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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494874
Report Date: 11/04/2021
Date Signed: 11/04/2021 05:14:43 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:MOMENTUM PTNFACILITY NUMBER:
197494874
ADMINISTRATOR:ARACELI ESPINOZAFACILITY TYPE:
850
ADDRESS:1815 W 213TH STREET #100TELEPHONE:
(310) 328-0276
CITY:TORRANCESTATE: CAZIP CODE:
90501
CAPACITY:30CENSUS: 3DATE:
11/04/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Stephanie Anderson - Senior DirectorTIME COMPLETED:
05:31 PM
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On 11/4/2021 at 1:00 P.M., Licensing Program Analyst (LPA) Chandler made an announced visit to Momentum Pediatric Therapy Network Early Head Start program for the purpose of conducting a pre-licensing inspection. The site is currently licensed under Pediatric Therapy Network Early Head Start (197417981), who's company merged with Momentum. The applicant is requesting a license for 22 preschoolers; ages 24 months - 36 months, and 8 toddlers; ages 18 months - 24 months, for a total of 30 children. Operational hours are Monday - Friday; 8:30 A.M. - 2:30 P.M. The center is located in a multi-business complex. There is an approved fire clearance on file conducted by inspector Christopher Rhodes of the Torrance Fire Department.

LPA met with Stephani Anderson (Senior Director) who provided a tour of the facility. Also present were Jennifer Ang (Site Supervisor) and Benito Iniquez (Facilities Director).

SUPERVISOR'S NAME: Peter FloresTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Jillinda ChandlerTELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2021
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: MOMENTUM PTN
FACILITY NUMBER: 197494874
VISIT DATE: 11/04/2021
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The following was observed of the:

INDOOR ACTIVITY SPACE

Fire extinguishers were 2AB10C or larger. Last inspection 01/26/2021

Carbon monoxide detectors were observed in a common area between the west and south classrooms, applicant was advised to add one to the east room.

First aid kits were located inside the classrooms; with the required essentials: scissors, bandages, tweezers, and thermometer

Age appropriate toys and equipment were observed in good repair. Applicant was advised, during the pandemic, children should not be sharing toys made with adsorbent materials

Drinking water will be provided through filtered water system

Heating and Cooling was provided by a central unit, temperatures were set at a comfortable temperature

Adequate lighting was observed

SUPERVISOR'S NAME: Peter FloresTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Jillinda ChandlerTELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2021
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: MOMENTUM PTN
FACILITY NUMBER: 197494874
VISIT DATE: 11/04/2021
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Storage for children’s belongings were observed

Trash cans used for solid waste were observed with tight fitting lids

No Fireplaces or open face heaters were observed during todays inspection

Disinfectants and cleaning solution and other toxins or poisons were made inaccessible to children, cabinets were equipped with locking mechanisms

There will be a separate area (the tree trunk) used for isolation of ill children and the staff restroom located directly outside of this area will be used for ill children. Applicant was advised that the child(ren) shall be supervised at all times.

The classrooms are equipped with working telephones

Parents and authorized adults, will sign in using their original signatures.

The required postings were also posted in each classroom.

Cots were observed for napping with individual napping materials, cot were observed in good condition.

SUPERVISOR'S NAME: Peter FloresTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Jillinda ChandlerTELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2021
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: MOMENTUM PTN
FACILITY NUMBER: 197494874
VISIT DATE: 11/04/2021
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FOOD SERVICE:

Lunches and snacks are delivered by an outside vendor on a weekly basis. The center has a full kitchen on site for refrigeration, storage and prepping. LPA did not observe any contaminated or spoiled foods in this area.

Weekly menus were posted for review. Applicant has preparation for alternate meals for children with allergies

Center has devised an Incidental Medical Service plan for children with allergies (epi-pen), asthmatic (inhalers), and children needing G-tube feeding


Toxins and poisons were made inaccessible to children by way of locked cabinets.

Open foods were properly labeled and stored
The kitchen was clean in good condition

RESTROOMS

THERE WERE:

Three age appropriate toilets for children's use (1 toilet per 15 children) and 8 sinks = 1 sink per 15 children. Some sink were standard sized, wide based steps were provided to assist children with accessing those sinks. Each restroom was equipped with a changing table within arms reach of a sink.

SUPERVISOR'S NAME: Peter FloresTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Jillinda ChandlerTELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2021
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: MOMENTUM PTN
FACILITY NUMBER: 197494874
VISIT DATE: 11/04/2021
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The restrooms were clean and sanitized with the necessary toiletries, sinks and toilets were operable and in good repair.

OUTDOOR ACTIVITY SPACE

The outdoors play area is located across the parking lot of the school. The applicant has devised a plan to assist children to the play yard. There is a portable mesh fence that extends across the parking lot and poles are inserted into holes to secure the fencing, also crossing markers are used to identify the painted crosswalk.

Age appropriate equipment were observed in the outdoor activity space in good repair.

The play yard was completely gated with a 4 inch or higher gate.

Artificial grass, sand, and resilient cushioning where found in good repair under all climbing apparatus.

Water fountains with disposable cups were available for an outdoor water source. Applicant was advised to make the age appropriate side of the fountain inaccessible to children during the pandemic.

Shade sails provided shading and benches for resting were available for children’s use.

SUPERVISOR'S NAME: Peter FloresTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Jillinda ChandlerTELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2021
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: MOMENTUM PTN
FACILITY NUMBER: 197494874
VISIT DATE: 11/04/2021
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The applicant was advised to remove a dwarf tree (at the south end) and other tree limbs that were could be a safety hazard to children in care, also the planter near the shed should be filled or devised to prevent a tripping hazard.

Measurements for the outdoor activity area were 1723.28 divided by 75 sq. ft. per child.

Center is requesting a waiver for Title 22, section 101216.4(2) for the purpose of sharing the outdoor play area with the preschool children. The applicant provide a full daily schedule with alternating play times and with at least 20-30 minutes between outdoor activities.

Based on todays inspection the facility shall be recommended for a capacity of 30 children determined by the number of toilets designated for children's use. Licensure will be approved pending, waiver approval and delivery of previously requested documents (see notice of incomplete application (NOIA dated 10/16/21).

This report was reviewed with Stephani Anderson, an exit interview was conducted and a copy of the report was provided.

SUPERVISOR'S NAME: Peter FloresTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Jillinda ChandlerTELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2021
LIC809 (FAS) - (06/04)
Page: 6 of 6