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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197495284
Report Date: 08/23/2023
Date Signed: 08/23/2023 02:10:35 PM

Document Has Been Signed on 08/23/2023 02:10 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:BLOOM PRESCHOOL LLCFACILITY NUMBER:
197495284
ADMINISTRATOR:KAWAILANI PIPERFACILITY TYPE:
850
ADDRESS:1700 MANHATTAN BLVDTELEPHONE:
(310) 376-1223
CITY:MANHATTAN BEACHSTATE: CAZIP CODE:
90266
CAPACITY: 72TOTAL ENROLLED CHILDREN: 72CENSUS: 0DATE:
08/23/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:49 AM
MET WITH:Kawailani Piper - Applicant/OwnerTIME COMPLETED:
02:30 PM
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On August 23, 2023, Licensing Program Analyst (LPA) Jillinda Chandler made an announced visit to Bloom Preschool LLC. LPA met with Kawalani Piper- Owner/Applicant who provided a tour of the facility. The applicant is requesting a preschool license with a capacity of 72 children, ages 2 – 5 years. The building is a single level building, there were 3 classrooms and a community room dedicated to day care activities. Day care operational days and hours will be Monday – Friday/ 7:30 A.M. – 5:30 P.M. There is an approved fire clearance on file conducted by Susana Conterras of the Manhattan Beach Fire Department.

The following was observed of the:

INDOOR ACTIVITY SPACE

Fire extinguishers were 2AB10C or larger, last serviced 7/27/2023

Carbon monoxide and smoke detectors were present and operable in each class room

First aid kits were available with the required essentials: scissors, bandages, tweezers, ointments, and thermometer. Pg. 1

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE: DATE: 08/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/23/2023
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 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: BLOOM PRESCHOOL LLC
FACILITY NUMBER: 197495284
VISIT DATE: 08/23/2023
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Age-appropriate furniture and equipment was observed in good repair.

Drinking water will be provided through water dispensers.

The facility has central heating and cooling.

Windows were in good repair free of chipping paint, dirt, insects or debris.

Adequate lighting was observed.

The classrooms were clean, in good repair.

Trash cans used for solid waste were observed with tight fitting lids.

No Fireplaces or open face heaters were observed during todays inspection.

Disinfectants and cleaning solutions and other toxins or poisons were made inaccessible to children, placed in locked cabinets and storage rooms

The office and the restroom in the indoor/outdoor area will be used for isolation of ill children.

The facility was equipped with a working telephone, located in the kitchen area.

Pg.2

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2023
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: BLOOM PRESCHOOL LLC
FACILITY NUMBER: 197495284
VISIT DATE: 08/23/2023
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 Parents and authorized adults will sign children in and out, using Bright Wheel electronic devise. The applicant was informed that these reports shall be made readily available upon request of any representative of the department.

The required postings were posted in a prominent area for viewing.

Measurements for the indoor activity space was 3484.71 divided by 35 SQ. FT. per child = 99 children.

FOOD SERVICE:

Meals will be provided by parents, and snacks will be provided by the center. Weekly menus were posted for review. Children will eat outdoors using lunch benches.

LPA observed a full kitchen area fully inaccessible to children in care, the kitchen was clean, refrigeration with thermostat, and storage for foods were observed. Inside the kitchen area LPA observed laundry equipment, per the applicant napping materials are cleaned by the school. LPA did not observe any hazardous conditions.

Center has devised an Incidental Medical Service (IMS) plan to provide to parents of children with allergies (epi-pen), asthmatic (inhalers), diabetic injections and children needing G-tube feeding.

Pg. 3

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2023
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: BLOOM PRESCHOOL LLC
FACILITY NUMBER: 197495284
VISIT DATE: 08/23/2023
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RESTROOMS

THERE WERE:

7 toilets and two urinals = 1 toilet per 15 children and 2 toilets per urinal for a total of 105 children . Toilets were age appropriate.

8 sinks = 1 sink per 15 children for a total of 120 children. Sinks were age appropriate.

The restrooms were clean and sanitized with the necessary toiletries, sinks and toilets were operable and in good repair. Faucets delivered cold water.

OUTDOOR ACTIVITY SPACE

Age appropriate toys and equipment were observed in good condition.

The play yard was gated with a 4 inch or higher gate with an alerting device. The outdoors activity space consist of three areas the indoor/outdoor area, the basket ball strip and the main play area. Parents uses the entry gate, leading from the parking lot to enter the school.

Wood chips were observed for cushioning under the climbing structure, the wood chips were in good condition. LPA advised applicant to devise a plan to make gapping between the circular climbing stairs inaccessible to children, the fall zone from this platform to the ground measured 5 feet, 4 inches.


Pg. 4
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2023
LIC809 (FAS) - (06/04)
Page: 4 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: BLOOM PRESCHOOL LLC
FACILITY NUMBER: 197495284
VISIT DATE: 08/23/2023
NARRATIVE
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Applicant was advised that the play structure should be under direct supervision at all times.

Water dispensers were readily available for an outdoor water source.

LPA observed a covered in door/outdoor space and trees for shade and benches or chairs for resting.

Measurements for the combined outdoor activity areas were 7240.15 divided by 75 sq. ft. per child for a capacity total of 96 children.

Based on today’s inspection the facility shall be recommended for a capacity of 72 children as requested by the applicant.

Pg. 5

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2023
LIC809 (FAS) - (06/04)
Page: 5 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: BLOOM PRESCHOOL LLC
FACILITY NUMBER: 197495284
VISIT DATE: 08/23/2023
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Applicant 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, 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.

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) or (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 applicant the LIC 311A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

LPA discussed the safe sleep regulations with applicant 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.
Pg.6
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2023
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: BLOOM PRESCHOOL LLC
FACILITY NUMBER: 197495284
VISIT DATE: 08/23/2023
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 LPA also informed applicant 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.

Applicant was informed of the MyChildCarePlan.org site, 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

Exit interview conducted and report was reviewed with the applicant Kawailani Piper

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 platforms.
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



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SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2023
LIC809 (FAS) - (06/04)
Page: 7 of 7