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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197414479
Report Date: 09/01/2022
Date Signed: 09/01/2022 02:42:26 PM

Document Has Been Signed on 09/01/2022 02:42 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
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:WESTSIDE WALDORF SCHOOL-SUNSET CAMPUSFACILITY NUMBER:
197414479
ADMINISTRATOR:JUDY PENROSEFACILITY TYPE:
850
ADDRESS:17310 SUNSET BOULEVARDTELEPHONE:
(310) 260-2708
CITY:PACIFIC PALISADESSTATE: CAZIP CODE:
90272
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 20DATE:
09/01/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:41 AM
MET WITH:Director: Judy PenroseTIME COMPLETED:
03:00 PM
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On 09/01/22 at 9:41 AM, Licensing Program Analyst (LPA) Antonio Almanza, conducted an unannounced Annual Required Inspection for the preschool license. LPA met with Assistant Director, Diane Ortega and toured the facility indoors and outdoors. Days and hours of operation are Monday – Friday 8-4:30 PM. Facility phone number is 310-454-7064. LPA conducted Risk Assessment prior to conducting site visit. Director Judy Penrose arrived at the facility after the tour of the facility had started. During today’s visit there are 20 children and 4 Adults providing care and supervision.

The facility has 4 classroom and is currently only operating 2 classrooms. Westside Waldorf School grades 1-8 is located on the premises with the preschool. There is a security gate around the premises of the facility and a security guard at the gate. There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition allowed or stored on the premises. Disinfectants, cleaning solutions, medication and other hazardous items are made inaccessible to children in care. All toilets and handwashing facilities are in safe and sanitary operating condition. Floors in the facility are clean and safe. Furniture and equipment are in good condition, free of sharp, loose or pointed parts. There are First Aid kits, Fire Extinguishers (serviced on 07/23/22), and Fire Pull-Down alarms in the classrooms. Hard wired Fire Alarm system was tested by Los Angeles Fire Department on 07/27/22 and passed. There is no indication on the report that the facility has an operating Carbon Monoxide system. Facility representative does not know if the facility has a Carbon Monoxide system included with the Fire Alarm system. Facility will get Clarification and notify LPA of the Carbon Monoxide system in place (Technical Violation Issued).

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SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE: DATE: 06/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/24/2022
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: WESTSIDE WALDORF SCHOOL-SUNSET CAMPUS
FACILITY NUMBER: 197414479
VISIT DATE: 09/01/2022
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Facility does not provide meals to children in care. Facility does provide snacks. Food preparation and storage areas are clean, free of litter/rubbish and free of rodents/vermin. Solid waste storage containers have tight-fitting covers and are in good repair. Drinking water is available both indoors and outdoors.

Playground equipment is in 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. Areas around high climbing equipment, swings and slides have cushioning material to absorb falls. The facility is free of flies, insects and rodents.

Prior to working or volunteering in a licensed child care facility, all individuals subject to a criminal record review have received a criminal record clearance or exemption. Upon notification from the Department, the licensee will comply and act immediately to terminate the employment of, remove from the facility or bar from entering the facility for any person it is deemed necessary while the Department considers granting or denying an exemption. Capacity and limitations as specified on the license are being maintained. At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at offsite activities. The name of the child care center director or fully-qualified teacher(s) designated to act in the director’s absence has been reported to the Department. The person who signs the child in/out of the facility shall use their full legal signature and record the time of day. Facility maintains a ratio of one teacher supervising no more than 12 children in care. LPA reviewed a sample of children’s files and observed files were complete with LIC 613 A Personal Right, LIC 700 Identification and Emergency Information, LIC 701 Physicians Report, LIC 995 Notification of Parents’ Rights, LIC 627 Consent for Medical Treatment. LPA reviewed a sample of staff files and observed files were complete with health screening, immunization records for influenza, pertussis and measles and current documentation of completed mandated reporter training. LPA observed all required postings in a prominent, public assessable area of the facility: Facility License, Menus, PUB 269 Child Passenger Restraint system poster, PUB 393 Notification of Parents Rights, LIC613A Personal Rights, and LIC610 Emergency Disaster Plan.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE:

DATE: 09/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2022
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: WESTSIDE WALDORF SCHOOL-SUNSET CAMPUS
FACILITY NUMBER: 197414479
VISIT DATE: 09/01/2022
NARRATIVE
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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, 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) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

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

Exit interview conducted and report was reviewed with the Director Judy Penrose.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE:

DATE: 09/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2022
LIC809 (FAS) - (06/04)
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