197493835-8-24-2021-54-CC-MRIA-C67SDQ-20210824134730

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197493835
Report Date: 08/24/2021
Date Signed: 08/24/2021 01:47:39 PM

Document Has Been Signed on 08/24/2021 01:47 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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	ST ALOYSIUS SCHOOL		FACILITY NUMBER:	197493835
ADMINISTRATOR:	NICOLE JOHNSON		FACILITY TYPE:	850
ADDRESS:	2023 NADEAU STREET		TELEPHONE:	(323) 582-4965
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90001
CAPACITY: 18	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	08/24/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:50 AM
MET WITH:	Nicole Johnson, Administrator		TIME COMPLETED:	02:00 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	Prior to entrance to the facility, LPA Mayra Rivera conducted a Covid 19 assessment and based on the Manager responses to the facility assessment questions, LPA Rivera determined safe to proceed. On Tuesday, August, 24, 2021 at 9:45 AM, Licensing Program Analyst (LPA) Mayra Rivera entered the facility to conduct an unannounced annual inspection and met with Office Manager Asucena Sotelo who guided LPA Rivera on a tour of the facility. Facility operation hours are Monday to Friday from 8:00 AM to 3:00 PM. At approximately 10:10 AM, LPA Rivera entered the preschool room to inspect for safety, comfort, cleanliness, and ventilation. During the inspection LPA Rivera did not observe any children. The preschool is currently on summer break and due to return in September. The following staff were present during this visit: Staff #1 and Staff #2. LPA observed the disinfectants, cleaning solutions, and other items that are dangerous to children underneath the sink cabinet, stand cabinet and inside the wall cabinet with key locks making it inaccessible to children to open the cabinets. LPA observed adequate storage such as cubbies for children's personal belongings and the furniture and equipment in good condition, age appropriate and free of sharp, loose, or pointed parts. LPA observed cots and bedding is provided by the parents. LPA observed hand washing sink area safe, sanitary and operating properly and floors clean and safe. For ventilation LPA observed a wall AC/heater unit high on the wall making it inaccessible to children. At approximately 10:17 AM, LPA Rivera entered the restroom and observed two toilets and one sink, paper towels, and hand soap dispenser empty. LPA advised the soap dispenser needs to be refilled. LPA observed the restroom to be in good condition. LPA observed a trash bin to discard food and waste with tight fitting lid. Drinking water is readily available both indoors and outdoors. LPA observed a water dispenser inside the classroom and per manager, children's water bottles are refiled as needed and children take their water bottle during outdoor play. Facility provides 2 snacks per day (AM & PM). Lunch is provided by the parents. Weekly snack menu was not posted.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:	DATE: 08/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2021

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ST ALOYSIUS SCHOOL	FACILITY NUMBER: 197493835
	VISIT DATE: 08/24/2021

NARRATIVE

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At approximately 10:30 AM, LPA Rivera inspected the outdoor area for safety, comfort and cleanliness. The facility was observed to be free of flies, insects and rodents. LPA observed the playground fenced with a self-latch gate door. LPA observed the outdoor playground equipment in safe condition, free of sharp, lose or pointed parts. All areas around or climbing equipment, slides, are cushioned with material that absorbs a fall. LPA observed a sail shade triangle in place and provides adequate shade in the yard. LPA observed the playground structures to be age appropriate ages two to five and observed the sandbox area to be covered and closed. There are no bodies of water on the premises

Smoke detectors are present in the facility, but were not tested as they are hardwired through the building.

LPA observed the required 2A10BC fire extinguisher located in the classroom and the valve on the green area indicating fully charged and serviced on September 9, 2020. LPA observed first aid kit inside the classroom.

At approximately 10:40 AM LPA observed on the bulletin wall the license, Parents Right's, daily schedule and did not observe LIC 308 Designation of Facility Responsibility, LIC 610 Emergency Disaster Plan, Facility Sketch, LIC 9148 Earthquake Checklist, PUB 269 Child Passenger System Poster, Drill log and snack menu. LPA provided the required LIC posting forms and the administrator completed and posted the forms during the visit.

At approximately 11:15 AM LPA reviewed staff files and issued LIC 859 Review of Staff. LPA provided required posting forms and file forms. Staff #1 and #2 completed during the visit LIC 508 Criminal Record statement, LIC 501 Personnel Record, LIC 9052 Notice of Employee Rights, LIC 9108 Statement Acknowledging Requirement to Report Child Abuse.

The following was discussed with the Administrator:

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

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:	DATE: 08/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2021

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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ST ALOYSIUS SCHOOL	FACILITY NUMBER: 197493835
	VISIT DATE: 08/24/2021

NARRATIVE

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Facility administers medication. Before administrating medication, parents sign a medication consent form, provides the medication in original container with Dr's prescription. At this time, facility has no children with medication or allergies.

LPA advised the administrator to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

LPA advised administrator that all adults 18 years of age and older providing Care & Supervision and/or have continuous presence in the facility shall adhere to a criminal background clearance with the Department of Justice, FBI and Child Abuse Index Check.

LPA observed incorrect pediatric First Aid/CPR certifications, and provided link https://emsa.ca.gov/childcare_provider1/

LPA did not observe AB 1207 child abuse certifications and advised that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com

LPA Rivera provided technical violations for incorrect CPR certification, expired center director permit, missing AB 1207 Child Abuse mandated certificate, personnel requirements ( LIC 9148 and 9052)

LPA provided The Notice of Site Visit (LIC 9213) and explained that it must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with administrator Nicole Johnson. LPA explained and discussed this report, including the appeal rights and provided a copy. The signature on this report acknowledges and confirms receipt of these documents.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:	DATE: 08/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2021

LIC809 (FAS) - (06/04)

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