198020965-3-15-2022-33-CC-CGRN-CC7TJJ-20220304134624

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020965
Report Date: 03/04/2022
Date Signed: 03/15/2022 12:03:36 PM

Document Has Been Signed on 03/15/2022 12:03 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	DORRIS PLACE ELEMENTARY		FACILITY NUMBER:	198020965
ADMINISTRATOR:	ISMAEL BERVER		FACILITY TYPE:	850
ADDRESS:	2225 DORRIS PLACE		TELEPHONE:	(323) 222-9185
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90031
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS:	DATE:	03/04/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Obioma Uche and Ismael Berver		TIME COMPLETED:	01:50 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	Licensing Program Analysts (LPAs) Crystal Green and Mireya Garcia conducted an announced pre-licensing site inspection to ensure the facility is following the state laws and the health and safety regulations and to measure the requested Preschool component for capacity determination. The applicant is requesting a total capacity of 24 preschool children. Licensing Staff met with Facility Representative, Obioma Uche and Ismael Berver. Due to COVID- 19 precautionary measures were taken during the entire inspection, and all individuals present during this inspection wore appropriate personal protective equipment. The facility hours of operation will be Monday-Friday, 7:30 AM- 3 PM. At 11:20 AM, LPA began the facility tour with Facility Representative. Prior to entry staff will sign the child in/out. Parents will be using the scan daily pass health screening that will be present to staff upon arrival. Parents will only stop at the table and not enter the classrooms at this time, unless they request to enter the entire class room, which at that time all precautionary measures will be taken for that individual entering. Facility staff will walk the child inside the classroom and bring the child out at pick up time. Licensing staff was then guided through the proposed preschool classroom, which will be Room 11. At 11:21 AM, Licensing staff observed 5 children and 2 staff eating lunch present in the Room 11. Per Facility Representative, the children and staff present are currently operating under an exempt Title 22 program with the California Department of Educational Early Learning and Care Division. The program is called California State Preschool Program (CSPP). Licensing staff observed the posting of the exemption notice on the Parent Board. LPA observed the classrooms to contain age appropriate furniture and equipment which were also inspected and observed to be in good condition.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2022

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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: DORRIS PLACE ELEMENTARY	FACILITY NUMBER: 198020965
	VISIT DATE: 03/04/2022

NARRATIVE

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LPAs observed that the children restroom will be located in between Room 11 and Room 12. Per Facility Representative, the children restroom will be shared with the children from Room 12, Expanded Transitional Kindergarten program. The program is called Expanded Transitional Kindergarten program that accepts children no longer age eligible for CSPP Program. LPAs observed the restroom to have 2 toilets and 1 sink. There is also a sink available inside room 11 accessible to the children. All toilets and sinks are in safe and sanitary operating conditions. Per Facility Representative, staff member will assist children to and from the restroom at all times. Napping equipment cots were inspected and observed to be in good condition. Carbon monoxide detectors was observed in the classroom.

Blankets and sheets will be provided by the parents, who will take it home at the end of each week to wash. Individual storage space will be available for each child inside the classroom. Water will be accessible to the children via water jugs and disposable cups in all classrooms. Breakfast and Lunch will be provided by the Los Angeles School District. Hazardous items including poisonous cleaning compounds were observed to be stored inaccessible to children.

The ill/isolation area is located in the nurse’s office located in the main building. The ill child will use the staff rest room located across from the nurse’s office. The ill/isolation area has a cot for a child to rest if needed.

Licensing staff was then guided to the designated preschool outdoor play area The yard was self-contained via a gate around it for separation from other areas in this entire gated yard. Water jugs with disposable cups will be used for children while outdoors. LPA observed age-appropriate outdoor toys and play equipment to be clean, safe, and in good repair, as well as adequate shade available via the building itself. All areas around and under play equipment and slides are cushioned with material to absorb a fall. LPA did not observe any bodies of water on the premises.

Measurements were obtained for the outdoor play yard, and the total outside capacity allows for the 38 preschoolers. LPA advised the facility representative that the children need to be within the direct care and supervision, including visual observation and supervision of the teacher(s) at all times. Facility does not provide transportation for preschool children.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2022

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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: DORRIS PLACE ELEMENTARY	FACILITY NUMBER: 198020965
	VISIT DATE: 03/04/2022

NARRATIVE

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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

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.
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.

Based on LPA measurements taken on this date and observations of the facility, the total indoor capacity of the preschool classroom can accommodate 20 preschool children. The measurements obtained for the outdoor space can accommodate a total of 38 preschool children. The Department has received an approved Fire Clearance from the Los Angeles Fire Department.

The following corrections will need to be made prior to submitting the application for approval.
1) Applicant will need to submit waiver request for the shared use of the restroom
2) Applicant will need to submit a waiver request for shared usuage of the Outdoor Playspace.

1: 40 PM Exit interview conducted, and report was reviewed Facility Representative,

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2022

LIC809 (FAS) - (06/04)

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