Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419098
Report Date: 05/10/2017
Date Signed: 05/11/2017 07:11:43 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:HARMON OAKS NURSERY SCHOOLFACILITY NUMBER:
197419098
ADMINISTRATOR:KUPCHYAN, MARIYAFACILITY TYPE:
850
ADDRESS:7028 BALBOA BOULEVARDTELEPHONE:
(818) 386-8409
CITY:LAKE BALBOASTATE: CAZIP CODE:
91406
CAPACITY:49CENSUS: 34DATE:
05/10/2017
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
07:30 AM
MET WITH:Mariya KupchyanTIME COMPLETED:
10:30 AM
NARRATIVE
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Licensing Program Analyst (LPA), Silva Garibyan met with the the director, Mariya Kupchyan, and conducted a Required-3 Year visit. LPA toured and inspected the preschool in accordance with the facility sketch. The facility operates a combination center consisting of a Pre-school and Toddler Option program. The facility operates Monday through Friday, from 7:00 AM to 6:00 PM. A review of the sign in/out sheet was conducted to verify the current census of children . Currently there are 6 teachers present along with the director. Facility is operating within capacity limitations. There are no bodies of water on the premises during the visit. The facility consists of 6 classrooms ( 5 preschool and 1 Toddler option) , a Director's office, and 2 play yards. There is a separate Kitchen for Preschool use. Director's office and staff bathroom are used as isolation areas for sick children. The following were observed during this visit:
1. Teacher/child ratio;
2. Care and supervision of children in care; teacher/child interaction;
3. Availability of drinking water to children both indoors and outdoor
4. Cleanliness of facility and children's toys/equipment; cushioning under outdoor equipment.
5. Cleanliness of bathrooms, operation of toilets and sinks.
The preschool bathroom has 4 toilets and 4 sinks.
6. Inaccessibility of chemicals and toxins to children in care;
7. Sign in/out sheets; postings; emergency disaster drill logs.
8. Storage of children's belongings/Napping equipment.
There are cubbies for children's belongings in the classrooms. LPA observed a sufficient quantity of cots available for napping children. The bedding is stored separately and properly.
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (310) 337-4826
LICENSING EVALUATOR NAME: Silva GaribyanTELEPHONE: (310) 337-3754
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2017
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 4


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: HARMON OAKS NURSERY SCHOOL
FACILITY NUMBER: 197419098
VISIT DATE: 05/10/2017
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9. Current certification for CPR and First Aid for Director expired ( 02/2017). As a condition of being a qualified director, CPR and First Aid certification, shall always be current
10. Sample of children's files were reviewed for accuracy and completeness.
11. Sample of staff files were reviewed. Files were complete

Children are inspected for illnesses as they arrive. A review of medication policy indicated that Medication is administered by the director or teachers, who documents the date, time and dosage onto a log. Medications are stored securely and inaccessible to children. There is a separate area for isolation and care of ill children in the director's office. There is a cot available for each ill child. An isolated toilet and sink are available for ill children.
Lunches are not be prepared by the school. Hot lunch is catered by an independent company. There is a clean, fully equipped kitchen area with sink, refrigerator, freezer and microwave oven for the facility staff use. The facility provides morning and afternoon snacks daily.

LPA observed an appropriate amount of food and snacks. The chemicals are kept separate from the food.
The following was discussed

Senate Bill 792: that prohibits a person from being employed or volunteering at a child care facility if he or she has not been immunized against influenza, pertussis and measles and Assembly Bill 290 (Alejo, Chapter 734, Statutes of 2013).

New Immunization Requirement: Law enacted by SB 277, beginning January 1, 2016 personal beliefs exemptions will no longer be an option for the vaccines that are currently required for entry into child care or school in California. Personal beliefs exemptions already on file will remain valid until the child reaches the next immunization checkpoint.

New Appeal Process: A licensee may file an appeal, in writing 15 business days from the date of receiving the penalty assessment.

SUPERVISOR'S NAME: Mary RuizTELEPHONE: (310) 337-4826
LICENSING EVALUATOR NAME: Silva GaribyanTELEPHONE: (310) 337-3754
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2017
LIC809 (FAS) - (06/04)
Page: 2 of 4


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: HARMON OAKS NURSERY SCHOOL
FACILITY NUMBER: 197419098
VISIT DATE: 05/10/2017
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Nutrition Requirement: Beginning January 1, 2016, AB 290 will require for each new license issued, at least one director or teacher at each child care center or family child care home to have at least one hour of training in the importance of childhood nutrition. This applies to anyone submitting a new application, relocating their facility, selling their facility or transferring their license. Please note this training cannot be completed online or by home study programs. The training must be taken from an Emergency Medical Services Authority (EMSA) approved training program OR an accredited college or university.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated 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

The licensee was informed of The Child Care Advocate Program (CCAP) that is administered from within the Community Care Licensing Division. CCAP participates in many community activities and special projects in order to disseminate information on the State’s licensing role, provide information to the public and parents on child care licensing, and provide many other helpful resources to the licensees and the public. CCAP’s direct contact information is as followed: Phone number: (916) 654-1541


Email Address: childcareadvocatesprogram@dss.ca.gov
No deficiencies were cited. Facility is in substantial compliance at time of visit.
Copy of report provided; exit interview.
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (310) 337-4826
LICENSING EVALUATOR NAME: Silva GaribyanTELEPHONE: (310) 337-3754
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2017
LIC809 (FAS) - (06/04)
Page: 3 of 4


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: HARMON OAKS NURSERY SCHOOL
FACILITY NUMBER: 197419098
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/10/2017
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/24/2017
Section Cited
101215.1(m)
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Child Care Center Director Qualifications and Duties:

Current certification for CPR and First Aid for Director expired ( 02/2017). As a condition of being a qualified director, CPR and First Aid certification, shall always be current
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Once the course is completed, Director will mail a copy of the current certification via US Mail or email.
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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: Mary RuizTELEPHONE: (310) 337-4826
LICENSING EVALUATOR NAME: Silva GaribyanTELEPHONE: (310) 337-3754
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2017
LIC809 (FAS) - (06/04)
Page: 4 of 4