Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197415614
Report Date: 06/28/2016
Date Signed: 06/28/2016 11:49:18 AM

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:GAN SHELANU PRESCHOOL CENTERFACILITY NUMBER:
197415614
ADMINISTRATOR:MEIR, ILANITFACILITY TYPE:
850
ADDRESS:13625 BURBANK BLVD.TELEPHONE:
(818) 266-4953
CITY:SHERMAN OAKSSTATE: CAZIP CODE:
91401
CAPACITY:40CENSUS: 33DATE:
06/28/2016
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
07:40 AM
MET WITH:Ilanit MeirTIME COMPLETED:
11:50 AM
NARRATIVE
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Licensing Program Analyst (LPA ) met with facility director, for the purpose of conducting an annual random visit. LPA toured/inspected the facility indoor and outdoor. The facility utilizes 4 classrooms . There were 33 children in the preschool classrooms( 3 classrooms) with three teachers and 6 children in the toddler option classroom with one teacher. Staff to child ratio was observed. There was another staff , cook, present during the visit. Furniture and equipment were observed to be age appropriateness and good repair . The facility was observed to operate within the license capacity . Telephone service, heating, lighting and ventilation were evaluated and were in compliance with Title 22 Division12 Chapter 1 regulations. Storage for children's belongings was noted to be proper and individualized. LPA inspected the Isolation area located in the director’s office which is by a restroom and the area was orderly and clean. The bathroom had Age appropriate sinks and toilets which were inspected for availability, good repair, water temperature, toilet paper, paper towels, soap, area safety and sanitation and all were in order. First Aid supplies were inventoried and smoke detectors/fire extinguishers/carbon monoxide detectors were observed to be well serviced during this visit. A review of medication policy, including administering, labeling, storage, and records was completed. Sign in and out sheets were reviewed, but were not complete. This was brought up to the facility director's attention. Napping equipment was inspected and was in good repair. Documentation of Fire and Earthquake drills, Emergency disaster plan were posted. Activity Schedule was posted in all classrooms. Snack/lunch menus were observed. Disposal of food/debris was discussed/ trash cans had lids on. Snacks were stored in kitchen area which was clean and the facility only provides snacks for children. Children bring their own lunch. Food preparation area was inspected and it met Title 22 regulations. Storing of toxins/cleaning compounds were in order, inaccessible to children. Cleaning supplies were stored out of children’s reach. During the visit, all Classrooms had drinking water via water pitcher and cups available for children as needed.
Outdoor equipment was inspected for safety, cushioning material and age appropriateness. Cushioning material was in poor repair and that was brought to the facility director's attention. The facility director inquired about the current regulation for regarding the cushioning material and outdoor space. LPA provided the facility director with a copy of the regulation.
SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (310) 337-4332
LICENSING EVALUATOR NAME: Myriam LugaTELEPHONE: (310) 337-4365
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2016
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6167 BRISTOL PARKWAY #400
CULVER CITY, CA 90230
FACILITY NAME: GAN SHELANU PRESCHOOL CENTER
FACILITY NUMBER: 197415614
VISIT DATE: 06/28/2016
NARRATIVE
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Required shade, drinking water ( water fountain/filtered water) and fencing were inspected and they were in compliance with Title 22 regulations.
Play area was inspected for hazards, miscellaneous debris such as branches, trash or leaves or accessibility to bodies of water and none was observed. Facility director was reminded to keep the playground maintained at all times.
LPA reviewed children’s files during this inspection and all were complete.
Teachers' personnel records were reviewed and were complete. All teachers and the facility director have current certificates of pediatric first aid and CPR which expire in 10/17 .
LPA discussed with facility director in depth incidental medical services . The facility director indicated the facility does not provide incidental medical services.
LPA addressed with the facility director Senate Bill 277- eliminating the exemption to immunizations for children attending public school and child care based facilities upon personal beliefs, leaving the medical exemption in place, and Senate Bill 792 that addresses that any person employed or volunteering at a child care facility , has to be immunized against influenza, pertussis and measles.
LPA reminded the facility director of child abuse index clearances, child abuse reporting requirements ( mandated child abuse reporter), inspection authority (allow the Department in the facility for inspection including, facility staff//children record review, during facility operation hours), capacity limitations (licensee is required to stay within the guidelines of the facility licensed capacity), process of exemptions/exclusions of staff if needed(parents’ notification), qualifications of teachers/teacher aides including verification of education via obtaining copies of official academic transcripts/child development teacher/Associate Teacher permit, etc., maintaining children’s and staff personnel records at all times, updating children’s roster (LIC9040) as needed, reporting of unusual incident/injury documentation (if an unusual incident or injury occurs, director shall notify the Department within 24 hours via telephone and within 7 days by a written report). LPA provided director with the Department’s website: www.ccld.ca.gov.
The director was reminded that the Notice of Site Visit must be posted to be visible for a period of 30 days. .
Exit interview was conducted and a copy of this report was submitted to facility director.
SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (310) 337-4332
LICENSING EVALUATOR NAME: Myriam LugaTELEPHONE: (310) 337-4365
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2016
LIC809 (FAS) - (06/04)
Page: 3 of 3


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6167 BRISTOL PARKWAY #400
CULVER CITY, CA 90230
FACILITY NAME: GAN SHELANU PRESCHOOL CENTER
FACILITY NUMBER: 197415614
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/28/2016
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/05/2016
Section Cited
101229.1(b)
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Sign In and Sign Out-(b) The person who brings the child to, and removes the child from, the center shall sign the child in/out.
There were 33 children were present during the visit but only 10 children were signed in.
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The facility director will ensure that the person who brings the child to, and removes the child from, the center shall sign the child in/out. The faciltiy director will send the department the proof of correction by 7/5/2016.
Type B
07/21/2016
Section Cited
101238.2(e)
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101238.2(e) Outdoor Activity Space. All playground equipment shall be cushioned with material that will absorb a fall.
The cushioning under playground equipment was in poor repair.
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The faciltiy director will repair or replace the cushioning material and send proof of correction to the department by 7/21/2016.
Type B
07/14/2016
Section Cited
101216.1(g)
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Teacher Qualifications and Duties. A photocopy of the teacher’s Child Development Permit or transcript(s) as specified shall be maintained at the child care center.
One teacher's file did not contain A photocopy of the teacher’s Child Development Permit or transcript(s)
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The faciltiy director will ensure that a photocopy of the teacher's child development permit or transcripts shall be maintained at the child care center. The facility director will send the departemnt proof of correction by 7/14/2016.
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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: Jennie FerreiraTELEPHONE: (310) 337-4332
LICENSING EVALUATOR NAME: Myriam LugaTELEPHONE: (310) 337-4365
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2016
LIC809 (FAS) - (06/04)
Page: 2 of 3