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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197415364
Report Date: 08/09/2022
Date Signed: 08/09/2022 03:09:58 PM

Document Has Been Signed on 08/09/2022 03:09 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:SOUTH BAY UNIVERSAL CHILD DEVELOPMENT CENTERFACILITY NUMBER:
197415364
ADMINISTRATOR:SUSAN TALEBIANFACILITY TYPE:
850
ADDRESS:14025 CORDARY AVENUETELEPHONE:
(310) 970-0435
CITY:HAWTHORNESTATE: CAZIP CODE:
90250
CAPACITY: 45TOTAL ENROLLED CHILDREN: 45CENSUS: 0DATE:
08/09/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:13 AM
MET WITH:Susan TalebianTIME COMPLETED:
03:00 PM
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 On 08/09/2022 Licensing Program Analyst (LPA), Doris Whitmore, conducted an unannounced inspection visit. LPA met with Susan Talebian Program Director and toured the facility inside and outside. At the time of the inspection there were no children in care and No Teachers Present. Teacher's will be back 08/15/2022 and the children will be back 08/24/2022. LPA observed all posting requirements posted on the board Facility License, Notification of Parents’ Rights. Emergency Disaster Plan. Personal Rights, & Earthquake Preparedness Checklist.


The facility operates two-part day session 8:15a.m. to 11:15 a.m. & 12:30p.m. to 3:30p.m. LPA inspected the furniture and equipment for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Isolation area is located in the Multipurpose/ Office. Age-appropriate sinks and toilets were inspected for availability, good repair, toilet paper, paper towels, area safety and sanitation. All classrooms has trash can with tight lids, first aid supplies, smoke detectors; carbon monoxide/fire extinguishers were observed. Program Director shared the Policy on Administering Medication, including administering, labeling, storage, and records was made. Sign in and out sheet will be reviewed at a later time. All food items and snacks are delivered daily to the facility from the Hawthorne school district. Outdoor play area was all fenced. Equipment was inspected for safety, cushioning material, good repair and age appropriateness. LPA observed shade, play area was inspected for hazards and inaccessibility to bodies of water. Incidental Medical Services (IMS) were discussed. Program Director shared the Incidental Medical Plan binder which included the Policy &Medication Log.

LPA reviewed Children files all documents were in the children files and discussed about the Blue Immunization Card. LPA reviewed staff files and discussed with the P[program Director about the Mandated Reporter Training Certificate which is only good for two years. LPA will do another visit Visit and observe Teacher Child Ratio, Care& Supervision & Sign in Sheets. The Program Director has a current CPR/ First Aid Card. LPA reviewed documentation in a binder of the Fire Drills and the Procedure.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Doris Whitmore
LICENSING EVALUATOR SIGNATURE: DATE: 08/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/09/2022
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: SOUTH BAY UNIVERSAL CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 197415364
VISIT DATE: 08/09/2022
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The Program Director was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Copies of the reports must also be provided to each parent when a serious deficiency, Type A, is cited (LIC9224).
An appeal may be filed, in writing 15 business days from the date of receiving the penalty assessment.

The Program Director was informed of The Child Care Advocate Program (CCAP) that is administered from within the Community Care Licensing Division. CCAP participates in many community activities and special projects in order to disseminate information on the State’s licensing role, provide information to the public and parents on child care licensing, and provide many other helpful resources to the licensees and the public. CCAP’s direct contact information is as followed: Phone number: (916) 654-1541
Email Address: childcareadvocatesprogram@dss.ca.gov

Senate Bill 792: this bill, commencing September 1, 2016, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles. LPA discussed the influenza waiver during the visit.
New Immunization Requirement: Law enacted by SB 277, beginning January 1, 2016, personal beliefs exemptions will no longer be an option for the vaccines that are currently required for entry into child care or school in California. Personal beliefs exemptions already on file will remain valid until the child reaches the next immunization checkpoint.
New Appeal Process: A licensee may file an appeal, in writing 15 business days from the date of receiving the penalty assessment.

Program Director is familiar with CCLD website and receives the PINS and Quarterly reports. Exit Interview was conducted and there are no citations given on 08/09/2022.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Doris Whitmore
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2022
LIC809 (FAS) - (06/04)
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