195700031-10-1-2024-58-CC-TBIM-D9MUEJ-20241001153113

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 195700031
Report Date: 10/01/2024
Date Signed: 10/01/2024 03:31:22 PM

Document Has Been Signed on 10/01/2024 03:31 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	BOULEVARD SCHOOL, THE		FACILITY NUMBER:	195700031
ADMINISTRATOR/ DIRECTOR:	JENNIFER WILL		FACILITY TYPE:	850
ADDRESS:	23022 VICTORY BLVD		TELEPHONE:	(818) 883-0607
CITY:	WOODLAND HILLS	STATE: CA	ZIP CODE:	91367
CAPACITY: 203	TOTAL ENROLLED CHILDREN: 175	CENSUS: 121	DATE:	10/01/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:15 AM
MET WITH:	Rodi Vogel		TIME VISIT/ INSPECTION COMPLETED:	03:46 PM

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Licensing Program Analyst (LPA) Tatiana Bickham conducted an unannounced random annual inspection on 10/01/2024. LPA arrived at the facility at 11:15 AM. LPA met with Director Rodi Vogel who guided LPA on tour of the facility. This is a preschool program licensed for 203 preschoolers. Facility consist of 17 classrooms. Hours of operation are Monday through Friday from 7:30am to 6:00pm.

All areas identified on the Facility Sketch were inspected. During inspection 121 children were present with 24 staff.

Teacher/child ratios were observed to be in accordance with Title 22 regulations. The Licensee is within the conditions, limitations, and capacity specified on the license. Staff names were recorded. All children were observed to be under visual supervision of a teacher at all times.

Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Children have their own cubby to store their belongings. Linens is taken home each week to be washed. Napping equipment (mats) were observed in each room. Per Director, the isolation area is located in the conference room. Age-appropriate sinks and toilets were inspected for availability and good repair in all restrooms.

General sanitation was observed. Availability of indoor drinking water was observed in classrooms via filtered pitchers. LPA observed during file review that the water was tested for lead in July 2022.

Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Carbon monoxide detector was observed in the classroom and is operable.

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SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Tatiana Bickham
LICENSING EVALUATOR SIGNATURE:	DATE: 10/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2024

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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: BOULEVARD SCHOOL, THE	FACILITY NUMBER: 195700031
	VISIT DATE: 10/01/2024

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All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish, rodents, and/or any other vermin. All storage containers for solid waste, including moveable bins have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids or solid waste bags shall be discarded immediately after each meal. Food is not provided by the facility. The facility provides PM snack and children bring their own lunch. First Aid supplies were observed. Per Director, medication is administered at the facility. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records.

Outdoor playground equipment is in a safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under high climbing equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard. Availability of outdoor drinking water was observed. LPA advised that no children shall be left without the supervision of a teacher at any time.

All floors were observed to be clean and safe. All materials accessible to children were observed to be toxic-free There are no firearms stored on the premises. There is a pool at the facility, the pool has a gate that is at least 5ft high, opens away from the bodies of water and is self-latching and self-closing.

Children’s records were reviewed for Admission Agreement, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, LIC 613-Personal Rights, LIC 702-Health History, and LIC 701 Physicians Report, and Immunization Records.

Staff records were reviewed for Education, LIC-501: Personnel Record, LIC 508-Criminal Record Statement, LIC 9052- Employee Rights, LIC503- Health Screening, 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 and current Mandated Reporter Training Certificate. There is at least one person trained in CPR and Pediatric First Aid present during this inspection. 4 out of 11 staff files were missing proof of immunization's against measles, pertussis and influenza or influenza declination. 1 staff is missing proof of transcripts.

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SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Tatiana Bickham
LICENSING EVALUATOR SIGNATURE:	DATE: 10/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2024

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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: BOULEVARD SCHOOL, THE	FACILITY NUMBER: 195700031
	VISIT DATE: 10/01/2024

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Director was reminded that all adults 18 and over, 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.

Incidental Medical Services (IMS) policy was discussed. 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

At this time, the facility is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today. Exit interview conducted and report was reviewed with Director, Rodi Vogel. A notice of site visit was given and must remain posted for 30 days.

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/tion-process.

Page 3.

SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Tatiana Bickham
LICENSING EVALUATOR SIGNATURE:	DATE: 10/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2024

LIC809 (FAS) - (06/04)

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