198020404-10-16-2019-33-CC-AEIN-BGZSTB-20191016140915

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020404
Report Date: 10/16/2019
Date Signed: 10/16/2019 02:09:47 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	DISNEY CHILDREN'S CENTER		FACILITY NUMBER:	198020404
ADMINISTRATOR:	C DALLAMORA & D OCASEK		FACILITY TYPE:	830
ADDRESS:	625 PAULA ST		TELEPHONE:	(818) 931-5437
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91201
CAPACITY:	36	CENSUS: 26	DATE:	10/16/2019
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Kim Thorstenson-Root, Regional Manager		TIME COMPLETED:	02:30 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	Licensing Program Analysts (LPA) Anomeh Eivazian and Fabiola Vasquez conducted an announced pre-licensing inspection. Licensing staff met with applicant Kim Thorstenson-Root, Regional Manager and Ana Ortiz, Assistant Director, who provided a tour of the facility. This is a change of ownership, previous license number was 198016081. Applicant is applying for a Infant License. Applicant is requesting a total capacity of 36 infants. The proposed program will operate Monday through Friday from 7:00 A.M. to 7:00 P.M. The proposed infant program will operate on the same site as the preschool program (#198020405). There are four buildings on the premises: Building A: East and West Administration, Building B: Infant Program, Building C: Two year old (preschool), and Building D: Preschool. There are three classrooms to be used for the infant program. Classrooms 1-2, 3-4, and 5-6 (6 weeks to 24 months old) infants. Licensing staff inspected and measured the classrooms, including the outdoor area which is gated for separation. Children will be signed in upon entrance to each classroom where a daily log is available. Parents will enter through a separate entrance near the main front gate which is located in building A. The Director's office is located near the main entrance area where it will be used by ill children. Applicant states that ill infants will be changed in the adult restroom if needed. (There is a wall mounted changing table available within arms reach of a sink). Applicant shall ensure that food is age appropriate and follows Federal Food Guidelines, as well as an extra supply is available on the occasion a parent forgets to provide. Food/Formula will be provided by the parents of the child. The facility provides AM and PM snack. There is a kitchen area in each classroom which is gated and inaccessible to the children. There is also a microwave and a refrigerator in each classroom in kitchen area. The sink has running water. Milk and any food which requires refrigeration will be stored in this refrigerator. Cabinets are available for storage. REPORT CONTINUES ON NEXT PAGE 1 OF 3

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2019

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 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: DISNEY CHILDREN'S CENTER	FACILITY NUMBER: 198020404
	VISIT DATE: 10/16/2019

NARRATIVE

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Infant changing tables have a padded surface no less than one inch thick and are covered with washable vinyl or plastic and have raised sides at least three inches high. Toys were observed to be clean and safe. There is a sink within arms reach of the infant changing table.

Indoor activity space for this infant program is physically separate from the other components at this facility, and meets the requirements of 101438.3 (a) - (e).

The applicant states that there will be a staff person in the napping area at all times. There are 36 cribs available.

Containers used to discard food have tight fitting lid at this time. Cleaning compounds are inaccessible and there are no poisons on the premises.

There is age-appropriate furniture and equipment observed in the classroom which appear to be in good condition. The napping area is separated by a wall and half door and will have a staff member inside during napping time. There are cribs available for the infants, and roll-away cribs in case of emergency or evacuation. Napping equipment (cots) were also observed in the classrooms. Children's linens are not to come in contact with other children's linens. The room has central heating and air-conditioning.

Overhead lighting provides the majority of the light in the classroom, but sunlight comes through doors and windows. Cubbies are available for children's belongings. Potty training services will provided. There is a toilet, two changing tables, and three sinks in each classroom.

The outdoor activity area is surrounded by an iron fence to separate the preschool and infant programs. The outdoor play area has age appropriate play structures, and are in good condition. Portable water will be provided to children during outdoor play.

REPORT CONTINUES ON NEXT PAGE 2 OF 3

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2019

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: DISNEY CHILDREN'S CENTER	FACILITY NUMBER: 198020404
	VISIT DATE: 10/16/2019

NARRATIVE

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Medication: This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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. Plan to provide IMS was submitted along with application.

First Aid supplies were inventoried. A first aid kit is kept in each classroom. Carbon monoxide detectors and smoke detectors are present and in operable condition. Fire extinguishers have been serviced in 07/17/2019.

A fire clearance has been approved and is on file. Fire clearance has been granted on 08/22/2019 for capacity of 36 preschoolers . All documents were reviewed.

The applicant states that there are no pets, firearms, weapons, and bodies of water on the premises and none were observed during this inspection.

LPA consulted and explained Child Abuse Reporting, Never Shake a Baby, Sudden Infant Death Syndrome (SIDS), and Safe Sleeping practices which always Baby is sleeping on his/her back. Infants should sleep mouth up, on their backs, free of clutter surrounding their sleeping space. Safe sleep concepts were provided. Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing. (use LIC624B for written report). Applicant shall reveal each facility license number in all advertisements, publications, or announcements made with the intent to attract clients. Mandated reporter training must be completed every 2 years. www.mandatedreporterca.com

LPAs advised the applicant how to access forms, regulations and quarterly updates , and Providers Information Notices (PIN) on line at: www.ccld.ca.gov.
Final review of application will be completed by LPAs prior to licensure.
Exit interview conducted with Applicant, Kim Thorstenson-Root, Regional Manager and Ana Ortiz, Director and a copy of report was given. Appeal rights were issued and discussed. A copy of this report and all other Licensing reports must be made available to the public for 3 years.

REPORT ENDS PAGE 3 OF 3

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2019

LIC809 (FAS) - (06/04)

Page: 3 of 3