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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494040
Report Date: 01/10/2022
Date Signed: 01/10/2022 05:59:19 PM

Document Has Been Signed on 01/10/2022 05:59 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:NU BUILDING BLOCKS II-PRESCHOOLFACILITY NUMBER:
197494040
ADMINISTRATOR:PATRICIA A. HARDYFACILITY TYPE:
850
ADDRESS:3130 W VERNON AVETELEPHONE:
(323) 477-3407
CITY:LOS ANGELESSTATE: CAZIP CODE:
90008
CAPACITY: 34TOTAL ENROLLED CHILDREN: 34CENSUS: 3DATE:
01/10/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Larry Solomon- DirectorTIME COMPLETED:
05:58 PM
NARRATIVE
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Licensing Program Analyst (LPA), Keyona Scott, conducted unannounced inspection to the child care center on 01/10/2022 at 3:15 PM for the purpose of delivering findings to complaint control number: 30-CC-20211015141317. LPA met with teacher (Adult 1) at 3:25 PM and observed one other teacher (Adult 2) present with three children in care. Licensee, Larry Solomon, arrived at the facility at approximately 3:45 PM. Director, Paige Solomon, arrived from break at approximately 4:00 PM.

LPA contacted LPA Adrian Risher at El Segundo Child Care Regional Office to verify Guardian clearances. LPA was advised Adult 2 has a criminal record clearance or exemption, however, Adult 1 does not have a criminal record clearance or exemption to be present in the facility which poses an immediate risk to the health, safety and/or personal rights to the individuals in care. Per interview with Director Paige Solomon, Adult 1 was present in facility today only.

During today's inspection on 01/10/2022, the facility was cited for Title 22 deficiency. Please see LIC 809-D of this report for further details. The Licensee was also assessed a civil penalty for an adult present in the child care center that does not have a criminal record clearance or exemption on file.

A copy of this report, Notice of Site Visit and Appeal Rights were explained and provided to the Director Paige Solomon.

SUPERVISORS NAME: Mary Ruiz
LICENSING EVALUATOR NAME: Keyona Scott
LICENSING EVALUATOR SIGNATURE: DATE: 01/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/10/2022
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 01/10/2022 05:59 PM - It Cannot Be Edited


Created By: Keyona Scott On 01/10/2022 at 04:48 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: NU BUILDING BLOCKS II-PRESCHOOL
FACILITY NUMBER: 197494040

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/10/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/10/2022
Section Cited
CCR
101170(a)

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(a) The Department shall conduct a criminal record review of all persons specified in Health and Safety Code Section 1596.871(b). The Department has the authority to approve or deny a facility license, or employment, residence or presence in the facility, based on the results of this review.
This requirement is not met as evidenced by:
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Director agrees Adult 1 will not be present at the facility until a criminal record clearance or exemption is obtained. Director will provide LPA with a written declaration by 01/11/2022 stating that no Adult that does not have a criminal record clearance or exemption will be present at the facility.
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Based on observation, record review and interview, Adult 1, does not have a criminal record clearance or exemption. Per Director, Adult 1 has been present at facility for today only 01/10/2022.
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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:Keyona Scott
LICENSING EVALUATOR SIGNATURE:
DATE: 01/10/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/10/2022


LIC809 (FAS) - (06/04)
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