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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197413414
Report Date: 03/09/2023
Date Signed: 03/09/2023 11:58:54 AM

Document Has Been Signed on 03/09/2023 11:58 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:ABC LITTLE SCHOOL VAN NUYS, LLCFACILITY NUMBER:
197413414
ADMINISTRATOR:JESSICA BROWN-VINCENTFACILITY TYPE:
850
ADDRESS:6447 WOODMAN AVENUETELEPHONE:
(818) 786-5169
CITY:VAN NUYSSTATE: CAZIP CODE:
91401
CAPACITY: 100TOTAL ENROLLED CHILDREN: 70CENSUS: 53DATE:
03/09/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH: Director- Jessica Brown - VincentTIME COMPLETED:
12:35 PM
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On 3/9/2023 Licensing Program Analyst (LPA), Suzette Ornelas conducted an unannounced Case Management - Incident Visit for the facility. LPA met with Director, Jessica Brown - Vincent, and toured the facility indoors and outdoors. Days and hours of operation are Monday through Friday 7a to 6p.

LPA observed all required postings in a prominent area. LPA observed 53 children and 10 adults. All children are under supervision, including visual supervision, of a teacher at all times. Capacity and limitations as specified on the license are being maintained. A walk through of the classroom area was conducted. LPA observed 6 licensed classrooms on the premises, 1 which is a toddler classroom.

RM A/B (CURRENTLY NOT IN USE); RM C (TODDLER); RM D (2Y); RM E (3-4Y); RM F (PRE-K 4Y & UP)


All areas identified on the Facility Sketch were inspected. The following staff were present during this inspection:

RM A: CURRENTLY NOT IN USE
RM B: CURRENTLY NOT IN USE
RM C: 11 toddler children with a ratio of 2 teachers
RM D: 22 preschool children with a ratio of 2 teachers
RM E: 12 preschool children with a ratio of 2 teachers
RM F: 8 preschool children with a ratio of 1 teacher

On 2/13/2023, the facility submitted an Unusual Incident/Injury Report to the Department. The report stated that on 2/9/2023, Staff #1 (S1) observed child #1 (C1) slip and fall on the play structure step during outdoor activity time. C1 fell and bumped his right cheek which became swollen.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE: DATE: 03/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/09/2023
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: ABC LITTLE SCHOOL VAN NUYS, LLC
FACILITY NUMBER: 197413414
VISIT DATE: 03/09/2023
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On 2/23/2023, LPA observed the daily operation of the facility, conducted interviews with staff. Based on the information obtained during observation and interviews, with the self reported Unusual Incident/Injury Report, it was determined that S1 observed the incident and provided medical attention to C1. Parent was notified immediately via parent portal and a voicemail was left after a phone call attempt. C1 continued to be in care for the remainder of the day and the facility followed the appropriate Reporting Requirements. Per Director, C1 last day at the facility was 2/9/2023. LPA observed play equipment and appeared in good condition and age appropriate for child. LPA took pictures of the area and play structure was observed to be safe and have appropriate padding.

On 3/1/2023, LPA Ornelas contacted Director to inquire about the age appropriateness of the play structure where incident occurred. Director immediately contacted Miracle Playground to inquire about the age appropriateness of the playground equipment in question and informed LPA with response from Miracle Playground representative stating that the "play structure is structured for children ages 2-5 years old. This is a very old structure that is now obsolete so we would not be able to replace any parts should the be needed. We are happy to see this older structure still maintained and in use".

During todays visit, LPA and director discussed creating a plan of correction to ensure that the moving forward, the non age appropriate play structure is made inaccessible and equipment purchased moving forward obtains verification of age appropriateness. Director purchased and provided LPA with proof of purchase for 3 Super Yard Color Play Panel Free Standing Gates to make the play structure inaccessible to toddlers in care while a permanent solution is pending. Director is taking all appropriate and necessary actions to ensure that the structure will be made inaccessible to toddlers in care as of 3/9/2023.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiency is being cited: 101239(m)(1) Fixtures, Furniture, Equipment and Supplies. (see next page, 809 D) Licensee was provided a copy of their appeal rights.
Upon receipt of a Type A violation, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. A copy of LIC 9224 was given to licensee.
This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:

DATE: 03/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2023
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Document Has Been Signed on 03/09/2023 11:58 AM - It Cannot Be Edited


Created By: Suzette Ornelas On 03/09/2023 at 10:39 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: ABC LITTLE SCHOOL VAN NUYS, LLC
FACILITY NUMBER: 197413414

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/09/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type A
03/09/2023
Section Cited
CCR
101239(m)(1)

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Fixtures, Furniture, Equipment and Supplies:
All play equipment and materials used by children shall be age-appropriate. (1) The licensee shall provide a variety of age-appropriate equipment, toys and materials

This Requirement is not met as evidenced by:
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Director purchased and provided LPA with proof of purchase for 3 Super Yard Color Play Panel Free Standing Gates to temporarily address the concern and make the play structure inaccessible to toddlers in care. A permanent solution will be set in place in the future.Director will provide picture to LPA of installed gates on or before the close of business on 3/24/2023.
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Based on LPA's observations, infromation obtained and interviews conducted, 1, 20 month old toddler became injured on an outdoor play structure that was not age appropriate which poses an immediate health, safety or personal rights risk to person 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:Lisa Rios
LICENSING EVALUATOR NAME:Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:
DATE: 03/09/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/09/2023


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