198020336-8-25-2021-33-CC-TRAO-C6928R-20210825171046

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020336
Report Date: 08/25/2021
Date Signed: 08/25/2021 05:10:55 PM

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	SEGRAY EAGLE ROCK		FACILITY NUMBER:	198020336
ADMINISTRATOR:	STEVE HELLER		FACILITY TYPE:	830
ADDRESS:	4475 EAGLE ROCK BLVD.		TELEPHONE:	(323) 507-2640
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90041
CAPACITY:	22	CENSUS: 9	DATE:	08/25/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Licensee Steve Heller and Annette Gladstone		TIME COMPLETED:	04:30 PM

NARRATIVE

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Licensing Program Analyst (LPA) Thelma Razo and Licensing Program Manager (LPM) Brandi VanOosten held an unannounced Required - 1 Year inspection and met with Licensees Steve Heller and Annette Gladstone. LPA stated the purpose of the visit and together with Licensees, toured the center. This is an infant program which consists of 1 classroom that serves infant from 12 months through 24 months. The facility has sufficient indoor space with toilets and sinks to accommodate 22 infants. Infant and toddler license (under Preschool LIC#198020337) have an approved waiver for outdoor rotation. Hours of operation is Monday through Friday, and was changed from 8AM-6PM to 8:30AM-5PM.

Furniture and equipment were inspected for age appropriateness and good repair. The facility has sufficient napping cots, feeding chairs, and changing table. Telephone service, heating, lighting and ventilation were evaluated. Children have their own cubby to store their belongings. Children bring their own bed roll and take them home on Friday. Age appropriate sinks and toilets were inspected for availability and good repair in all restrooms. General sanitation was observed. Availability of indoor drinking water was observed in classrooms.

Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Licensee Gladstone states there are no poisons at the facility. Carbon monoxide detectors was observed and was operable.

All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish, rodents, and/or any other vermin. All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Center provides morning and afternoon snacks.

The outdoor playground was observed to be physically separate from the preschool component. Outdoor playground equipment is in a safe condition, free of sharp, loose or pointed parts. The surface of the outdoor
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SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Thelma Razo	TELEPHONE: (323) 981-3387
LICENSING EVALUATOR SIGNATURE:	DATE: 08/25/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2021

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: SEGRAY EAGLE ROCK	FACILITY NUMBER: 198020336
	VISIT DATE: 08/25/2021

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activity space is maintained in a safe condition and is free of hazards. All floors were observed to be clean and safe. There are no firearms stored on the premises. There are no pools or bodies of water at the facility.

Children’s Records were reviewed. Infant Needs and Service plans were missing. Currently, there are no children under 12 months of age.

LPA also reviewed staff records. The review of Staff records was documented on the LIC 859. Staff present did have proof of the AB 1207 Mandated Reporter Training certificate on file. Staff present had an immunization record on file. All staff have been given on the-job training sanitation principles, housekeeping, including universal health precautions. All individuals present have obtained a criminal record clearance or criminal record exemption. There is at least one person trained in CPR and Pediatric First Aid present during this inspection.

Children's roster was reviewed and is current. Electronic copy of Sign-In and Sign-Out sheets were reviewed. Children present were signed in.

First Aid supplies were observed in the classrooms. The facility was observed to be equipped with an isolation area for any child who becomes ill and it is located in the office.

Medication: This facility provides Incidental Medical Services – IMS. Currently, there are no children enrolled that received Incidental Medical Services. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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.
A deficiency was cited during this visit and is on the next page, LIC809-D.

The Notice of Site Visit (LIC 9213) – 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, Appeal Rights discussed.

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SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Thelma Razo	TELEPHONE: (323) 981-3387
LICENSING EVALUATOR SIGNATURE:	DATE: 08/25/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2021

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: SEGRAY EAGLE ROCK	FACILITY NUMBER: 198020336
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/25/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 09/08/2021 Section Cited	1 2 3 4 5 6 7	Infant Needs and Services Plan. The facility shall ensure that each infant has an Infant Needs and Services Plan that meets the requirements of 101419.2(a-b). This requirement was not met as evidenced by the absence of Needs and Services Plan for all the infants. This poses a potential health and safety risk to the childrten in care.
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	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

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: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Thelma Razo	TELEPHONE: (323) 981-3387
LICENSING EVALUATOR SIGNATURE:	DATE: 08/25/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2021

LIC809 (FAS) - (06/04)

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