197494937-11-4-2021-30-CC-JCHR-C8FPRR-20211104113310

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494937
Report Date: 11/04/2021
Date Signed: 11/04/2021 11:33:28 AM

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:	STAR AT HERMOSA VISTA		FACILITY NUMBER:	197494937
ADMINISTRATOR:	ANNIE HOWARD		FACILITY TYPE:	840
ADDRESS:	417 25TH STREET		TELEPHONE:	(310) 462-3312
CITY:	HERMOSA BEACH	STATE: CA	ZIP CODE:	90254
CAPACITY:	140	CENSUS: 0	DATE:	11/04/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:05 AM
MET WITH:	Ann Howard - Site Director		TIME COMPLETED:	11:51 AM

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 11/4/2021 Licensing Program Analyst (LPA) Chandler made an announced visit to the Hermosa Vista Elementary School for the purpose a school-age pre-licensing inspection. The applicant is requesting an after school school-age license with a capacity of 140. LPA met with site director; Ann (Annie) Howard who provided a tour of areas assigned to the after school program according to the provided facility sketch. The school will be operated by Star (Sports, Theater,Arts & Recreation Inc.). Operating days and hours will be Mon,Tues, Thurs and Friday; 7:00 A.M. - 9:00 A.M./ 2:00 P.M. - 6:00 P.M. - Wednesday 1:00 P.M. - 6:00 P.M. The applicant provided a annual fire inspection report conducted on 4/12/2021 by inspector E. Lopez of the County of Los Angeles Fire Department, no deficiencies were noted on the submitted report (Title 22 sect. 101471). The program will operate using the multi-purpose room and rooms 101-108 . The following was was observed of the indoor activity areas: Fire extinguishers were 2AB10C or larger were observed, carbon monoxide is detected through the school air flow system First aid kit with the required essentials: scissors, bandages, tweezers, medical ointments and thermometers.

SUPERVISOR'S NAME: Peter Flores	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Jillinda Chandler	TELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:	DATE: 10/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021

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: STAR AT HERMOSA VISTA	FACILITY NUMBER: 197494937
	VISIT DATE: 11/04/2021

NARRATIVE

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Age appropriate toys and equipment were observed in good repair

Children will bring personal drinking water and containers. The program will supply additional bottled water as needed.

Central heating and cooling provides classrooms with comfortable temperatures.

Windows were in good repair free of chipping paint, dirt, insects or debris.

Adequate lighting was observed

Classrooms were clean,in good repair

Children belongings are stored in their personal back packs.

Trash cans used for solid waste were observed with tight fitting lids were observed in the multi purpose room and the outdoor lunch area.

Disinfectants and cleaning solution and other toxins or poisons were not observed during todays inspection

Per Health and Safety code 1596.860 (b)(1), the program is exempt from isolation requirements.

The classrooms are equipped with working telephones

Authorized staff shall sign children in upon arriving to the program and the parent or authorized adult will sign children out.

SUPERVISOR'S NAME: Peter Flores	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Jillinda Chandler	TELEPHONE: (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)

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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: STAR AT HERMOSA VISTA	FACILITY NUMBER: 197494937
	VISIT DATE: 11/04/2021

NARRATIVE

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FOOD SERVICE:

Snacks will be provided by parents during the Covid 19 pandemic. The site director was advised that there should be a supply of of emergency snacks made available in case in cases of emergencies or incidental mis-fortunes.

Weekly menus shall be posted for review when snacks are served by the program. Applicant shall make preparation for alternate meals for children with allergies

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

RESTROOMS

THERE WERE:

Gender identified restroom for individual privacy

Toilets and sinks were age appropriate

The restrooms were clean and sanitized with the necessary toiletries, sinks and toilets were operable and in good repair.

OUTDOOR ACTIVITY SPACE

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

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

No hazardous conditions or equipment was observed during today’s visit

SUPERVISOR'S NAME: Peter Flores	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Jillinda Chandler	TELEPHONE: (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)

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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: STAR AT HERMOSA VISTA	FACILITY NUMBER: 197494937
	VISIT DATE: 11/04/2021

NARRATIVE

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Children will have access to the school's existing out doors play area as indicated on the facility sketch and authorization of use agreement. The climbing apparatus shall be off limits to the after school program.

Personal water and containers will be used as an outdoor water source. Water faucets were made inaccessible to children during the pandemic

Awnings and shade sails provided shading, benches for resting were available for children’s use

Per Health and Safety code section 1596.806; the program shall be exempt from square footage measurement both indoors and outdoors, toilets and sinks requirements, and isolation requirements.

The capacity per room for a school-age child care program that meets the requirements of Health and Safety Code Section 1596.806 shall not exceed the number of children for which a room of this size is commonly approved for school use during the school day.

Ratios standards shall be met at all times per Title 22, section 101516.5.

Based on todays observation the program shall be granted a capacity of 140 based on the requested capacity and delivery of required documents.

An exit interview was conducted and the report was reviewed and a copy was provided to the site director Ann Howard

SUPERVISOR'S NAME: Peter Flores	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Jillinda Chandler	TELEPHONE: (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)

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