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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419528
Report Date: 03/01/2023
Date Signed: 03/01/2023 05:30:49 PM

Document Has Been Signed on 03/01/2023 05:30 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: 16DATE:
03/01/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
05:00 PM
MET WITH:CANDICE ADDISON, ADMINISTRATORTIME COMPLETED:
06:00 PM
NARRATIVE
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On 03/01/2023 Licensing Program Analyst (LPA) Lisa Clayton conducted an unannounced at the CCC. Upon arrival LPA met with teacher Esma Itzate, and teacher Bettye Staten. LPA Clayton toured the facility for a Health and Safety inspection and observed 16 children being supervised and cared for by 1 teacher. Later, Administrator Candice Addison arrived.

During the inspection, LPA Clayton toured the playground and observed bags of recycling, trash and what appeared to be inoperable equipment. LPA Clayton advised Administrator Candice that those items pose a risk to the Health and Safety of children in care and are to be removed immediately.



In addition, LPA Clayton requested to review the Breakfast/Lunch menu, and was advised by both Teacher Esma and Admin Candice that the menu was not available at this time.

In addition, LPA Clayton requested to review the Breakfast/Lunch menu, and was advised by both Teacher Esma and Admin Candice that the menu was not available at this time.


On 02/22/2023, LPA Clayton was at the facility and requested to review the staff records. Per the Licensee, her staff files were at her home and unavailable for review.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, deficiencies are cited: (see next page 890D) Licensee was provided a copy of their appeal rights.

An exit interview was conducted, a copy of this report was read and provided to Admin Candice Addison.

This report shall me made available to the public upon request. LIC 9213 Notice of Site Visit was provided and required to be posted for 30 days.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, deficiencies are cited: (see next page 890D) Licensee was provided a copy of their appeal rights.

An exit interview was conducted, a copy of this report was read and provided to Admin Candice Addison.

This report shall me made available to the public upon request. LIC 9213 Notice of Site Visit was provided and required to be posted for 30 days.

SUPERVISORS NAME: Mary Ruiz
LICENSING EVALUATOR NAME: Lisa Clayton
LICENSING EVALUATOR SIGNATURE: DATE: 03/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/01/2023
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 03/01/2023 05:30 PM - It Cannot Be Edited


Created By: Lisa Clayton On 03/01/2023 at 04:58 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: JUS KIDS ACADEMY
FACILITY NUMBER: 197419528

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/01/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/01/2023
Section Cited
CCR
101217(c)(d)(1)

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101217 Personnel Records (c) All personnel records shall be available to the Department to inspect, audit, and copy upon demand during normal business hours...... personnel records shall be maintained at the child care center and shall be available to the licensing agency for review.(1) The licensee may keep such records in a central administrative location provided that they are readily available to the Department at the child care center site as specified in Section 101217(c).
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LPA Clayton observed 4 of the 5 requested files on 03/01/2023, at the CCC. Licensee isntructed to review and submit a wriiten declaration of the understanding of Title 22 Regulaion 101217
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This requirement was not met as evidenced by LPA observations, LPA Clayton requested to review the staff files on 02/22/2023, and per licensee, the staff files were at her home, and therefore unavailable for department/LPA review.
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Type B
03/06/2023
Section Cited
CCR101238.2(d)(1)(2)

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101238.2 Outdoor Activity Space(d) The surface of the outdoor activity space shall be maintained:(1) In a safe condition for the activities planned. (2) Free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard.
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Licenses to remove the inoperable equipment, trash and bags of recycling from the playground by the POC date
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This requirement was not met as evidenced by LPA observations, LPA Clayton toured the playground and observed bags of recycling, trash and what appeared to be inoperable equipment.
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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:Mary Ruiz
LICENSING EVALUATOR NAME:Lisa Clayton
LICENSING EVALUATOR SIGNATURE:
DATE: 03/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/01/2023


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Document Has Been Signed on 03/01/2023 05:30 PM - It Cannot Be Edited


Created By: Lisa Clayton On 03/01/2023 at 05:05 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: JUS KIDS ACADEMY
FACILITY NUMBER: 197419528

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/01/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/06/2023
Section Cited
CCR
101227(a)(6)

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101227(a)(6) (a) In child care centers providing meals to children, the following shall apply: (6) Menus shall be in writing and shall be posted at least one week in advance in an area accessible for review by the child's authorized representative. Copies of the menus as served shall be dated and kept on file for at least 30 days. Menus shall be made available for review by the child's authorized representative and the Department upon request.
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Director/Licensee will create menu, post it for parent/auth rep review and Dept review by POC date
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This requirement was not met as observed by LPA observations, LPA Clayton requested to review the menu, and was told it has not been created and therefore not available
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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:Mary Ruiz
LICENSING EVALUATOR NAME:Lisa Clayton
LICENSING EVALUATOR SIGNATURE:
DATE: 03/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/01/2023


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