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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419528
Report Date: 11/04/2021
Date Signed: 11/04/2021 01:49:57 PM

Document Has Been Signed on 11/04/2021 01:49 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:JUS KIDS ACADEMYFACILITY NUMBER:
197419528
ADMINISTRATOR:VITELA, MARIANAFACILITY TYPE:
850
ADDRESS:11211 WESTERN AVETELEPHONE:
(323) 777-0704
CITY:LOS ANGELESSTATE: CAZIP CODE:
90047
CAPACITY: 29TOTAL ENROLLED CHILDREN: 29CENSUS: 19DATE:
11/04/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Margaret PettisTIME COMPLETED:
12:00 PM
NARRATIVE
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On 11/4/2021, Licensing Program Analyst (LPA) Lillian Casillas conducted an unannounced Case Management - Deficiencies inspection. LPA met with Licensee, Margaret Pettis, and explained the purpose of the inspection.

During the inspection, LPA observed 19 children with 1 staff. Licensee stated one teacher was a no-show and another teacher is at a dental appointment. Licensee stated substitute teachers are unavailable. Licensee hired 1 fully qualified substitute teacher (see LIC 811 Confidential Names) and LPA associated the substitute via Guardian.

Based on observations and interviews, LPA issued a Type A deficiency pursuant California Code of Regulations Title 22 101216.3 (see LIC9099-D for details). Upon receipt of this report, the Director must post the report along with the Notice of Site of Site Visit for 30 days for parents to view. A copy of this report must be provided to parents /guardians of children in care at the facility and parents/guardians of children newly enrolled at the facility of this Type A citation for the next 12 months (1 year). The report shall be provided, no later than the next business day or the next day that the child is in care. The LIC 9224 Acknowledgement of Receipt of Licensing Reports shall be signed and kept in each of the children’s records. If the Licensee fails to comply an $100.00 civil penalty shall be assessed for each family enrolled and in attendance.

An exit interview was conducted and a copy of this report along with the Notice of Site Visit and Appeal Rights were provided to Licensee.

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Lillian J Casillas
LICENSING EVALUATOR SIGNATURE: DATE: 11/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/04/2021
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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Document Has Been Signed on 11/04/2021 01:49 PM - It Cannot Be Edited


Created By: Lillian J Casillas On 11/04/2021 at 10:31 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: JUS KIDS ACADEMY
FACILITY NUMBER: 197419528

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/04/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/04/2021
Section Cited
CCR
101216.3(a)

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101216.3 Teacher-Child Ratio
(a) There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance

This requirement was not met as evidenced by:
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Licensee associated 1 fully qualified subsitute teacher during today's inspection.
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Based on observation, interviews, and record review, Licensee did not ensure the ratio of one teacher for no more than 12 children as LPA observed 1 staff with 19 children, which poses an immediate Health, Safety or Personal Rights risk to children 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:Maureen Neal
LICENSING EVALUATOR NAME:Lillian J Casillas
LICENSING EVALUATOR SIGNATURE:
DATE: 11/04/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/04/2021


LIC809 (FAS) - (06/04)
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