198021117-1-26-2023-33-CC-CRES-CNFRWS-20230126122338

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198021117
Report Date: 01/26/2023
Date Signed: 01/26/2023 12:23:52 PM

Document Has Been Signed on 01/26/2023 12:23 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:	MODERN SCHOOLHOUSE, THE		FACILITY NUMBER:	198021117
ADMINISTRATOR:	ATHWAL, SUKHJIT		FACILITY TYPE:	850
ADDRESS:	5117 EAGLE ROCK BLVD		TELEPHONE:	(408) 421-0352
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90041
CAPACITY: 30	TOTAL ENROLLED CHILDREN: 30	CENSUS: 0	DATE:	01/26/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Sukhjit Athwal (Sue)		TIME COMPLETED:	12:40 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	An announced pre-licensing site inspection was conducted today by Licensing Program Analyst (LPA) Cynthia Reyes to inspect and measure the facility for capacity determination. Due to COVID- 19 precautionary measures were taken during this inspection. Applicant is requesting a Preschool capacity of 15 and a toddler option program with a capacity of 15. LPA met with Applicant Sukhjit Athwal (Sue), who guided analysts on a tour of the facility indoors and out. This facility is located on the premises of a 2 story business complex on the lower level. The designated preschool classroom is located in the back of the facility and the Toddler Option is located at the front of the facility. The facility operating hours for both programs preschool and toddler option, will be Monday-Friday 7:30 AM-5:30 PM. At 9:30 AM, LPA began the tour of the facility with Sue beginning at the front entrance to the school located off the street, Eagle Rock Blvd, where the parents will enter and exit during Covid or not. Parents will sign the child in/out at the entrance using an electrical sign in/out called bight wheel. The parent board is located in this same area with licensing required postings and are visible for all to see. Temperatures and health checks and use of hand sanitizer will be conducted in this same area. The ill/isolation area is located in the back of the preschool class room where the staff rest room is located and will be used by the ill child. The ill/isolation area has a cot for a child to rest if needed. LPA was then guided through the preschool and toddler classroom. LPA observed in both classrooms, toys to be age appropriate clean and safe. Furniture and equipment was inspected for age appropriateness and is in good repair.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2023

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

FACILITY NAME: MODERN SCHOOLHOUSE, THE	FACILITY NUMBER: 198021117
	VISIT DATE: 01/26/2023

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

Page 3

11:30 AM Licensing staff was then guided to the preschool outdoor play area which is located in the back behind the preschool class room. Preschool children can walk right out the back door and up a few stairs to get to their outdoor play yard. Toddlers will need to request a waiver because they can only walk through the preschool class room or walk out the front door around the building to get to the waiver requested shared play yard with the preschool children. The yard is self contained by a gate/brick wall around it for separation from other areas located near the facility. 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 is available by lots of trees and the buildings. All areas around play equipment and slides are cushioned with material to absorb a fall. Measurements were taken of the outdoor play yard and the total outside capacity allows for the XXXX preschoolers. Applicant will submit a waiver for the Toddlers to share space in the preschool play yard using a staggered play schedule, as they do not have their own out door play yard.
LPA advised the applicant 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 has no transportation policy for preschool or Toddler children. Applicant states that any lifesaving medication will be stored in a locked area inaccessible to children in care. Facility does not have a staff lounge, however Director will set up a space outside for staff to use if needed.

Items discussed during this Inspection:

Licensing does not tolerate the following: Refused Entry to a Facility or Any Part of a Facility is a
violation of Section 1596.852, 1596.853 or 1597.09. Regulations 101238 (g) (2), The Presence of an Excluded Individual, Fire Clearance Violations, Accessible Bodies of Water, Accessible Firearms, Ammunition or Both.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2023

LIC809 (FAS) - (06/04)

Page: 3 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MODERN SCHOOLHOUSE, THE	FACILITY NUMBER: 198021117
	VISIT DATE: 01/26/2023

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

Page 2

Napping equipment (cots) were inspected and observed to be in good condition. Children will bring own blankets and parents will take home at the end of each week to wash. Appropriate Individual storage space was observed to be available for each child and cleanliness was observed in both rooms. The children will be provided jugs of water and disposable cups and they can bring their own labeled Sippy cups. AM and PM snack will be provided by the facility and all children will bring their own lunch or can order lunch from an outdoor vendor. Menus were observed posted. Containers used to discard food have tight fitting lids. Facility has extra linen and food available if needed.

10:30 AM, LPA observed the Preschool children have a bathroom inside their class room with 1 toilet, one portable sink and a sink for staff right outside the staff rest room and are in good condition, water temperature, paper towels, toilet paper, and all were inspected for safety and sanitation. It was also observed that the Toddlers do not have a bathroom & only have a changing table with no sink in their class room.

Food preparation area is in the preschool class room where LPA also observed a large triple see through door refrigerator, microwave and small counter with a sink. Space was inspected for safety and cleanliness. There is a fully equipped first aid kit available in each classroom. LPA observed the facility has central heat and air. Overhead lights as well as natural light, is used.

Carbon monoxide detectors and smoke detectors are present and are in operable condition in the facility. Smoke and Carbon Monoxide detectors should be checked and batteries replaced as needed. The fire extinguisher type 2A-10BC (Service date 02/11/2022) must be serviced annually or as often as necessary. Hazardous items including poisonous cleaning compounds were observed to be stored inaccessible to children.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2023

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

FACILITY NAME: MODERN SCHOOLHOUSE, THE	FACILITY NUMBER: 198021117
	VISIT DATE: 01/26/2023

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

Page 4 Continued Items discussed during this Inspection:
Breakfast/Lunch/Snack Menus: Menus are required to be posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days must also be available upon request.
Current Children’s Roster LIC 9040: Each child day care facility shall maintain a current roster of children who are provided care in the facility. The roster shall include the name, address, and daytime telephone number of the child's parent or guardian, and the name and telephone number of the child's physician. This children roster must be updated and available to the licensing agency upon request.
Pediatric First Aid and CPR: At least one person in the facility, along with the Director/Administrator must be trained in Pediatric First Aid and CPR and present in the facility.
Designated Staff: The name of the childcare center director or fully qualified teacher(s) designated to act in the director's absence must be on file.
Qualifications and staff files: Educational background, training, and/or experience and all required documents by the department for each staff present must be available for review.
Children’s Records: All required licensing documents must be available for review; including but not limited to, the following: Name, address and telephone number of the child's authorized representative and of relatives or others who can assume responsibility for the child if the authorized representative cannot be reached when necessary. Visit www.shotsforschool.org for immunization information.
Immunization Requirements: 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 flu, pertussis, & measles
Criminal background clearance: LPA advised Director that all adults 18 years of age and older providing Care & Supervision and/or have continuous presence in the facility shall adhere to a criminal background clearance with the Department of Justice, FBI and Child Abuse Index Check.
Reporting Requirements Section 101212: Changes at the facility must be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your location. The Director was also advised of the requirement to report Unusual Incidents and/or injuries to the parent/guardian and to CCL within the time frame specified by the regulation.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2023

LIC809 (FAS) - (06/04)

Page: 4 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MODERN SCHOOLHOUSE, THE	FACILITY NUMBER: 198021117
	VISIT DATE: 01/26/2023

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

Page 5

12 Noon Incidental Medical Services (IMS): This facility will not provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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 consulted with applicant regarding COVID-19 health and safety guidelines on this date.

Based on the LPA observations, the following corrections need to be completed before a license can be granted.

1) Waiver approval of shared play yard. (Preschool & Toddler Option using a staggered schedule) (2) Waiver for Toddlers to share bathroom with Preschool children. (3) Make a changing table close to a sink in toddler room. (4) Waiver for Toddlers to walk through preschool class to get to outdoor play yard. (5) Outdoor yard, trims trees, yellow paint on uneven pavement and fill in holes on brick wall. (6) Final File Review.

Based on LPA measurements taken on this date and observations of the facility, the indoor measurements for the preschool is 15, Toilet & Sink capacity allows for 15 preschool and outdoor space allows for 33 children. Toddlers Indoors cap 15, Toddlers have no outdoor or bathroom space. Once all completed license will be approved for 15 Preschool and 15 Toddlers. Fire clearance on file.

1 PM Exit interview conducted with Sukhjit Athwal (Sue), Owner and a signed copy of this report was given on this date.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2023

LIC809 (FAS) - (06/04)

Page: 5 of 5