Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419929
Report Date: 04/23/2019
Date Signed: 04/23/2019 10:46:19 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:MUSICAL GANFACILITY NUMBER:
197419929
ADMINISTRATOR:SORAYA SADIGHIMFACILITY TYPE:
850
ADDRESS:13624 BURBANK BLVDTELEPHONE:
(818) 786-7800
CITY:SHERMAN OAKSSTATE: CAZIP CODE:
91401
CAPACITY:36CENSUS: 0DATE:
04/23/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Sapir AdaniTIME COMPLETED:
11:15 AM
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Licensing Program Analyst (LPA ) Marina Pilossian met with the licensee, for the purpose of conducting an annual random visit. LPA, and licensee toured/inspected the facility indoor and outdoor on 4/23/19 at 9:35am. LPA did not observe any day care children during the inspection due to facility close for Jewish Holiday. Facility will be closed until 4/26/19, and will resume on 4/29/2019.

The facility utilizes 3 classrooms. Furniture and equipment were observed to be age appropriateness and good repair . 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 bathrooms that 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/carbon monoxide detectors, and the fire extinguishers were observed to be well serviced. A review of medication policy, including administering, labeling, storage, and records was completed. Facility does not administer medication.
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Marina PilossianTELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2019
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MUSICAL GAN
FACILITY NUMBER: 197419929
VISIT DATE: 04/23/2019
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The facility was found to be in compliance per Title 22 regulations, there shall be a NO Type A or Type B deficiencies cited today.

A copy of this report along with a Notice of Site Visit were issued and explained to the Director.
An exit interview was discussed and conducted including but not limited to: Provider Rights, Appeal Procedures and Agency's Consultative Role.
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Marina PilossianTELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2019
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MUSICAL GAN
FACILITY NUMBER: 197419929
VISIT DATE: 04/23/2019
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Sign in and out sheets were not reviewed due to no children present at the facility. Napping equipment was inspected, and was stored in the Director's office. 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 provides snacks and lunch for children. 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. Per Drinking water is available in the classroom by form of a pitcher and plastic cups with children's names.

Outdoor equipment was inspected for safety, cushioning material, good repair and age appropriateness. Required shade, drinking water in form of a pitcher and plastic cups are available for the children. Fencing were inspected and they were in compliance with Title 22 regulations. Climbing structures/slides and other large play equipment were found to be securely anchored with adequate resilient cushioning material underneath and around the perimeter. 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.

Staff records, and children's records were reviewed during inspection for completeness including but not limited to Criminal Record Clearances, Director Qualifications and verification of CPR/First Aid and Health and Safety preventative practices documentation. LPA Pilossian observed CPR/First Aid expires 12/2020. All Staff members are currently associated to the facility where they are assigned to work. Required postings were observed by LPA.



SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Marina PilossianTELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2019
LIC809 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MUSICAL GAN
FACILITY NUMBER: 197419929
VISIT DATE: 04/23/2019
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The licensee was informed of The Child Care Advocate Program (CCAP) that is available 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

AB 1207: Beginning on January 1, 2018, this law requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Website: www.mandatedreporterca.com

Senate Bill 792: this bill, commencing September 1, 2016, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles. LPA discussed the influenza waiver during the visit.

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. Appeal may be submitted and mailed to the following address:
300 N Continental Boulevard Suite #290A, MS 29-13
El Segundo, CA 90245

The licensee was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Copies of the reports must also be provided to each parent when a serious deficiency,
Type A, is cited (LIC9224).
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Marina PilossianTELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2019
LIC809 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MUSICAL GAN
FACILITY NUMBER: 197419929
VISIT DATE: 04/23/2019
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The following requirements were discussed with the licensee:
Mandatory forms for all the staff files; requirements for fire drills, earthquake drills, and documentation for both; role and responsibilities of being a mandated reporter. The licensee was advised on how to access forms and Regulations for Child Care Center online at www.ccld.ca.gov . Licensee was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care. The licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must have the facility’s phone number at all times; if the phone number is changed, licensing must be notified. Regulation prohibits the smoking of tobacco on the premises.

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 ADA requires that child care providers not discriminate against persons with disabilities on the basis of disability, that is, that they provide children and parents with disabilities with an equal opportunity to participate in the child care center's programs and services. Requirements for fingerprint clearances and associations were discussed with the licensee. Licensee can be cited a civil penalty of $100 per day, up to $500.00 (5 days) for the 1st offense and up to $3000.00 for the 2nd offense within a 12-month period. The licensee was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and licensing within the time frame specified by the regulation. The "Notification of Parent's Rights" (PUB394) poster must be posted in an area accessible to parents. The information regarding new legislation with regards to exemptions and Parent’s Rights was also discussed.

SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Marina PilossianTELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2019
LIC809 (FAS) - (06/04)
Page: 3 of 5