191870752-3-16-2022-54-CC-DGIS-CCKTBC-20220316143454

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191870752
Report Date: 03/16/2022
Date Signed: 03/16/2022 02:35:10 PM

Document Has Been Signed on 03/16/2022 02:35 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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	HOLMES AVENUE EARLY EDUCATION CENTER		FACILITY NUMBER:	191870752
ADMINISTRATOR:	ELIZABETH OKORO		FACILITY TYPE:	850
ADDRESS:	1810 EAST FIFTY SECOND STREET		TELEPHONE:	(323) 589-6427
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90058
CAPACITY: 114	TOTAL ENROLLED CHILDREN: 114	CENSUS: 37	DATE:	03/16/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Elizabeth Okoro, Facility Representative		TIME COMPLETED:	02:00 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) Denise Gibbs conducted an unannounced annual required inspection at the above facility on 3/16/22 at 11:15 AM. LPA met with Elizabeth Okoro, Facility Representative (FR) who guided analysts on a tour of the facility. There were 37 children and 11 staff present when LPA arrived. Facility capacity is in compliance License capacity and Title Five ratio guidelines. All individuals present have obtained a criminal record clearance or criminal record exemption as a condition of employment with the Los Angeles Unified School District. At 11:15 AM LPA toured Classrooms #1, #2/PCC ,and #3, All classrooms had furniture in good condition, free of loose, sharp and/or pointed parts. The floors and surfaces in the classrooms were clean and safe. LPA did not observe any tripping hazards. Water is made readily available by via water bottles provided by the facility. There are also water fountains in all room that are currently not in use due to COVID-19 precautions. Per FR, there are currently no children taking medication and there is no medication stored at the facility. Children have cubbies to store personal belongings separate from each other. LPA observed napping cots stored in each classroom. At 11:20 AM LPA toured the children’s restrooms. Restrooms were observed to be safe and sanitary with operable sinks and toilets. At 11:30 AM LPA toured the outdoor play area. Outdoor area was observed to have age appropriate toys and material for children, free of loose, sharp, and/or pointed parts. LPA observed required cushioning under climbing structure to absorb fall. Shade was observed throughout the outdoor area. Water bottles are brought outside for children due to water fountain being out of use. The yard is sectioned off per classroom to help prevent the spread os COVID-19. Toys and materials are cleaned and sanitized after use. ---------------------PAGE 1

SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 03/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2022

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

FACILITY NAME: HOLMES AVENUE EARLY EDUCATION CENTER	FACILITY NUMBER: 191870752
	VISIT DATE: 03/16/2022

NARRATIVE

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At 11:40 AM LPA observed required posted documentation which included, Facility License, Publication (PUB) 393- Notification of Parent Rights, Licensing Form (LIC) 610- Facility Disaster Plan, PUB 269- Child Passenger Restraint System, LIC 613A- Notification of Personal Rights and Lunch/Snack Menu. All documents were observed.

Facility records were reviewed for LIC 9040- Facility Roster, 9148- Earthquake Preparedness form, Daily schedule and Disaster drill log, last drill conducted on 2/21/22. All documents were observed.

LPA reviewed Sign In/Out sheets located in each classroom. All children present were signed in with date, time and full signature of the Teacher who accepts the child. Due to COVID-19 precautions parents do not enter the facility. A digital daily pass (approved child health assessment) is scanned and the child is dropped off. In order to limit the amount of contact and the spread of COVID-19, one teacher handles the sign in clipboard and pen.

At 11:50 AM LPA toured the kitchen located adjacent to the main office. Facility provides AM snack, PM snack and lunch. Food is not cooked at the facility. Prepackaged food is brought from the neighboring, elementary school. Extra food is stored in the kitchen. Kitchen was observed to be clean, free of litter, insects and rodents. LPA observed trash cans for solid waste have tight fitting lids. cleaning supplies are stored separate from the food. Carbon monoxide detector was observed and operable at facility entrance.

Children’s records were reviewed at 12:00 PM for Emergency Card, Immunization Records, Licensing Form (LIC) 627- Consent for Medical Treatment, LIC 995 Notification of Parents’ Rights, LIC 701- Physician’s Report, LIC 613A- Personal Rights, and signed Admissions Agreement. Records were discussed.

Staff records were reviewed at 12:30PM for approved Pediatric First Aid and CPR certification for at least one staff member, LIC 9052- Employee Rights, Proof of immunization against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse, Transcripts or Permit and current Mandated Reporter Training Certificate. Records were discussed.

During inspection all children were observed to be treated with dignity and respect, they were observed to be receiving safe, healthful and comfortable accommodations, furnishings and equipment, and free from corporal and/or unusual punishment. ----------------------PAGE 2

SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 03/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2022

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

FACILITY NAME: HOLMES AVENUE EARLY EDUCATION CENTER	FACILITY NUMBER: 191870752
	VISIT DATE: 03/16/2022

NARRATIVE

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LPA observed that facility is implementing COVID-19 precautions and procedures as required by Los Angeles Unified School District and the Department of Public Health.

Incidental Medical Services (IMS):
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a plan for providing 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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm

Based on the LPA observations and record review no deficiencies will be cited today 3/16/22.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Facility representative was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

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

Exit interview conducted and report was reviewed with the Facility Representative Elizabeth Okoro.

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SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 03/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2022

LIC809 (FAS) - (06/04)

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