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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197417876
Report Date: 01/16/2025
Date Signed: 01/16/2025 05:27:29 PM

Document Has Been Signed on 01/16/2025 05:27 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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:CLOVER STARFACILITY NUMBER:
197417876
ADMINISTRATOR/
DIRECTOR:		RASTIN, KATHERINEFACILITY TYPE:
840
ADDRESS:11020 CLOVER AVENUETELEPHONE:
(310) 678-6030
CITY:LOS ANGELESSTATE: CAZIP CODE:
90034
CAPACITY: 120TOTAL ENROLLED CHILDREN: 120CENSUS: 72DATE:
01/16/2025
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:ISAAC OLMOS, DIRECTORTIME VISIT/
INSPECTION COMPLETED:
05:30 PM
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On 01/16/2025, Licensing Program Analyst (LPA) Lisa Clayton conducted an unannounced Required 3-year Inspection on the school age license for STAR – Clover. LPA met with Site Director Isaac Olmos. The facility operates Monday, Wednesday, Thursday and Friday 2:30pm to 6:00pm and Tuesday 1:30pm to 6:00pm. LPA observed 38 children in the E-TK, TK and kindergarten program and 34 children (1st – 5th grade) being supervised and cared for appropriately by 8 fingerprint cleared staff.

LPA Clayton toured the classrooms, restrooms, cafeteria areas and play yards utilized by the STAR program.

The Program operates on the Clover Elementary School campus. The program currently operates in the following areas: room #9, bungalow 22, bungalow 24, bungalow 25, the cafeteria and the yard. Site Director stated the children do homework and arts & crafts in the classrooms, and sports, dance and recreation on the yard. Furniture and equipment are in good condition, free of sharp, loose or pointed parts. All materials and surfaces accessible to children are toxic free. The isolation area is located in bungalow 24 (the Star office). LPA inspected the outside play area and surface of the outdoor activity space is maintained in a safe condition and is free of hazards.

LPA Clayton observed the grass/soccer field and the grass planter areas outside of bungalows 18 – 21 and bungalows 26 – 29 gated off and made inaccessible to children in care. Per Site Director Isaac the soil in those areas were tested for planned construction and the results showed high levels of arsenic. The areas have been off limits since November 2024.

The facility provides hot supper (evening snack) to children in care which is provided and prepared by Clover Elementary School staff. LPA Clayton toured the kitchen and inspected the food storage areas designated for the after-school program. Menus are posted at least one week in advance.
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Lisa Clayton
LICENSING EVALUATOR SIGNATURE: DATE: 01/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/16/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 01/16/2025 05:27 PM - It Cannot Be Edited


Created By: Lisa Clayton On 01/16/2025 at 05:00 PM
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: CLOVER STAR
FACILITY NUMBER: 197417876

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/16/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101216(f)
Personnel Requirements
(f) At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA observation during file review and interview with Director, there is no one with current pediatric CPR/First Aid certification present at the facility the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 01/17/2025
Plan of Correction
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Director Isaac and Asst. Director Julio Ramos will take a CPR/First Aid class tomorrow 01/17/2025 and email the certificate of completion to LPA Clayton immediately upon reciept. Director will ensure that all staff have current CPR/ First no later February 1, 2025.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Karren Starks
LICENSING EVALUATOR NAME:Lisa Clayton
LICENSING EVALUATOR SIGNATURE:
DATE: 01/16/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/16/2025


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Document Has Been Signed on 01/16/2025 05:27 PM - It Cannot Be Edited


Created By: Lisa Clayton On 01/16/2025 at 05:00 PM
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: CLOVER STAR
FACILITY NUMBER: 197417876

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/16/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
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
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Based on LPA Clayton record review there are no current certificates on file, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/27/2025
Plan of Correction
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Director Isaac and Asst. Director Julio Ramos will esure that staff complete the required Mandated Reporter training email the certificate of completion to LPA Clayton immediately upon reciept no later Jauary 17, 2025.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Karren Starks
LICENSING EVALUATOR NAME:Lisa Clayton
LICENSING EVALUATOR SIGNATURE:
DATE: 01/16/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/16/2025


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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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CLOVER STAR
FACILITY NUMBER: 197417876
VISIT DATE: 01/16/2025
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The children have access to 1 boy’s bathroom & 1 girls bathroom inside of the main building. All toilets and handwashing facilities are in safe and sanitary operating condition.

Drinking water is available inside and outside. The children bring in their own refillable water bottles, but cups are available if needed.



Facility was observed to have a centralized smoke detector/alarm system. LPA Clayton observed a fully charged 2A10BC Fire Extinguisher in each classroom. LPA Clayton instructed Site Director to install a carbon monoxide detector in each classroom according to CA Health and Safety Codes.

LPA Clayton reviewed 5 children’s files and observed files to have current contact information of parents and authorized representatives, and authorization for medical treatment, signed Parent’s Rights and signed Personal Rights receipts.

LPA Clayton reviewed 5 employee files and observed immunization records required for childcare providers.

Site Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Childcare Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.



Incidental Medical Services (IMS) policy was discussed, and LPA Clayton provided Site Director with an IMS Plan sample for his reference. For IMS information see PIN 22-02-CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Lisa Clayton
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025
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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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CLOVER STAR
FACILITY NUMBER: 197417876
VISIT DATE: 01/16/2025
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LPA Clayton informed Site Director of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

Per file review and interview with Director, there is no one with current pediatric CPR/First Aid certification present at the facility. Mandated reporter training certificates are also expired.

Based on record review, the licensee did not comply with the section cited above in three out of three persons which poses/posed a potential health, safety or personal rights risk to persons in care.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations and/or Health and Safety Codes, Deficiencies were cited (see LIC 809D), and Technical Violations were issued (see LIC 9102).


During the exit interview the report was reviewed and a copy was provided to Site Director Isaac.

Appeal rights reviewed and provided.

LPA Clayton posted a Notice of Site Visit which must remain posted for 30 days.
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Lisa Clayton
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025
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