198400217-8-6-2020-54-CC-AMOY-BS92E7-20200806171927

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198400217
Report Date: 08/06/2020
Date Signed: 08/06/2020 05:21:35 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	BESA SCHOOL, THE		FACILITY NUMBER:	198400217
ADMINISTRATOR:	BRIDGETTE ROBINSON		FACILITY TYPE:	840
ADDRESS:	15000 STUDEBAKER RD		TELEPHONE:	(562) 474-1848
CITY:	NORWALK	STATE: CA	ZIP CODE:	90650
CAPACITY:	50	CENSUS: 0	DATE:	08/06/2020
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Bridgette Robinson		TIME COMPLETED:	01:15 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	Due to COVID-19 and precautionary measures, this pre-licensing inspection was conducted via video conference using FaceTime application. Licensing Program Analysts (LPAs) Alicia Mooberry and Armando J. Lucero met with Applicant Bridgette Robinson for the purpose of continuing a Pre-Licensing Inspection from 7/29/20 and to obtain measurements for facility capacity. Applicant is applying for a School Age Center License. Also present was Jose Hernandez, Director’s spouse. Applicant is requesting a total capacity of 50 children. The proposed program will operate Monday through Friday from 8:00am to 4:00pm. The proposed program is located on the campus of the church. All indoor and outdoor areas identified on the facility sketch were toured during this visit. The program will use Rooms 16 and Room 17. The program will enter through gate that is adjacent to the preschool program. The restrooms are located down the hall from classrooms. First Aid supplies were inventoried. A first aid kit is kept in Classroom 16. Carbon monoxide detectors and smoke detectors are present and in operable condition. Fire extinguishers have been serviced in. The applicant states that the director's office will be used as the ill isolation area and children will use the staff restroom. The facility will provide hot lunch, AM and PM snack. Meal are prepared on site in facility kitchen. The facility will administer prescription and non-prescription medications. Medications will be stored in the director's office, unless refrigeration is needed. In this case, medication will be stored in the kitchen. Sign in/out procedures will be implemented at the entrance to the facility. Sign in/out sheets will be located at the school age entrance. There is water available indoors and outdoors. Containers used to discard food have tight fitting lids. Cleaning compounds and any poisons are to be locked with a key lock in storage room. The facility will ensure storage space is available for children’s belongings. Page 1 of 3

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Alicia Mooberry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 08/06/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2020

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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: BESA SCHOOL, THE	FACILITY NUMBER: 198400217
	VISIT DATE: 08/06/2020

NARRATIVE

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Playground equipment is in safe condition, free of sharp, loose or pointed parts. There is a grassy in front of the classroom which will be used as outdoor activity space, it is maintained in a safe condition and is free of hazards. There is outside shade in the table are. The outdoor area is completely fenced. The applicant states that there are no bodies of water on the premises and none were observed during this visit.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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

The following was discussed with the Applicant:
Rooms that are off-limits need to be made inaccessible during operating hours.

The Applicant was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care.

The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and Carbon Monoxide detectors should be checked and batteries replaced as needed. Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your location.

Mandatory Forms for the children’s files and staff files, requirements for fire drills, earthquake drills and documentation were discussed. Role and responsibilities of being a Mandated Reporter were reviewed. Applicant was made aware that it is her responsibility to know the regulations as well as anyone who assists in providing care.

LPA advised Applicant that all adults 18 years of age and older providing Care & Supervision and/or have continuous presence in the facility shall adhere to a criminal background clearance with the Department of Justice, FBI and Child Abuse Index Check. Page 2 of 3

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Alicia Mooberry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 08/06/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2020

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: BESA SCHOOL, THE	FACILITY NUMBER: 198400217
	VISIT DATE: 08/06/2020

NARRATIVE

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The Applicant was advised how to access forms and Regulations and LIVE SCAN application online at https://cdss.ca.gov/inforesources/community-care-licensing. Records for all children and staff must be maintained for three (3) years after separation from the facility.

The Applicant was also advised of the requirement to report Unusual Incidents and/or injuries to the parent/guardian and to CCL within the time frame specified by the regulation.

Applicant advised that indoor and outdoor supervision required at all times.

Licensing Department received Fire Clearance on 7/28/20 approved for 50 school age children.
Based on measurements of facility obtained on this date via facetime by licensing staff, it was determined that the total capacity 45 school aged children.

Licensing staff will send out for new STD 850 for new fire clearance when updated application is received

The following requirements are needed prior to the applicant obtaining a School Age Child Care Center license:

1. Fire Extinguishers: Provide proof of service date or date of purchase.

2. Incidental Medical Services (IMS) Plan must be submitted to CCL
3. Tables and chairs shall be provided to meet the needs of the children
4. Provide individual permanent or portable storage space for each child’s belongings
5. Staff preparing and handling food needs to obtain the required training and certification
6. Update Fire Clearance (STD 850)

THE ABOVE CORRECTIONS ARE DUE ON OR BEFORE 9/8/2020
Once the above items have been corrected, and all application documents approved, the department will make its determination on whether to approve the Applicant for a School Age Child Care Center license.

Exit interview was conducted with Bridgette Robinson, via tele-inspection, during which appeal rights were explained. This report along with a copy of the appeal rights will be sent to the Applicant via email with a read receipt or confirmation of receipt of email, which will act as the Applicants signature. Page 3 of 3

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Alicia Mooberry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 08/06/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2020

LIC809 (FAS) - (06/04)

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