197494621-11-18-2021-30-CC-LRIS-C8VSTY-20211118131019

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494621
Report Date: 11/18/2021
Date Signed: 11/18/2021 01:10:41 PM

Document Has Been Signed on 11/18/2021 01:10 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:	OAK TREE- VIEW PARK WINDSOR HILLS		FACILITY NUMBER:	197494621
ADMINISTRATOR:	TAYLOR SPEARMAN		FACILITY TYPE:	850
ADDRESS:	4416 W. SLAUSON AVENUE		TELEPHONE:	(323) 815-1093
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90043
CAPACITY: 37	TOTAL ENROLLED CHILDREN: 37	CENSUS: 35	DATE:	11/18/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Michelle Lundancy & Taylor Spearman		TIME COMPLETED:	01:30 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 11/18/2021 Licensing Program Analyst Lisa Rios (LPA), conducted an unannounced 1 Year Annual Required Inspection for the preschool license. LPA met with Compliance Officer Michelle Lundancy (Director Taylor Spearman showed up at 10:00am), and toured the facility indoors and outdoors. Days and hours of operation are Monday-Friday 6:30am-6:00pm. Due to Covid-19 Masks are worn by all staff and students and hand sanitizers are located throughout the facility offered both indoors and outdoors. The facility was inspected inside and out. Inside: the facility consists of 3 classrooms. All classrooms have disinfectants, cleaning solutions, medication and other hazardous items are made inaccessible. Inside: Furniture and equipment are in good condition, free of sharp, loose or pointed parts. All toilets and hand washing facilities are in safe and sanitary operating condition. Floors in the facility are clean and safe. The entranceway has most required postings (outdoor waiver needs to be posted). A smoke and carbon monoxide detector and a fire extinguisher is in each room and at least as big as an 2A10BC (serviced on 4/19/21). Each classroom has a fully equipped first aid kit and disaster drills have been conducted monthly and documented in a disaster drill log. All kitchen, food preparation and storage areas are clean, free of litter/rubbish and free of rodents/vermin. All foods/beverages capable of rapid spoiling are stored in covered containers at 45 degrees F or less. Solid waste storage containers do not have tight-fitting covers and are in good repair (see TA dated 11/18/21).

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Lisa Rios
LICENSING EVALUATOR SIGNATURE:	DATE: 11/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 5

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: OAK TREE- VIEW PARK WINDSOR HILLS	FACILITY NUMBER: 197494621
	VISIT DATE: 11/18/2021

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
26
27
28
29
30
31
32

Outside:
Areas around high climbing equipment, swings and slides have cushioning material to absorb falls. All materials and surfaces accessible to children are toxic free. The facility is free of flies, insects and rodents.

LPA reviewed 10% or 10 (whichever number is higher) children’s files and observed 1 file was incomplete with missing immunization's (see 809D). LPA reviewed all staff files and observed some files were incomplete with documents missing for required immunization records for DTAP, TB and MMR, flu waivers and Health History LIC503 forms. Three staff present had proof of current First Aid and CPR Training.

LPA discussed with the Director to improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Licensee [or facility representative] was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Lisa Rios
LICENSING EVALUATOR SIGNATURE:	DATE: 11/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021

LIC809 (FAS) - (06/04)

Page: 2 of 5

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: OAK TREE- VIEW PARK WINDSOR HILLS	FACILITY NUMBER: 197494621
	VISIT DATE: 11/18/2021

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
26
27
28
29
30
31
32

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are being cited: (see next page, 809 D). The Director was provided a copy of their appeal rights.

Upon receipt of a Type A violation, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. A copy of the Fact Sheet - Child Care Parent Notification Requirements and a copy of LIC 9224 would be given to licensee.

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

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Lisa Rios
LICENSING EVALUATOR SIGNATURE:	DATE: 11/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021

LIC809 (FAS) - (06/04)

Page: 3 of 5

Document Has Been Signed on 11/18/2021 01:10 PM - It Cannot Be Edited

Created By: Lisa Rios On 11/18/2021 at 12:26 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: OAK TREE- VIEW PARK WINDSOR HILLS	FACILITY NUMBER: 197494621
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/18/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.7995(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 5 out of 6 persons which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/17/2021
	Plan of Correction
1 2 3 4	The Director and/or Complaince Officer will email proof of vaccinations, Health Screenings, TB screen and flu shots/waivers to LPA Lisa Rios at lisa.rios@dss.ca.gov

Type B

Section Cited

CCR

101220.1(g)

Immunizations

(g) The licensee shall document each child's immunizations and shall maintain such documentation in the center for as long as the child is enrolled. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 1 out of 10 persons which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/17/2021
	Plan of Correction
1 2 3 4	The Director and Compliance Officer will email proof of vaccinations for 1 child to LPA Lisa Rios at lisa.rios@dss.ca.gov

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:

Claudia Escobedo

LICENSING EVALUATOR NAME:

Lisa Rios

LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021

LIC809 (FAS) - (06/04)

Page: 4 of 5