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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400231
Report Date: 11/01/2024
Date Signed: 11/01/2024 12:21:55 PM

Document Has Been Signed on 11/01/2024 12:21 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:NU BUILDING BLOCK INFANT CENTERFACILITY NUMBER:
198400231
ADMINISTRATOR/
DIRECTOR:		PEYTON SOLOMONFACILITY TYPE:
830
ADDRESS:2141 W JEFFERSON BLVDTELEPHONE:
(323) 732-5439
CITY:LOS ANGELESSTATE: CAZIP CODE:
90018
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 3DATE:
11/01/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:35 AM
MET WITH:Peyton SolomonTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
NARRATIVE
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On 11/1/24, at 10:05 a.m., Licensing Program Analysts (LPA) Claudia Kam and Joshua Ortega conducted an unannounced case management inspection and met with Peyton Solomon and Paige Solomon. LPAs disclosed the purpose of the inspection and was granted entry into the facility by teacher Kimberly Jamerson.

There were 3 children and 2 staff present during the inspection.

The purpose of today's inspection was to clear plan of corrections for deficiencies assessed on 9/27/24.

At 10:07 a.m. LPAs observed and took pictures of the carbon monoxide detector plugged on the top left wall center of room. Monitor was observed operable and tested. Disaster plan was observed at 10:59 a.m. completed and posted on the wall at the entry to the facility. Safety gate was observed installed in the indoor play area separating the play area from crib area, however the crib area that has been separated is being used as play area with a rug for rug time and cubby shelves with toys in the cordoned off crib area. Prior plans of correction were observed as not completed by due dates.

The deficiency listed on the following page was observed by the LPAs and is being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809-D. The deficiency that is being cited needs to be cleared to protect the children’s health & safety.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Paige Solomon.
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Claudia Kam
LICENSING EVALUATOR SIGNATURE: DATE: 11/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/01/2024
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
Document Has Been Signed on 11/01/2024 12:21 PM - It Cannot Be Edited


Created By: Claudia Kam On 11/01/2024 at 11:06 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: NU BUILDING BLOCK INFANT CENTER
FACILITY NUMBER: 198400231

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/01/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/01/2024
Section Cited
CCR
101438.3(c)(1)

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(c) The calculation of indoor activity space for infants shall not include space designated and used for cribs. (1) The sleeping area for infants shall be physically separate from the indoor activity space. This separation accomplished by (b) This requirement is not met as evidenced by:
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Director will move the gate and take toys out of the sleeping area by 11/11/24.
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Based on observation, the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care. Play and care is taking place in area designated for cribs.
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Type B
11/01/2024
Section Cited
HSC1596.7995(a)(1)

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(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if...not been immunized against influenza, pertussis, and measles. Each.. shall receive an influenza vaccination .... This requirement is not met as evidenced by:
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Director will request records and have them on file by 11/15/24.
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Based on observation, the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care. Vaccinations are not present in staff file.
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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:Denise Gibbs
LICENSING EVALUATOR NAME:Claudia Kam
LICENSING EVALUATOR SIGNATURE:
DATE: 11/01/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/01/2024


LIC809 (FAS) - (06/04)
Page: 2 of 5
Document Has Been Signed on 11/01/2024 12:21 PM - It Cannot Be Edited


Created By: Claudia Kam On 11/01/2024 at 11:21 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: NU BUILDING BLOCK INFANT CENTER
FACILITY NUMBER: 198400231

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/01/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/01/2024
Section Cited
CCR
101216(G)(1)

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(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.
This requirement is not met as evidenced by:
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Director will complete health screenings and have on file by 11/15/24.
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Based on observation, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. Health screening for staff is not present in file.
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Type B
11/01/2024
Section Cited
CCR101223(A)(2)

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(a) The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
This requirement is not met as evidenced by:
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Director will order furnishings and have them in the play area by 11/15/24.
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Based on observation, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. Facility does not have furnishings for older infants in care.
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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:Denise Gibbs
LICENSING EVALUATOR NAME:Claudia Kam
LICENSING EVALUATOR SIGNATURE:
DATE: 11/01/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/01/2024


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Document Has Been Signed on 11/01/2024 12:21 PM - It Cannot Be Edited


Created By: Claudia Kam On 11/01/2024 at 11:30 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: NU BUILDING BLOCK INFANT CENTER
FACILITY NUMBER: 198400231

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/01/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/01/2024
Section Cited
CCR
101171(a)

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(a) All child care centers shall secure and maintain a fire clearance approved by the city or county fire department, the district providing fire protection services, or the State Fire Marshal.
This requirement is not met as evidenced by:
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Director will submit application for fire clearance and documentation for clearance to the department or proof of clearance by 11/15/24.
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Based on observation, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. Fire clearance is not present in the facility.
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Type B
11/01/2024
Section Cited
CCR101174(d)

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(d) Disaster drills shall be conducted at least every six months.
This requirement is not met as evidenced by:
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Disaster drill will be conducted on 11/5, and will be posted and submitted to the department by 11/15/24.
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Based on observation, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. Disaster drill log is not posted and has not been conducted.
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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:Denise Gibbs
LICENSING EVALUATOR NAME:Claudia Kam
LICENSING EVALUATOR SIGNATURE:
DATE: 11/01/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/01/2024


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/01/2024 12:21 PM - It Cannot Be Edited


Created By: Claudia Kam On 11/01/2024 at 11:35 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: NU BUILDING BLOCK INFANT CENTER
FACILITY NUMBER: 198400231

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/01/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/01/2024
Section Cited
CCR
101238.2(g)

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(g) The playground shall be enclosed by a fence to protect children and to keep them in the outdoor activity area. The fence shall be at least four feet high.
This requirement is not met as evidenced by:
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Director will order a fence and have it installed and submit verification to the department by 11/18/24.
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Based on observation, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. Outdoor play area is not enclosed.
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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:Denise Gibbs
LICENSING EVALUATOR NAME:Claudia Kam
LICENSING EVALUATOR SIGNATURE:
DATE: 11/01/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/01/2024


LIC809 (FAS) - (06/04)
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