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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197413079
Report Date: 05/03/2022
Date Signed: 05/03/2022 11:36:03 AM

Document Has Been Signed on 05/03/2022 11:36 AM - 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:SOUND OF MUSIC PRESCHOOL, INC.FACILITY NUMBER:
197413079
ADMINISTRATOR:LISA GARCIAFACILITY TYPE:
850
ADDRESS:1256 S. VAN NESS AVENUETELEPHONE:
(323) 733-1327
CITY:LOS ANGELESSTATE: CAZIP CODE:
90019
CAPACITY: 78TOTAL ENROLLED CHILDREN: 78CENSUS: 17DATE:
05/03/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Lisa Garcia, DirectorTIME COMPLETED:
11:40 AM
NARRATIVE
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On 05/03/2022, Licensing Program Analyst (LPA) Sabrina Martinez conducted a Case Management- Deficiencies visit for the purpose of citing for the deficiencies that were observed during the visit on 05/03/2022.

LPA met with Licensee Lisa Garcia. There were 17 children in care being supervised by Licensee, Staff #1 and Staff #2.

On 05/03/2022, LPA Martinez toured Classroom #3 and inspected the changing table. Licensee stated that children who wear diapers are changed in the changing table and children and staff would wash their hands in the bathroom sink. LPA informed Licensee that the changing table should be placed within arm's reach of a sink.

The facility is found to be in violation of Title 22 CCR 101439 (h) (4). Type B citation was issued today, 05/03/2022. (See LIC 809-D for deficiency page).

An exit interview was conducted with Licensee Lisa Garcia. A copy of this report, Notice of Site Visit, and appeal rights were provided to Licensee.
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Sabrina Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 05/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/03/2022
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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Document Has Been Signed on 05/03/2022 11:36 AM - It Cannot Be Edited


Created By: Sabrina Martinez On 05/03/2022 at 11:23 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: SOUND OF MUSIC PRESCHOOL, INC.
FACILITY NUMBER: 197413079

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/03/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/10/2022
Section Cited
CCR
101439(h)(4)

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Infant Care Center Fixtures, Furniture, Equipment and Supplies. Infant changing tables shall: While in use, be placed within arm's reach of a sink. This requirement is not met as evidenced by: On 05/03/2022, LPA Martinez inspected the changing table and observed that the changing table is not placed within arm's reach of a sink. This is a Type
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Licensee stated that the changing table will be placed in an area that is within arm's reach of a sink. Licensee stated that she will correct the deficiency on or before May 10, 2022.

Licensee will email photos to LPA Martinez no later than May 10, 2022.
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B citation and poses a potential risk to the health and safety of children in care.
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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:Maureen Neal
LICENSING EVALUATOR NAME:Sabrina Martinez
LICENSING EVALUATOR SIGNATURE:
DATE: 05/03/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/03/2022


LIC809 (FAS) - (06/04)
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