<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197416690
Report Date: 04/03/2024
Date Signed: 04/03/2024 02:42:14 PM


Document Has Been Signed on 04/03/2024 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:BARTON HILL ELEMENTARY SCHOOL CSPPFACILITY NUMBER:
197416690
ADMINISTRATOR:MARDESICH, LOUIEFACILITY TYPE:
850
ADDRESS:423 NORTH PACIFIC AVENUR RM.24TELEPHONE:
(310) 547-2471
CITY:SAN PEDROSTATE: CAZIP CODE:
90731
CAPACITY:23CENSUS: 13DATE:
04/03/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
09:48 AM
MET WITH:Steve Donahue, Assistant PrincipalTIME COMPLETED:
02:55 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Lilia Hernandez conducted an unannounced annual inspection to the above facility on 04/03/2024. LPA arrived at the facility at 09:48AM, identified self and met with Steve Donahue, Assistant Principal, who guided analyst on a tour of the facility. LPA provided the principal with a copy of the LIC 125 Entrance Checklist to help facilitate the inspection. This is a state preschool program located on an elementary campus in Room 24. Hours of operation are Monday – Friday from 8:00AM – 2:23PM.

There were 13 children and 2 staff present when LPA arrived. Criminal record clearance was not reviewed. However, per condition of employment with the Los Angeles Unified School District, all individual’s present have obtained a criminal record clearance or criminal record exemption.

The following was observed during the tour of the facility:


Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting, and ventilation were evaluated. LPA observed children's back packs stored in a bin near the door entry to the classroom. Children do not have an individual space for jackets to be stored. LPA observed jackets placed on a table stacked on top of each other. (Photo taken) Cots and linens are provided for each child enrolled. Linens are washed weekly by school district. Age-appropriate sinks and toilets were inspected for availability and good repair in the restroom. Rooms 24 has a bathroom that has 1 sink and 1 toilet accessible for children. Facility has a waiver to include outdoor restroom to be used by children with supervision of a teacher. Room 24 also has an additional sink for handwashing only. General sanitation was observed. Availability of indoor drinking water was observed in the classroom.

Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Assistant Principal stated that poisons are kept in a locked room outside of Room 24. Disaster drill log was available, last drill was conducted on 03/04/2024 and Fire Drill on 03/14/2024. ---Page 1 of 3
SUPERVISOR'S NAME: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia HernandezTELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:
DATE: 04/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/03/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 7


Document Has Been Signed on 04/03/2024 02:42 PM - It Cannot Be Edited

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: BARTON HILL ELEMENTARY SCHOOL CSPP
FACILITY NUMBER: 197416690

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/03/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
WD
101700(b)
Written Directives for Lead Testing
(b) All licensed Child Care Centers operating in buildings constructed before January 1, 2010, shall test their water for lead pursuant to these written directives.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interview, the licensee did not comply with the section cited above in Assistant Principal did not have documentation for the remediation on the lead exceedance for Room 24 which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/24/2024
Plan of Correction
1
2
3
4
Per Assistant Principal, documentation for plan of correction to address exceedance will be submitted to LPA via email by POC due date. Supporting documentation should include: External Water Sampler Self-Certification Form (LIC 9275); Child Care Center Sampling Checklist Form (LIC 9276); Facility Sketch (LIC 999) in which all water outlets are noted; and a copy of water testing results summary.
Type B
Section Cited
CCR
101238.4(a)
Storage Space
(a) The licensee shall ensure that each child has an individual permanent or portable storage space for his/her clothing, personal belongings and/or bedding.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above in LPA observed children's back packs stored in a bin near the door entry to the classroom. Children do not have an individual space for jackets to be stored. LPA observed jackets placed on a table stacked on top of each other which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/24/2024
Plan of Correction
1
2
3
4
Per Assistant Principal, individual permanent or portable space will be made for children in care. Corrections will be submitted in a form of invoice for any purchases or photos. Corrections will be submitted to LPA via email by POC due date.
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: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia HernandezTELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:
DATE: 04/03/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/03/2024
LIC809 (FAS) - (06/04)
Page: 2 of 7


Document Has Been Signed on 04/03/2024 02:42 PM - It Cannot Be Edited

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: BARTON HILL ELEMENTARY SCHOOL CSPP
FACILITY NUMBER: 197416690

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/03/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101239(f)(1)
Fixtures, Furniture, Equipment and Supplies
(f) Solid waste shall be stored, located and disposed of in a manner that will not transmit communicable diseases or odors, create a nuisance, or provide a breeding place or food source for insects or rodents. (1) All containers used for storage of solid wastes, including moveable bins, shall have a tightfitting cover that is kept on; shall be in good repair; and shall be leakproof and rodent-proof.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above in LPA observed trash can in lunch area used for solid waste without a tight fitting cover which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/24/2024
Plan of Correction
1
2
3
4
Per Assistant Principal, tight fitted lids for trash bins used for solid waste will be obtained. Proof of correction will be submitted in form of receipt as proof of purchase and photo of trash bins in lunch area. Corrections will be submitted via email to LPA by POC due date.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interview, the licensee did not comply with the section cited above in Assistant Principal stated no staff records were not available for review which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/24/2024
Plan of Correction
1
2
3
4
Per Assistant Principal, mandated reporter training's thst meet the AB1207 will be completed. Certificates of completion for Principal, Teacher and Aide will be submitted to LPA via email by POC due date.
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: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia HernandezTELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:
DATE: 04/03/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/03/2024
LIC809 (FAS) - (06/04)
Page: 3 of 7


Document Has Been Signed on 04/03/2024 02:42 PM - It Cannot Be Edited

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: BARTON HILL ELEMENTARY SCHOOL CSPP
FACILITY NUMBER: 197416690

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/03/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interview, the licensee did not comply with the section cited above in Assistant Principal stated no staff records were not available for review which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/24/2024
Plan of Correction
1
2
3
4
Per Principal, proof of immunization's for Principal, Teacher and Aide will be obtained. Copies of records will be submitted to LPA via email by POC due date.
Type B
Section Cited
CCR
101217(a)
Personnel Records
(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information:

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interview, the licensee did not comply with the section cited above in Assistant Principal stated no staff records were not available for review which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/24/2024
Plan of Correction
1
2
3
4
Per Principal, Personnel Records will be kept in the facility and made available during inspection. A copy of the personnel records that includes, Staff qualifications, proof of immunization, Current First Aid/CPR certificate, Mandated reporter training, LIC9108 and LIC9052 for Principal, Teacher and Aide will be submitted to LPA via email by POC due date.
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: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia HernandezTELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:
DATE: 04/03/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/03/2024
LIC809 (FAS) - (06/04)
Page: 4 of 7


Document Has Been Signed on 04/03/2024 02:42 PM - It Cannot Be Edited

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: BARTON HILL ELEMENTARY SCHOOL CSPP
FACILITY NUMBER: 197416690

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/03/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101229.1(a)(1)
Sign In and Sign Out
(a) In addition to the sign-in procedure requirement of Section 101226.1(b), the licensee shall develop, maintain and implement a written procedure to sign the child in/out of the child care center that shall, at a minimum, include the following: (1) The person who signs the child in/out shall use his/her full legal signature and shall record the time of day.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above LPA observed 3 of 13 children not signed in on signing/out sheets. Aide disclosed children arrived late and children are dropped off at the main office of school campus which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/24/2024
Plan of Correction
1
2
3
4
 Per Assistant Principal, a policy/procedure will be put in place for the person who drops off the child to sign the sign in/out sheets at arrival and departure. A written plan will be submitted to LPA via email by POC due date.
Type B
Section Cited
CCR
101212(b)
Reporting Requirements
(b) The name of the child care center director, and any fully qualified teacher(s) designated to act in the child care center director's absence, shall be reported to the Department within 10 days of a change of child care center director or designee(s).

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above in the Department did not receive an LIC308 for the current principal which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/24/2024
Plan of Correction
1
2
3
4
Per Assistant Principal, an LIC308 Designation Of Facility Responsibility with the current principal information will be submitted to LPA via email by POC due date.
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: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia HernandezTELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:
DATE: 04/03/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/03/2024
LIC809 (FAS) - (06/04)
Page: 5 of 7


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: BARTON HILL ELEMENTARY SCHOOL CSPP
FACILITY NUMBER: 197416690
VISIT DATE: 04/03/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Carbon monoxide detector were observed in the classroom. IQ Air Filtration Technology installed has built in carbon monoxide detector. This system was installed due to refineries located near the facility.

LPA observed menus posted. Menus for the past 30 days are available upon request. The facility provides breakfast and lunch to children in care. 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 shall have tight-fitting covers that are kept on, and in good repair. LPA observed trash can in lunch area used for solid waste without a tight-fitting cover. (photo taken)

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, slides, and similar equipment are cushioned with material that absorbs a fall. LPA observed trees in the outdoors that provide shade. 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 Per Assistant Principal, there are no firearms stored on the premises. LPA did not observe pools or bodies of water at the facility.

LPA did not observe at least one person trained in CPR and Pediatric First Aid present during this inspection.

There were no staff records in the facility for LPA to review. Missing documentation was documented on the LIC 859. Staff present did not have proof of the AB 1207 Mandated Reporter Training certificate on file. Staff present did not have proof against TB, measles, pertussis, and influenza. LPA advised Assistant Principal to submit an LIC308 Designation of Facility Responsibility with the current principal’s information.



Children’s Records were reviewed. Inspection of required forms was made and documented on the LIC 857. Children's roster was reviewed. Sign-In and Sign-Out sheets were reviewed. LPA observed 3 of 13 children not signed in on signing/out sheets. Aide disclosed children arrived late and children are dropped off at the main office of school campus. ---Page 2 of 3
SUPERVISOR'S NAME: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia HernandezTELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2024
LIC809 (FAS) - (06/04)
Page: 6 of 7
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: BARTON HILL ELEMENTARY SCHOOL CSPP
FACILITY NUMBER: 197416690
VISIT DATE: 04/03/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
LPA observed First Aid supplies in the classroom. LPA also observed additional first aid supplies in the nurse’s office. Per principal, medication is only administered to a child when accompanied with a doctor's note and is stored in the nurse’s office. The facility was observed to be equipped with an isolation area for any child who becomes ill, and it is in the nurse’s office.

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

LPA advised the licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov. UPDATE: LPA provided the principal with a copy of the Effects of Lead Exposure form during the inspection and discussed the following Provider Information Notices (PINs) Required Lead Testing: PIN 20-01 CCP Effects of Lead Exposure, and Guardian User Account Access - PIN 20-20-CCLD.


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.

The following deficiencies listed on the attached deficiencies page are being cited in accordance with California Code of Regulations Title 22.

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

Exit interview conducted and report was reviewed with Steve Donahue, Assistant Principal.---Page 3 of 3

SUPERVISOR'S NAME: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia HernandezTELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2024
LIC809 (FAS) - (06/04)
Page: 7 of 7