counted.

Outdoor:

Outdoor area was observed with a shaded rest area for the children. LPA Lowe advised outdoor areas shall be free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard. Shed on Playground # 4 “Outdoor Garden" has a shed storage unit made out of wood that is in need of repair.

LPA Lowe advised as a condition of licensure, the areas around and under high climbing equipment, swings, slides and other similar equipment shall be cushioned with material that absorbs falls. Slide on Toddler playground was observed to have material that absorbs falls under the artificial grass.

LPA Lowe advised sandboxes shall be inspected daily and kept free of hazardous foreign materials. Playground # 2 the Sand Yard is majority a sand box.

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (434) 301-3069
LICENSING EVALUATOR NAME: Deborah Lowe	TELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2021

LIC809 (FAS) - (06/04)

Page: 6 of 10

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: WILSHIRE BLVD TEMPLE-UNIVERSITY CAMPUS	FACILITY NUMBER: 197494866
	VISIT DATE: 09/10/2021

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
26
27
28
29
30
31
32

Playgrounds were observed to be enclosed by a fence to protect children and to keep them in the outdoor activity area. The fence was observed to be at least four feet high.

LPA Lowe advised any construction or equipment that could pose a hazard in the outdoor activity area shall be made inaccessible to children in care. This shall include, but not be limited to, incinerators, air- conditioning equipment, water heaters, and fuse boxes. None were observed during visit.

No pools or bodies of water were observed during visit. Playground #4 “Outdoor Garden” has a built-in concrete above ground water play area children can stand and use with their hands. Water faucet was observed. Area was empty with no water observed.

There shall be at least 75 square feet per child of outdoor activity space based on the total licensed capacity.

Health Related Services:

Medications shall be kept in a safe place inaccessible to children. LPA Lowe observed locked cabinet in directors office for the storage of medications. A refrigerator in kitchen will be used to store any medication that requires refrigeration.

The licensee has developed and implemented 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.

Food Service:

LPA Lowe advised all food shall be safe and of the quality and in the quantity necessary to meet the needs of the children. Each meal shall include, at a minimum, the amount of food components as specified by Title 7, Code of Federal Regulations, Part 226.20, (Revised January 1, 1990) Requirements for Meals, for the age group served. All food shall be selected, stored, prepared and served in a safe and healthful manner.

LPA Lowe observe a thermometer in the refrigerator, LPA Lowe advised 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.

LPA Lowe advised pesticides and other similar toxic substances shall not be stored in food storerooms, kitchen areas, food-preparation areas, or areas where kitchen equipment or utensils are stored.

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (434) 301-3069
LICENSING EVALUATOR NAME: Deborah Lowe	TELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2021

LIC809 (FAS) - (06/04)

Page: 7 of 10

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: WILSHIRE BLVD TEMPLE-UNIVERSITY CAMPUS	FACILITY NUMBER: 197494866
	VISIT DATE: 09/10/2021

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
26
27
28
29
30
31
32

Soaps, detergents, cleaning compounds or similar substances were observed be stored in areas separate from food supplies.

All kitchen, food-preparation and storage areas were observed to be kept clean and free of litter and rubbish; and measures shall be taken to keep all such areas free of rodents and other vermin.

LPA Lowe advised the food-preparation area shall not be used for: Children's play activities, unless such activities are part of a supervised food-education program. Full-day programs shall offer a midmorning and a midafternoon snack.

Full-day programs shall ensure that each child has a lunch. Applicant stated children will bring own lunch from home. Half-day programs shall offer a midmorning or midafternoon snack.

Postings:

The license shall be posted in a prominent, publicly accessible location in the center.

LPA Lowe observed a copy of the LIC 613A (9/96) posted in a prominent, publicly accessible area in the center along with PUB 393 (8/02), Child Care Center Notification of Parents' Rights Poster, snack menus, LIC 610 Emergency Disaster Plan, LIC 9148 Earthquake Preparedness checklist,

LPA Lowe advised menus shall be in writing and shall be posted at least one week in advance in an area accessible for review by the child's authorized representative. Copies of the menus as served shall be dated and kept on file for at least 30 days. Menus shall be made available for review by the child's authorized representative and the Department upon request.

LPA Lowe observed disaster and mass casualty plan of action.

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

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (434) 301-3069
LICENSING EVALUATOR NAME: Deborah Lowe	TELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2021

LIC809 (FAS) - (06/04)

Page: 8 of 10

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: WILSHIRE BLVD TEMPLE-UNIVERSITY CAMPUS	FACILITY NUMBER: 197494866
	VISIT DATE: 09/10/2021

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
26
27
28
29
30
31
32

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. LPA discussed flyer given today (Never Shake a Baby) Applicant reviewed flyer and understands the preventive practices of shaken baby syndrome and abusive head trauma.

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

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

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (434) 301-3069
LICENSING EVALUATOR NAME: Deborah Lowe	TELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2021

LIC809 (FAS) - (06/04)

Page: 9 of 10

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: WILSHIRE BLVD TEMPLE-UNIVERSITY CAMPUS	FACILITY NUMBER: 197494866
	VISIT DATE: 09/10/2021

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
26
27
28
29
30
31
32

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.

The following corrections are needed before a capacity increase will be considered:

· Playground #4 “Outdoor Garden” shed/ storage unit in need of repair.

· Air Conditioner unit accessible in playground # 2 “Sand Yard” is rusted with peeling paint in need of repair.

· Outdoor Activity Space Waiver for Preschool age group will be needed.

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 09/17/2021.

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (434) 301-3069
LICENSING EVALUATOR NAME: Deborah Lowe	TELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2021

LIC809 (FAS) - (06/04)

Page: 10 of 10