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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494698
Report Date: 07/07/2022
Date Signed: 07/07/2022 01:41:29 PM


Document Has Been Signed on 07/07/2022 01:41 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:HARMON OAKS NOHO WESTFACILITY NUMBER:
197494698
ADMINISTRATOR:MARIYA KUPCHYANFACILITY TYPE:
850
ADDRESS:12531 VANOWEN STTELEPHONE:
(818) 386-8409
CITY:NO HOLLYWOODSTATE: CAZIP CODE:
91605
CAPACITY:20CENSUS: 16DATE:
07/07/2022
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
07:59 AM
MET WITH:Executive Director, Mariya KupchyanTIME COMPLETED:
01:15 PM
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On 07/07/2022 at 8:00 a.m. Licensing Program Analyst (LPA) Deborah Lowe met with site Executive Director, Mariya Kupchyan. The purpose of the visit was an announce case management – licensee initiated inspection at the facility to ensure that health, safety and personal rights as requires by Title 22 and Health and Safety Regulations governing California Child Care Centers will be met. There were 16 children were present during this inspection. This is a capacity increase application with the addition of a toddler option for 86 children, ages 18 months to entry into 1st grade. The child care center will operate Monday – Friday 8:00 a.m. – 5:00 p.m. The fire clearance was approved on 6/24/2022.

Upon arrival LPA Lowe observed the building with the rooms 1, 2, and 3 (newly requested rooms) to show a number address of 12527. Facility currently licensed with facility address of 12531 (room 4). The additional rooms will create a dual address for this facility. All classrooms open to the same outdoor area. Facility was observed with one parking area.

LPA Lowe toured and measured the on-limits areas and classrooms located at the facility. The facility has a total of 4 classrooms. Preschool classrooms are rooms 1, 2, and 4. Toddler Option classroom will be in room 3. Children will have access to 6 sinks and 7 toilets.

Classroom measurements are:

Indoor total Preschool measurements: 2,198.26 square (sq) feet (ft) divided by 35 sq ft = 62 preschool children.

Indoor total Toddler Option measurements: 761.01 sq ft divided by 35 sq ft = 21 toddlers (application is for 18 Toddlers).

Outdoor Play measurements are:

Preschool Outdoor total measurements: 4,292.32 sq ft divided by 75 sq ft = 57 preschool children.

SUPERVISOR'S NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Deborah LoweTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:
DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/07/2022
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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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: HARMON OAKS NOHO WEST
FACILITY NUMBER: 197494698
VISIT DATE: 07/07/2022
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Toddler Option Outdoor total measurements: 1,379.52 sq ft divided by 75 sq ft = 18 toddler children.

Indoor/Children’s Area:

All outdoor and indoor passageways, stairways, inclines, ramps, open porches and other areas of potential hazard were observed to be free of obstruction. The child care center was observed be clean, safe, sanitary and in good repair. Floors of all rooms have a surface that is safe and clean. A comfortable temperature for children was observed. Furniture and equipment were observed to be maintained in good condition, free of sharp, loose or pointed parts. Tables and chairs were observed to be meet the needs of the children. All play equipment and materials used by children were observed to be age-appropriate. LPA advised the licensee shall ensure that each child has an individual permanent or portable storage space for his/her clothing, personal belongings and/or bedding. Executive Director stated cabinets located in the bathrooms are designated for children’s personal belongings. All materials and surfaces accessible to children, including toys, shall be free of toxic substances.

Drinking water from a noncontaminating fixture or container was observed to be readily available both indoors and in the outdoor activity area. The facility has a pest control service that provides service quarterly to assist in keeping the center free of flies, other insects, and rodents. LPA advised all containers used for storage of solid wastes, including moveable bins, shall have a tightfitting cover that is kept on; shall be in good repair; and shall be leakproof and rodent-proof. Per Executive Director trash cans are on order and scheduled to be delivered within the week. No Fireplaces or open-faced heaters were observed at facility. Facility has sliding window doors in rooms 3 and 4 that open to the outdoor play area. All window screens were observed to be in good repair and free of insects, dirt and debris.

LPA advised disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. LPA advised storage areas for poisons shall be locked. No poisons were observed during visit. The licensee shall maintain the following first-aid supplies in a location accessible to staff but inaccessible to children: LPA observed a current edition of a first-aid manual, sterile first-aid dressings, bandages or roller bandages, adhesive tape, scissors, tweezers, thermometer, and antiseptic solution.

The center is equipped to isolate and care for any child who becomes ill during the day. The isolation area is located in the office to afford easy supervision of children by center staff. The isolation area will use the

SUPERVISOR'S NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Deborah LoweTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022
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: HARMON OAKS NOHO WEST
FACILITY NUMBER: 197494698
VISIT DATE: 07/07/2022
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child’s cot for each ill child. LPA advised the isolation area shall not be located in the kitchen area or the general-use toilet area.

LPA verified with Executive Director the facilities carbon monoxide detectors are included in the facilities Fire Life Safety system. LPA advised all child care centers shall have working telephone service on the premises.

The facility is using ProCare app for sign in / out of children. LPA observed a parent using a QRS scan on their phone during drop off.

LPA advised the licensee shall be responsible for ensuring that children with obvious symptoms of illness including, but not limited to, fever or vomiting, are not accepted. LPA observed signage at the gate asking wellness check questions for families to respond to in the ProCare App.

LPA advised smoking is prohibited on the premises of a child care center as specified in Health and Safety Code Section 1596.795(b). LPA advised a baby walker shall not be allowed on the premises of a child care center in accordance with Health and Safety Code Sections 1596.846(b) and (c).

LPA advised there shall be at least 35 square feet of indoor activity space per child based on the total licensed capacity. Based on the total licensed capacity, one toilet and one handwashing fixture shall be maintained for every 15 children, or fraction thereof.

Napping:

LPA Lowe observed cots used for napping, they were observed to be maintained in a safe condition. Covered with vinyl or similar material that can be wiped. Executive Director stated cots are cleaned/ disinfected daily in addition to when soiled or wet. LPA advised each cot or mat shall be equipped with a sheet to cover the cot or mat and, depending on the weather, a sheet and/or blanket to cover the child. Executive Director stated children bring their own bedding.

LPA observed a variety of age-appropriate equipment, toys and materials in good condition and in sufficient quantity to allow children present to fully participate in planned activities.

Restrooms:

All toilets, handwashing and bathing facilities were observed to be maintained in safe and sanitary operating condition. LPA advised additional equipment, aids and/or conveniences shall be provided as needed in

SUPERVISOR'S NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Deborah LoweTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022
LIC809 (FAS) - (06/04)
Page: 3 of 7
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: HARMON OAKS NOHO WEST
FACILITY NUMBER: 197494698
VISIT DATE: 07/07/2022
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centers that serve children with physical disabilities.

LPA advised hot water temperature controls shall be maintained to automatically regulate temperature of hot water delivered to plumbing fixtures used by children to attain a hot water temperature of not less than 105 degrees F (40.5 degrees C) and not more than 120 degrees F (48.8 degrees C).

Notwithstanding (e) and (e)(1) above, handwashing fixtures shall not be required to deliver hot water. LPA observed handwashing fixtures to not deliver hot water.

LPA advised there shall be one toilet and one handwashing fixture, separate from and in addition to the number of toilets and handwashing fixtures required in (h) above, designated for use by children who are ill, for use by staff, and for emergency use. Staff bathroom will be used. This toilet and handwashing fixture shall be conveniently located in relation to the isolation area.

Outdoor:

LPA observed umbrellas and outdoor awning to provide a shaded rest area for the children. LPA observed the outdoor area to be free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard. LPA observed the areas around and under high climbing equipment and slide to be with grass.

LPA advised sandboxes shall be inspected daily and kept free of hazardous foreign materials. LPA did not observe a sandbox at facility.

The playground shall be enclosed by a fence to protect children and to keep them in the outdoor activity area. The fence was observed to be at least four feet high.

LPA advised any construction or equipment that could pose a hazard in the outdoor activity area shall be made inaccessible to children in care. This shall include, but not be limited to, incinerators, air- conditioning equipment, water heaters, and fuse boxes. Outdoor area located behind room 3 with access from the toddler outdoor space was observed with equipment that will need to be made inaccessible to children in care.

No pools or other bodies of water was observed at facility.

LPA advised there shall be at least 75 square feet per child of outdoor activity space based on the total licensed capacity.

SUPERVISOR'S NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Deborah LoweTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022
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: HARMON OAKS NOHO WEST
FACILITY NUMBER: 197494698
VISIT DATE: 07/07/2022
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Health Related Services:

LPA advised medications shall be kept in a safe place inaccessible to children. A refrigerator shall be used to store any medication that requires refrigeration. A refrigerator was observed in room 4. Facility currently does not have any medications.

LPA advised the licensee shall develop and implement a written plan to record the administration of prescription and nonprescription medications and to inform the child's authorized representative daily when such medications have been given.

Food Service:

LPA advised all food shall be safe and of the quality and in the quantity necessary to meet the needs of the children. Each meal shall include, at a minimum, the amount of food components as specified by Title 7, Code of Federal Regulations, Part 226.20, (Revised January 1, 1990) Requirements for Meals, for the age group served. All food shall be selected, stored, prepared and served in a safe and healthful manner.

LPA advised all foods or beverages capable of supporting the rapid and progressive growth of microorganisms that can cause food infections or food intoxications shall be stored in covered containers at 45 degrees F (7.2 degrees C) or less.

LPA advised pesticides and other similar toxic substances shall not be stored in food storerooms, kitchen areas, food-preparation areas, or areas where kitchen equipment or utensils are stored.

LPA Lowe observed soaps, detergents, cleaning compounds or similar substances to be stored in areas separate from food supplies. LPA observed food-preparation and storage areas to be clean and free of litter, free of rodents and other vermin.

The facility does not have a kitchen. Room 4 was observed with a counter area used for preparation of snack.

Facility provides am and pm snacks and children bring lunch from home.

Postings:

LPA Lowe observed the following postings located in room 4 and office area near room 2. The license, LIC 613A (9/96), the PUB 393 (8/02), Child Care Center Notification of Parents' Rights Poster, LIC 610 Emergency

SUPERVISOR'S NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Deborah LoweTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022
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: HARMON OAKS NOHO WEST
FACILITY NUMBER: 197494698
VISIT DATE: 07/07/2022
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Disaster Plan with the telephone number of the local health department, information on child passenger restraint systems, and a contingency plan for action during fires, floods and earthquakes.

Menu is in writing and posted at least one week in advance in room 4. Per Executive Director menus are provided to families with the monthly newsletters and within enrollment packet. LPA advised 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.

LPA advised each licensee shall have a disaster and mass casualty plan of action.

Facility representative was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.

LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A 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



LPA reviewed with facility representative the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.
SUPERVISOR'S NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Deborah LoweTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022
LIC809 (FAS) - (06/04)
Page: 6 of 7
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: HARMON OAKS NOHO WEST
FACILITY NUMBER: 197494698
VISIT DATE: 07/07/2022
NARRATIVE
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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

The following corrections are needed before a capacity increase will be considered. Corrections are due by 7/15/2022:

· Make outdoor area behind toddler classroom inaccessible to children.

· Secure child gate located at the base of the outdoor stair case.

· Room 2 remove boxes and furniture (per Executive Director) not intended for classroom use.

· Provide proof of trash cans with tight fitting lids for rooms 1, 2, and 3.

· Outdoor concrete area between stairs and room 2 – make concrete nails inaccessible to children.

· Completion of remaining application documents including revised lease to show dual address.

· Approval of a revised Fire Clearance due to correction to facility address.

· Outdoor Preschool Schedules with 15 min transition between groups for outdoor waiver.

A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

An exit interview was conducted with the above items discussed and a copy of this report was provided to the Executive Director, Mariya Kupchyan. Final license determination will be made upon review by the Licensing Program Manager and correction of the above issues.

SUPERVISOR'S NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Deborah LoweTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022
LIC809 (FAS) - (06/04)
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