198021258-9-7-2023-33-CC-CRES-CVFTAP-20230907143353

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198021258
Report Date: 09/07/2023
Date Signed: 09/07/2023 02:34:04 PM

Document Has Been Signed on 09/07/2023 02:34 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	VAN NESS AVENUE ELEMENTARY SCHOOL		FACILITY NUMBER:	198021258
ADMINISTRATOR:	HONG, JUNG		FACILITY TYPE:	850
ADDRESS:	501 N VAN NESS AVE		TELEPHONE:	(323) 469-0992
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90004
CAPACITY: 46	TOTAL ENROLLED CHILDREN: 46	CENSUS: 11	DATE:	09/07/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Regina Ramos/Director		TIME COMPLETED:	02:45 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 (LPA) Cynthia Reyes conducted an announced Pre-Licensing inspection on this date for the purpose of inspecting the facility to ensure the health and safety standards as required by the regulations governing childcare centers are met and measuring the facility for capacity determination for initial licensure. Applicant is requesting a preschool license with a capacity of 46. This facility location is on the LAUSD Van Ness Elementary school site. A copy of the Pre licensing Entrance Checklist for Child Care Centers form (LIC 9275) was provided. LPA met with Regina Ramos, principal, who guided analysts on a tour and helped measure class rooms B10 and B11 and the play yard for preschool children. The facility operating hours for the preschool program will be Monday-Friday 8 AM-2:23 PM. The tour of the facility began at the front entrance of building, where the parents will enter and exit from the parking lot off Van Ness Street. The children sign in/out for the parents is located at the entrance of each class room. The parent board is located in each classroom with licensing required postings and are visible for all to see. The facility has telephone service and phone number to the school was verified. Temperatures and health checks and use of hand sanitizer will be conducted and used at the entrance of each class room. The ill/isolation area is located in the main office where the nurses office is located with a bath room. A cot/mat is located in the ill isolation area for a child to rest if needed. LPA was guided through the Preschool class rooms B10 and B11 where LPA observed, toys and play equipment to be age appropriate clean and safe. Fixtures, furniture and equipment was inspected for age appropriateness and is in good repair. LPA observed the facility has central heat and air, overhead lights as well as natural light. (Class room B11 needs to be set up for child care).

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023

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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: VAN NESS AVENUE ELEMENTARY SCHOOL	FACILITY NUMBER: 198021258
	VISIT DATE: 09/07/2023

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LPA observed that the preschool children do not have their own bathroom and the applicant will request a waiver to share a bathroom with the visually impaired (VI) children. The bathroom the preschool children are requesting is designated as the VI woman's bathroom and it has 4 sinks and 4 toilets. All are in good condition, water temperature, paper towels, toilet paper, and all were inspected for safety, sanitation and operable. (4 toilets = capacity of 60 and 4 sinks = capacity of 60 children).

Napping equipment (mats) were inspected and observed to be in good condition. Mats are stored on a shelf. The facility provides blankets/sheets and a company washes each week. Appropriate Individual storage space was observed to be available for each child and cleanliness was observed in the room. The children will be provided plastic water bottles purchased by the school and they can bring their own labeled water bottles/Sippy cups. Breakfast and lunch is provided by the district and parents bring snacks. Menus were observed posted. Containers used to discard food have tight fitting lids. Facility has extra linen and food available if needed.

Child care centers shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well being of children, employees and visitors.

The facility has a kitchen/food pre area next to the entrance of the facility, children do not have access. LPA observed a refrigerator and large counter tops for use of food preparation in this area. Space was inspected for safety and cleanliness. The applicant will take measures to keep the facility free of flies, other insects and rodents.

Carbon monoxide detectors and smoke detectors are present and are in operable condition in the class room. Smoke and Carbon Monoxide detectors should be checked and batteries replaced as needed. The fire extinguisher type 2A-10BC (Service date 02/24/2023) must be serviced annually or as often as necessary. Fire and earthquake drills must be done every 3 months and documented. Hazardous items including disinfectants, poisonous, cleaning solutions and any other items that could pose a danger to children were observed to be stored inaccessible to children.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023

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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: VAN NESS AVENUE ELEMENTARY SCHOOL	FACILITY NUMBER: 198021258
	VISIT DATE: 09/07/2023

NARRATIVE

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Licensing staff was then guided to the preschool outdoor play area which is located right outside class room B10 and B11. The yard is self contained by a gate around it for separation from other areas. Water bottles will be used for children while outdoors. LPA observed age appropriate outdoor toys, play equipment and materials to be clean, safe and in good repair, as well as adequate shade available by use of the building. trees and canopy. All areas around play equipment and slides are cushioned with material to absorb a fall. 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 children. Applicant states that any lifesaving medication will be stored in a locked area inaccessible to children in care. First aid supplies were observed to have all the required items including a thermometer. There is a fully equipped first aid kit available in each class room.

Items discussed during this Inspection:

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.
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.
Criminal Records clearance: Applicant was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provide 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.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023

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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: VAN NESS AVENUE ELEMENTARY SCHOOL	FACILITY NUMBER: 198021258
	VISIT DATE: 09/07/2023

NARRATIVE

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Page 4 Continued: Items discussed during this Inspection:

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.
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.
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.
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.
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.

Review of records to be maintained - Child Care Centers 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.

Update: Effects of Lead Exposure and the following Provider Information Notices (PINs) Required Lead Testing: PIN 20-01 CCP Effects of Lead Exposure, and Guardian User Account Access - PIN 20-20-CCLD. were discussed Applicant will have kitchen and water fountain lead tested. Water for children to drink is cases of 16 oz water bottles, located in the classrooms. .

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023

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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: VAN NESS AVENUE ELEMENTARY SCHOOL	FACILITY NUMBER: 198021258
	VISIT DATE: 09/07/2023

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) tollfree 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.

MyChildCarePlan.org--Child Care Centers 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.

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-carelicensing/subscribe and select the Child Care option to receive email communication.

Applicant’s email address was verified/obtained during this inspection. The applicant was advised that the email may be public information.

Measurements taken allows for a capacity of 44 children inside (22 in each room) and 18 children outdoors. Applicant is requesting a capacity of 46, however based on LPA measurements taken and observations of the facility, and the preschoolers not having a bathroom (Waiver needs to be requested to share with the visually impaired children (1 woman Bathroom with 4 toilets and 4 sinks, cap 60). The facility will be licensed for 44 once the waiver is submitted and approved by the department and final file review. Fire clearance approved for 46.

Corrections needed: Two (2) Waiver request (Bathroom and play Yard), Set up room B11, cushion & toys outside, Submit updated documents and final file review.
Exit interview conducted and report was reviewed with the applicants Regina Ramos, Director.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023

LIC809 (FAS) - (06/04)

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