197494990-4-20-2022-30-CC-DLOE-CDNSZ3-20220420141827

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494990
Report Date: 04/20/2022
Date Signed: 04/20/2022 02:18:45 PM

Document Has Been Signed on 04/20/2022 02:18 PM - It Cannot Be Edited

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:	VILLAGE TREE PRESCHOOL		FACILITY NUMBER:	197494990
ADMINISTRATOR:	KERN, KIMBERLY		FACILITY TYPE:	850
ADDRESS:	3754 DUNN DRIVE		TELEPHONE:	(310) 876-0116
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90034
CAPACITY:	144	CENSUS: 0	DATE:	04/20/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:18 AM
MET WITH:	Kimberly Kern		TIME COMPLETED:	02:25 PM

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On 4/20/2022 at 8:18 a.m. Licensing Program Analyst (LPA) Deborah Lowe met with Director Kimberly Kern. The purpose of the visit was an announce pre-licensing inspection 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. There were no children present during this inspection. This is an application for 144 preschool with a toddler option children, ages 18 months to 6 years old. The child care center will operate Monday – Friday 7:30 a.m. – 5:30 p.m. The fire clearance was approved on 3/22/2022.

Cindy Contreras, Director of a Village Tree Preschool’s sister location was present for pre-licensing visit. Facility is located on the property of First Lutheran Church. Facility entrance is on Dunn Drive, the Church entrance is located on Hughes Ave. No other educational programs are provided within the Churches property.

LPA Lowe 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 11 sinks and 10 toilets. Fire extinguishers were observed with a service date of 9/03/2021.

Classroom measurements are:

Total preschool indoor activity space measurements: 3832.64 divided by 35 sq. feet = 109 children

Total toddler option indoor activity space measurements: 750.42 divided by 35 sq. feet = 21 toddler children

Outdoor Play measurements are:

Total preschool outdoor activity space measurements: 22,762.94 divided by 75 sq feet = 303 children

Total toddler outdoor activity space measurements: 2116.23 divided by 75 sq feet = 28 children

Review of total measurements shows a maximum capacity of 130 children.

SUPERVISOR'S NAME: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Deborah Lowe	TELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2022

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: VILLAGE TREE PRESCHOOL	FACILITY NUMBER: 197494990
	VISIT DATE: 04/20/2022

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Indoor/Children’s Area:

All outdoor and indoor passageways, stairways, inclines, ramps, open porches and other areas of potential hazard were observed to be free of obstruction. The child care center was observed 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 was observed. Furniture and equipment were observed to be maintained in good condition, free of sharp, loose or pointed parts. Tables and chairs were observed to be meet the needs of the children. All play equipment and materials used by children were observed to be age-appropriate. LPA observed individual permanent or portable storage space for children’s clothing, personal belongings and/or bedding. All materials and surfaces accessible to children, including toys, were observed to be free of toxic substances.

Drinking water from a noncontaminating fixture or container was observed to be readily available both indoors and in the outdoor activity area with the use of water pitchers. LPA advised the licensee shall take measures to keep the center free of flies, other insects, and rodents. Director stated they have a pest control service. All containers used for storage of solid wastes, including moveable bins, were observed to have a tightfitting cover that is kept on; in good repair; and leakproof and rodent-proof. LPA Lowe did not observe any fireplaces or open-faced heaters at the facility.

LPA Lowe advised disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. Cleaning solutions observed in a classroom cabinet. Director provided a child proof latch to cabinet during visit. LPA advised storage areas for poisons shall be locked. LPA observed pest control poison in the laundry room inaccessible to children but not locked. Director moved the pest control poison to an outdoor locked storage room during visit. 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.

LPA observed the isolation area to be located in the office. LPA advised the isolation area shall be located to afford easy supervision of children by center staff. The isolation area was observed to be equipped with a cot for each ill child. LPA advised the isolation area shall not be located in the kitchen area or the general-use toilet area.

SUPERVISOR'S NAME: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Deborah Lowe	TELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2022

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: VILLAGE TREE PRESCHOOL	FACILITY NUMBER: 197494990
	VISIT DATE: 04/20/2022

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Every licensed child day care center shall have one or more carbon monoxide detectors in the facility. Facility was observed with an integrated fire life safety system. Facility was observed to have working telephone service on the premises.

LPA advised 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, Director stated facility will use sign in/out sheets located at the entrance of facility. During sign in/out facility will evaluate the child for obvious symptoms of illness through a wellness check.

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

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:

Cots used for napping were observed to be maintained in a safe condition. Covered with vinyl or similar material that can be wiped. Wiped with a detergent/disinfectant weekly or when soiled or wet.

LPA advised 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. Children will bring sheets and blankets from home.

LPA Lowe 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.

Restrooms:

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

LPA advised hot water temperature controls shall be maintained to automatically regulate temperature of hot

SUPERVISOR'S NAME: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Deborah Lowe	TELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2022

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: VILLAGE TREE PRESCHOOL	FACILITY NUMBER: 197494990
	VISIT DATE: 04/20/2022

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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. Children sinks were observed with sensor activation and only cold water observed.

LPA 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. Staff restroom will be used for children in isolation area.

Common towels or washcloths are prohibited.

Outdoor:

LPA Lowe observed a shaded rest area for the children. LPA observed outdoor area to be free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard. LPA Lowe observed the area around and under high climbing equipment, slides and other similar equipment to be cushioned with material that absorbs falls.

LPA advised sandboxes shall be inspected daily and kept free of hazardous foreign materials.

The playground shall 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 surrounding the facility.

LPA 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. LPA observed what looked like an electrical box at child’s level on the outdoor area behind room 4 building attached to the wall of the building. LPA advised director area will need to be covered.

Open outdoor storage space located on playground with climbing structure near room 5 was observed in need of cleaning and de-cluttering. Director stated area will be used to store outdoor play equipment. Area was observed to be accessible to children.

LPA Lowe did not observed any pool or other bodies of water at facility.

SUPERVISOR'S NAME: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Deborah Lowe	TELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2022

LIC809 (FAS) - (06/04)

Page: 4 of 7

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: VILLAGE TREE PRESCHOOL	FACILITY NUMBER: 197494990
	VISIT DATE: 04/20/2022

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LPA Lowe advised storage room entrance door located on the Toddler Option outdoor area shall remain closed and locked. Door was observed open and unlocked during visit. Director locked while LPA was present.

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

Health Related Services:

Medication box was observed in the office for the storage of medications and observed to be inaccessible to children. A refrigerator was observed be used to store any medication that requires refrigeration. A separate medication box for the refrigerator was observed.

The licensee has developed 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 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 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 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.

LPA advised soaps, detergents, cleaning compounds or similar substances shall 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.

LPA advised the food-preparation area shall not be used for: Children's play activities, unless such activities

SUPERVISOR'S NAME: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Deborah Lowe	TELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2022

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: VILLAGE TREE PRESCHOOL	FACILITY NUMBER: 197494990
	VISIT DATE: 04/20/2022

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are part of a supervised food-education program. Full-day programs shall offer a midmorning and a midafternoon snack.

Facility will offer snacks and children will bring their own lunch from home.

Postings:

LPA Lowe observed a posting board located in the entrance hallway near the front door. LPA Lowe observed the following postings: LIC 613A (9/96) Personal Rights, PUB 393 (8/02), Child Care Center Notification of Parents' Rights Poster, LIC 610 Emergency Disaster Plan, child passenger restraint systems poster, and LIC 9148.

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 advised each licensee shall have a disaster and mass casualty plan of action.

Transportation:

Director stated facility will not provide transportation services.

The following items were discussed:

Applicant was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant, of the importance of checking for recalled infant devices on

SUPERVISOR'S NAME: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Deborah Lowe	TELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2022

LIC809 (FAS) - (06/04)

Page: 6 of 7

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: VILLAGE TREE PRESCHOOL	FACILITY NUMBER: 197494990
	VISIT DATE: 04/20/2022

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the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A 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.htm

LPA reviewed with applicant the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

The following corrections are needed before a licensure will be considered. Corrections are due by 4/22/2022:

Peeling paint in room 4 located on cabinet door under sink is in need of repair.
Outdoor open shed area intended for the use of outdoor play materials is in need of cleaning and de-cluttering items not intended for use by children.
Outdoor area located behind room 4 building make wire and electrical boxes inaccessible by children.
Update Facility Sketch to show division of room 4 and clarify outdoor areas and titles.

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

SUPERVISOR'S NAME: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Deborah Lowe	TELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2022

LIC809 (FAS) - (06/04)

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