Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493135
Report Date: 11/09/2017
Date Signed: 11/09/2017 03:16:05 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:EXPLORING MINDS MONTESSORI HAZELTINEFACILITY NUMBER:
197493135
ADMINISTRATOR:KARINA NAVAFACILITY TYPE:
850
ADDRESS:5128 HAZELTINE AVETELEPHONE:
(818) 465-3216
CITY:SHERMAN OAKSSTATE: CAZIP CODE:
91423
CAPACITY:24CENSUS: 22DATE:
11/09/2017
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Karina NavaTIME COMPLETED:
03:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Marina Pilossian conducted an unannounced site visit for the purpose of an annual required inspection. This facility will operate Monday through Friday, from 8:30 am to 4:00 pm. Upon arrival, LPA observed 22 children in the play yard with three teachers. LPA toured the facility with Jessica Brain, assistant director. After a short time, facility director Ms. Karina Nava arrived at the facility.

The facility is converted residential property. It is comprised of two large classrooms that open to each other. Classroom # 1 (to the right), and #2 .(to the left of the property upon entrance from the main door).

The adult restroom adjacent to this room will be used by sick children as well.

There is a full size kitchen that will be used to prepare snacks. The kitchen is equipped with full size refrigerator and a sink with hot and cold running water. The kitchen is completely off limits to the day-care children and LPA observed child proof gates installed at both (2) entrances of the kitchen.

The office is located adjacent to classroom # 1; it will be used to isolate/rest sick children. Drinking water will be offered in the classrooms by a water dispenser.

There is a restroom that is accessible through Classroom # 1 as well as the yard. This will be used by the
children.

The classrooms were observed to be set up with age appropriate toys and equipment. There are children's cubbies to store their belongings.
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (310)337-4341
LICENSING EVALUATOR NAME: Marina PilossianTELEPHONE: (310) 337-4340
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2017
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: EXPLORING MINDS MONTESSORI HAZELTINE
FACILITY NUMBER: 197493135
VISIT DATE: 11/09/2017
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Napping equipment was inspected there is adequate cots and bedding for the children in care, bedding is stored separately, sheet are washed weekly, director advised that blankets and bedding should always be laundered at least once a week or more often if soiled.

Director is reminded that if medication is to be administered it shall be is properly labeled and stored in the original container. Director advised that children should be screened every morning for illness and unusual marks. First Aid supplies are stored in the kitchen and some in the class rooms.

There is an operating telephone in the Child Care Center, 2:10ABC fire extinguisher is located outside of the director's office mounted on the wall. There is an operating smoke alarm detector and carbon monoxide detector in the facility.

Children records were reviewed for completeness records were found to be complete. Staff records were reviewed for completeness records were found to be complete. Director advised that records for all children and staff must be maintained for 3 years after separation from the facility.

Current certification for CPR and First Aid for the director expire 06/2018. As a condition of being a qualified director, CPR and First Aid certification, shall always be current.

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.

SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (310)337-4341
LICENSING EVALUATOR NAME: Marina PilossianTELEPHONE: (310) 337-4340
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2017
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: EXPLORING MINDS MONTESSORI HAZELTINE
FACILITY NUMBER: 197493135
VISIT DATE: 11/09/2017
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
The backyard is completely fenced in and there are no bodies of water observed. The outdoor space was observed to be set up with different types of activities, and separated with short fence and ramp. There is a large play equipment with 2 large slides. One slide is covered. There are cushioning material under the play equipment and other parts of the yard. On the other side, there is a large stage set up for performances by the children. The back part of the property includes parking spaces and detached/converted garage. These areas will be completely off limits to the day-care children and children will not be received from this end of the property.

There are large shade structures installed to provide shade on most part of the yard.
A review of the sign in/out sheet was conducted to verify the current census of children.
A record of teachers/assistants names was check against current facility roster.

Furniture was found to be in good repair and age appropriate. There is adequate heating, lighting and ventilation. Drinking water is readily available in classroom in the form of a pitcher and water dispenser. Director states that the isolation area for sick students is located on a cot or mat in the Director's Office.

The bathroom area(s) was inspected toilets flush properly. Toilet and sinks are reachable by the children in care. Each rest-room has adequate Toilet paper and paper towels available. Bathrooms were found to be clean. There is adequate lighting/ventilation in the bathroom area(s).

Lunches are not prepared by the school, children bring their own lunch from home. The day care does provide AM and PM snacks. Food preparation area is not accessible to children in care. Snack Menu(s) are posted for parents to view Food preparation area is adequately equipped, clean and free from hazards. Cleaning supplies are out reach of children and is stored separately and away from food. There is adequate food for snacks. There is hot and cold running water in the food preparation area. Refrigerator is clean and operating at the proper temperatures. Trash cans have lids .



SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (310)337-4341
LICENSING EVALUATOR NAME: Marina PilossianTELEPHONE: (310) 337-4340
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2017
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: EXPLORING MINDS MONTESSORI HAZELTINE
FACILITY NUMBER: 197493135
VISIT DATE: 11/09/2017
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
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

Licensee was made aware 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

There is a $100.00 per day Civil Penalty initially to the licensee for any adult not fingerprint cleared that is working or living at the facility or persons previously cleared through the Department of Social Services not associated to the facility. Licensee can be cited a civil penalty up to $500.00 for the 1st offense and up to $3000.00 for the 2nd offense within a 12 month period, per person.



Failure by a licensed child care center or a family child care home to post any of the required site visit reports for 30 consecutive days will result in an immediate civil penalty assessment of $100.00

Whenever a Type A deficiency is cited, licensee shall post and provide copies of this licensing report to parents/guardians of the children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. $100.00 civil penalty per parent not notified of an exempt person in the facility
No deficiencies were cited. Facility is in substantial compliance at time of visit.
Copy of report provided; exit interview.
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (310)337-4341
LICENSING EVALUATOR NAME: Marina PilossianTELEPHONE: (310) 337-4340
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2017
LIC809 (FAS) - (06/04)
Page: 4 of 4