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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016726
Report Date: 04/25/2023
Date Signed: 04/25/2023 05:40:46 PM


Document Has Been Signed on 04/25/2023 05:40 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:PRIME TIME SPORTS CAMP @ IVANHOE ELEMENTARY SCHOOLFACILITY NUMBER:
198016726
ADMINISTRATOR:CARLA IEZZAFACILITY TYPE:
840
ADDRESS:2828 HERKIMER STREETTELEPHONE:
(310) 838-7872
CITY:LOS ANGELESSTATE: CAZIP CODE:
90039
CAPACITY:150CENSUS: 93DATE:
04/25/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Director, Carla IezzaTIME COMPLETED:
05:45 PM
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Licensing Program Analyst (LPA) Mireya Garcia conducted an unannounced Annual Required Inspection. LPA met with Director Carla Iezza, who guided LPA on a tour of the facility indoors and outdoors. This is a school-age program which consists of 5 classrooms; RM 2, 4, 5, 8, 9 and the Auditorium. Facility operation hours are Monday through Friday from 2:34 PM to 6:00 PM during regular school sessions. This facility has a capacity of 150 children; School age children ages 4.9 to 12 years of age.

LPA arrived prior to program starting. During LPA’s inspection the following staff were present during this inspection: RM 2: Staff #1 and #2 with 11 school age children; RM 4: Staff #3 and #4 with 20 school age children, RM 5: Staff #5 and #6 with 19 school age children, RM 8: Staff #7 and #8 with 19 school age children and RM 9: Staff #9 and #10 with 24 school age children. Teacher-child ratio is met. All individuals present have obtained a criminal record clearance or criminal record exemption. All children were observed to be under visual supervision of a teacher at all times.

REPORT CONTINUES ON NEXT PAGE 1 OF 5.

SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:
DATE: 03/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/22/2023
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: PRIME TIME SPORTS CAMP @ IVANHOE ELEMENTARY SCHOOL
FACILITY NUMBER: 198016726
VISIT DATE: 04/25/2023
NARRATIVE
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LPA observed the facility to be clean, safe, sanitary and in good repair. Furniture and equipment were inspected for good repair, free of sharp, loose, or pointed parts. Indoor classrooms were inspected to ensure that the floors have a surface that is safe and clean. All toilets and hand washing facilities are in safe and sanitary operating conditions. All materials and surfaces accessible to children are toxic free. At this time, the Nurse’s office is used as an isolation area. There is a restroom, sink and space available to place chairs/mat in the office. Parents are contacted immediately when children are determined to be ill and staff are ensuring that children with obvious symptoms of illness are not being accepted.

Food menus were reviewed to ensure that they are being posted at least one week in advance and visible to an authorized representative. Facility provides children with PM Snack. All children gather at the lunch tables for snack. Per Director, children bring their water bottles from home and water is provided if needed. LPA observed several drinking stations located outdoors and water fountains in each room. Storage of water bottles were observed in quantities to meet the needs of children in care.

All kitchen, food preparation, and storage areas are clean, free of litter, rubbish, and rodents/vermin. All food is protected from contamination, and LPA inspected that any contaminated food is discarded immediately. All storage containers for solid waste, including moveable bins, have tight fitting covers on and are in good repair. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are stored in an area inaccessible to children. Director states that there are no poisons stored at the facility.
REPORT CONTINUES ON NEXT PAGE 2 OF 5.
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:

DATE: 04/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2023
LIC809 (FAS) - (06/04)
Page: 2 of 9
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: PRIME TIME SPORTS CAMP @ IVANHOE ELEMENTARY SCHOOL
FACILITY NUMBER: 198016726
VISIT DATE: 04/25/2023
NARRATIVE
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Facility has one functioning carbon monoxide detector that meets statutory requirements. The carbon monoxide detector is located inside the Director’s office library/yellow building (to the left of the front entrance), which was tested at 3:27 pm, and it is in operable condition.

Outdoor play equipment was observed to be in good condition, free of sharp, loose or pointed parts. Outdoor activity space surface is maintained in a safe condition as is free of hazards. Areas around and/or under climbing equipment and slides have soft cushioning to absorb a fall.

Children are picked up from classrooms and signed in by staff. Upon departure child’s parent/authorized person will signed out child. There are separate gender assigned restrooms which are located directly across or adjacent to the school age classrooms. Per Director, children are escorted to restrooms at all times.

Staff Records were reviewed to ensure that personnel records are maintained on all staff. Children’s Records were reviewed to ensure that Identification and Emergency form and a medical assessment are on file. LPA issued the Children’s Record Review (LIC 857) and the Review of Staff records (LIC 859) to the Director during this inspection. There is at least one person trained in CPR and Pediatric First Aid present during this inspection.

SB792 (Immunization Requirements for Staff and Employees) was discussed with the facility representative.

AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018 any person who works in a child care facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers


REPORT CONTINUES ON NEXT PAGE 3 OF 5.
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:

DATE: 04/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2023
LIC809 (FAS) - (06/04)
Page: 3 of 9
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: PRIME TIME SPORTS CAMP @ IVANHOE ELEMENTARY SCHOOL
FACILITY NUMBER: 198016726
VISIT DATE: 04/25/2023
NARRATIVE
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Incidental Medical Services (IMS) policy was discussed. This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. In review of medication for Child #1 LPA observed Child #1's Epinephrine Injection expired 03/2023. 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.htm

The following was discussed:
  • Reporting Requirements.
  • The facility shall ensure that each child is accorded the following personal rights: to be accorded safe, healthful and comfortable accommodations.
  • All personnel shall be in good health and shall be physically and mentally capable of performing assigned tasks; personnel that pose a threat to the health and safety of children shall be relieved of their duties.
  • All personnel shall be given on the job training in housekeeping, sanitation principles and universal health precautions.

REPORT CONTINUES ON NEXT PAGE 4 OF 5.
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:

DATE: 04/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2023
LIC809 (FAS) - (06/04)
Page: 4 of 9
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: PRIME TIME SPORTS CAMP @ IVANHOE ELEMENTARY SCHOOL
FACILITY NUMBER: 198016726
VISIT DATE: 04/25/2023
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LPA advised the facility representative to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov. In addition, LPA advised Director that only the rooms that have been approved and licensed are to be used. Director understands that only rooms 2, 4, 5, 8, 9, auditorium and restrooms are approved by the Department for facility to use with school age children and staff. During this inspection the Director provided LPA with a copy of the facility sketch with highlighted areas used by children and staff; rooms 2,4,5,8,9 and auditorium.

LPA Garcia discuss PIN 21-21.1 CCP Written directives for Lead Testing of Water in Licensed Child Care Centers pursuant to AB2370 Chapter 676, Statutes of 2018 with Director during this inspection. A copy of PIN 21-21.1CCP was provided to the Director.

The following deficiencies are being cited in accordance to Title 22 of the California Code of Regulations and Health & Safety codes. Please refer to LIC809D for documentation of deficiencies cited.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with facility representative, Carla Iezza.

REPORT ENDS HERE PAGE 5 OF 5.
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:

DATE: 04/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2023
LIC809 (FAS) - (06/04)
Page: 5 of 9
Document Has Been Signed on 04/25/2023 05:40 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754


FACILITY NAME: PRIME TIME SPORTS CAMP @ IVANHOE ELEMENTARY SCHOOL
FACILITY NUMBER: 198016726

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/25/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.16(a)(1)
Lead Testing
(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview disclosure with Director, drinking water outlets have not been tested for lead contamination. This poses a potential health and safety risk to children in care.
POC Due Date: 05/16/2023
Plan of Correction
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LPA Garcia discuss PIN 21-21.1 CCP with Director during this inspection. Per Director facility will work on being in compliance with testing water outlets by POC due date 05/16/2023.
Type B
Section Cited
CCR
101215.1(m)
Child Care Center Director Qualifications and Duties
(m) A child care center director shall complete 16 hours of health and safety training if necessary pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on records review and interview disclosure Director has not completed heath and safety course. This poses a potential health and safety risk to children in care.
POC Due Date: 05/16/2023
Plan of Correction
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Per Director, she will enroll in an EMSA approved health and safety course and will submit proof of course completion to LPA Garcia via email by POC due date 05/16/23.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:
DATE: 04/25/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/25/2023
LIC809 (FAS) - (06/04)
Page: 6 of 9


Document Has Been Signed on 04/25/2023 05:40 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754


FACILITY NAME: PRIME TIME SPORTS CAMP @ IVANHOE ELEMENTARY SCHOOL
FACILITY NUMBER: 198016726

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/25/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(g)(2)
Personnel Requirements
(2) Each person specified in (g) above shall have a health-screening report signed by the person performing the screening. This report shall indicate the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on records review of Staff #2 file, no health screening report was available for review. This poses a potential health and safety risk to children in care.
POC Due Date: 05/16/2023
Plan of Correction
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Per Director, Staff #2 will obtain health screening report and a copy will be scan to LPA Garcia via email by POC due date 05/16/23
Type B
Section Cited
CCR
101226(e)(3)(A)
Health-Related Services
(3) Prescription medications may be administered if all of the following conditions are met: (A) Prescription medications shall be administered in accordance with the label directions as prescribed by the child's physician.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA's inspection of Child #1's Epinephrine Injection expired 03/2023. This poses a potential health and safety risk to children in care.
POC Due Date: 04/26/2023
Plan of Correction
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During LPA's inspection the child #1's parent was notified of expired medication. Per Director, child's parent will bring in new medication prior to child returning to program. A picture of the new medication will be submitted to LPA Garcia via email by POC due date 04/26/23.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:
DATE: 04/25/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/25/2023
LIC809 (FAS) - (06/04)
Page: 7 of 9