Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191607580
Report Date: 11/18/2016
Date Signed: 11/18/2016 12:47:56 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6167 BRISTOL PARKWAY #400
CULVER CITY, CA 90230
FACILITY NAME:SANTA MONICA-MALIBU USD/MCKINLEY H.S./S.P.FACILITY NUMBER:
191607580
ADMINISTRATOR:KIMBERLY KERNFACILITY TYPE:
850
ADDRESS:2401 SANTA MONICA BLVD.TELEPHONE:
(310) 828-3010
CITY:SANTA MONICASTATE: CAZIP CODE:
90404
CAPACITY:73CENSUS: 37DATE:
11/18/2016
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:41 AM
MET WITH:Reham Dabash, Assistant DirectorTIME COMPLETED:
10:25 AM
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Licensing Program Analyst (LPA), Tiffanie Tran, conducted an unannounced random site visit. LPA met with Reham Dabash, Assistant Director . LPA toured the facility inside and outside and visually inspected all areas.

The facility was located on Mckinley Elementary premises. The program operates with two classroom from (8:00AM - 2:30 PM). Upon arrival, LPA observed class 01 presented 3 staffs with 18 children and class 02 presented 5 staffs with 17 children. LPA observed appropriate care and supervision.

Furniture and equipment was inspected. Equipment and toys were age appropriate and in good repair. Telephone service, heating, lighting and ventilation were in good condition. Menu was properly posted in addition to all required posting. Per facility staff, all food items and snacks are delivered daily to the facility from the school district. Kitchen area observed to be clean and cleaning supplies were made inaccessible to children. Napping equipment were observed to be safe and clean. The facility had a functional smoke detector and carbon monoxide detector. All trash can had tight lids. Outdoor equipment was in good repair. LPA observed shade in the outdoor play area. Drinking water was available indoor and outdoor. Sign in/out sheets reviewed. Children's records were in good order. Staff's files were located in the main office. The facility roster was up to date, fire and disaster drills were conducted monthly. The facility staffs are currently certified in pediatric first aid and CPR.

Incidental Medical Services Plan of Operation (IMS-PO) was discussed. The facility is in the process of completing the IMS-PO then submits to the department.

There were no deficiencies found, this facility was in substantial compliance of Title 22 Regulations at the time of the visit. An Exit interview was conducted. The content of this report was read and discussed in detail at the time of with the noted contact person. Notice of site visit shall be posted for 30 days upon receipt. For additional information visit our website at: www.ccld.ca.gov

SUPERVISOR'S NAME: Sharon GreeneTELEPHONE: (310) 337-4313
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: 310-337-4335
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2016
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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