197492957-4-12-2024-30-CC-JLAO-D49R3B-20240412123937

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197492957
Report Date: 04/09/2024
Date Signed: 04/12/2024 12:41:13 PM

Document Has Been Signed on 04/12/2024 12:41 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:	WEST LA EXTENDED DAY		FACILITY NUMBER:	197492957
ADMINISTRATOR:	JOLENE DOUCETTE		FACILITY TYPE:	840
ADDRESS:	6550 W. 80TH STREET		TELEPHONE:	(310) 642-8386
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90045
CAPACITY:	180	CENSUS: 0	DATE:	04/09/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	12:35 PM
MET WITH:	Kimberly Raza-Senior Director		TIME COMPLETED:	03:10 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	On 4/9/2024 Licensing Program Analyst (LPA) Judy Laureano conducted an unannounced Annual Required Inspection for the school age license at above mentioned facility. LPA met with Senior Director Kimberly Raza and toured the facility indoors and outdoors. Facility operates Monday- Tuesday-Wednesday and Friday 2:00 p.m.- 6:00 p.m. and Thursday 1:45 p.m. to 6:00 p.m. Facility is licensed for children in Transitional Kindergarten Age through 11 years old for a max capacity of 180 school age children. After school activities will be conducted in rooms 21, 22, 23 and 24. Senior Director was informed that any changes to ages, hours and days of operation shall be submitted to the department via signed LIC 200A, for approval prior to initiation of changes. Program operates within a WISH Charter Elementary School and Public LAUSD Middle School. LPA did not observed any children in care during the initial inspection. LPA observed 4 classrooms that are currently being used for after school activities. There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition allowed or stored on the premises. Disinfectants, cleaning solutions, medication and other hazardous items are made inaccessible. LPA observed the emergency red bag back in the classrooms. LPA reminded director to have a system in place to ensure that equipment and First Aid kits are checked annually. Facility is open to enroll children that might need medication administered. Medication, if needed, is stored in the schools main office. Senior Director confirmed program has access to the main office during program hours. LPA reminded facility to ensure that all

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy Laureano	TELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:	DATE: 04/09/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024

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: WEST LA EXTENDED DAY	FACILITY NUMBER: 197492957
	VISIT DATE: 04/09/2024

NARRATIVE

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medication is stored with all necessary LIC forms. All prescription and nonprescription medication shall be centrally stored in accordance with the following requirements: medication shall be kept in a safe place inaccessible to the children in care, each container shall have an unaltered label.

Cleaning solutions that are used daily are kept in program office- area is off limits to the
children in care. No poisons were observed during the inspection. No bodies of water were observed in the space.

Furniture and equipment are in good condition, free of sharp, loose or pointed parts. All materials and surfaces accessible to children are toxic free. All toilets and handwashing facilities are in safe and sanitary operating condition. All floors in the facility are clean and safe.

All kitchen, food preparation and storage areas are clean, free of litter/rubbish and free of rodents/vermin. All food is protected against contamination. Contaminated food is discarded immediately. Facility provides PM snacks. Menus are posted at least one week in advance where an authorized representative can view them. LPA observed menu posted outside the classroom. 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.

Solid waste storage containers have tight-fitting covers and are in good repair. Drinking water is available both indoors and outdoors. LPA observed a water dispensers and facility admin confirmed paper cups are provided if children forget their water bottles. All children are encourage to bring in their on refillable water bottle.

Playground equipment is in 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.

The facility is free of flies, insects and rodents. Facility was observed to have a centralized fire and smoke alarm. LPA observed Senior Director test the carbon monoxide alarm in the space. Senior Director confirmed that fire drills and earthquake drills are completed by program.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy Laureano	TELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:	DATE: 04/09/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024

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: WEST LA EXTENDED DAY	FACILITY NUMBER: 197492957
	VISIT DATE: 04/09/2024

NARRATIVE

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The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. The Department has inspection authority as specified in Health & Safety Code.

Prior to working or volunteering in a licensed child care facility, all individuals subject to a criminal record review have received a criminal record clearance or exemption. Upon notification from the Department, the licensee will comply and act immediately to terminate the employment of, remove from the facility or bar from entering the facility for any person it is deemed necessary while the Department considers granting or denying an exemption.

Capacity and limitations as specified on the license are being maintained. At the end of the inspection 52 children and 19 staff members were observed.

At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at offsite activities. Senior Director, K. Raza’s CPR and Pediatric First Aid was taken 2/26/2024 and Mandated Reporter Training was taken on 8/18/2023. LPA reminded facility admin to ensure all CPR and First Aid Training needs to be EMSA approved. Mandated Reporter Training was reviewed and LPA discussed the importance of ensuring the approved training is completed by all staff.

LPA reviewed a sample of staff files, 6 files were reviewed. LPA provided facility with the following documents to use as a reference when auditing file: LIC 9095-Evaluation of Teacher Qualification, LIC 125 Entrance Check List, LIC 311A Records to be Maintained at the Facility.

LPA reviewed a sample of children’s files and observed files were complete with contact information for authorized representative and or relatives or others who can assume responsibility for the child and medical assessment.

The name of the child care center director or fully-qualified teacher(s) designated to act in the director’s absence has been reported to the Department. The person who signs the child in/out of the facility shall use their full legal signature and record the time of day.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy Laureano	TELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:	DATE: 04/09/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024

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: WEST LA EXTENDED DAY	FACILITY NUMBER: 197492957
	VISIT DATE: 04/09/2024

NARRATIVE

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LPA observed programs sign out sheet outside the classroom.

All children are under supervision, including visual supervision, of a teacher at all times. Facility maintains a ratio of one teacher supervising no more than 14 children in care.

Licensee 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 Child Care 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.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for
drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).
LPA verified that the lead testing was completed on 12/22/2023, in accordance to the Written Directives outline.

Incidental Medical Services (IMS) policy was discussed. 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/. PIN 22-05-CCP Page Five

Senior Director K. Raza was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Senior Director Kimberly Raza.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy Laureano	TELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:	DATE: 04/09/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024

LIC809 (FAS) - (06/04)

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