Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493531
Report Date: 04/16/2019
Date Signed: 04/16/2019 02:36:06 PM

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:RIVERSIDE STARFACILITY NUMBER:
197493531
ADMINISTRATOR:GONZALES, ANGELOFACILITY TYPE:
840
ADDRESS:13061 RIVERSIDE DRIVETELEPHONE:
(310) 842-8040
CITY:SHERMAN OAKSSTATE: CAZIP CODE:
91423
CAPACITY:60CENSUS: 25DATE:
04/16/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Carlos Hernandez:TIME COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Marina Pilossian conducted a case management visit for increase of capacity for the after school program. LPA arrived at the facility at 12:30pm. LPA and Director Mr. Carlos Hernandez toured the facility inside and outside on 4/16/19 at 1:00pm. The facility is housed at the school campus of Riverside Star Elementary school. LPA Pilossian spoke to Amy Smith, and Vicki Feldmar, Director of Program. The facility is already licensed to utilize room # 27, and #28 for the after school program. The Program Directors are requesting to add room #29 to the existing license for 30 additional children. Total of 90 children. The facility has a waiver on hand for the use of the restrooms. LPA observed 25 children with 4 staff members.

The Riverside Star program will run an after-school program for the students of the elementary site. Riverside Star is requesting a capacity of 30 additional children. The facility is already licensed for 60 children, therefore the facility will be licensed for total of 90 after school age children. The program will operate from 2:30pm to 6pm Monday thru Friday, except Tuesday 1:00 pm to 6:00 pm.

The indoor (classroom #29) will not be measured according to Title 22 Division 12, Chapter 1, Subchapter 03. School Age Child Care Center 101538.3 as the program is located on an existing school site.

The outdoor (play yard) will not be measured according to Title 22 Division 12, Chapter 1, Subchapter 03. School Age Child Care Center 101538.2 as the program is located on an existing school site.
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Marina PilossianTELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:

DATE: 04/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2019
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: RIVERSIDE STAR
FACILITY NUMBER: 197493531
VISIT DATE: 04/16/2019
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The program is currently utilizing Room #27, and #28, and is planning on adding Room #29. LPA observed the required posting on the parent board in room #27. The sign in and out sheets will be place in room #27 for parents to sign in or out.

First Aid supplies were inventoried and kept in room #27. Each classroom has water and cups in place for the children. The program will offer a nutritious snack for the children. Snack/menus were reviewed. Food and snacks were checked for availability, quantity and appropriateness to children in care. All food shall be protected against contamination, advised to always place open food items in zip lock bags or plastic containers. LPA observed all storage containers for solid waste, it was advised that moveable bins have tight-fitting covers and that they are kept on, and in good repair. LPA observed all areas that are accessible to the children were toxic free and director was advised to take measures to keep the facility free of flies, other insects and rodents.

The children will utilize the restrooms on campus, girls and boys will have separate restrooms. Furniture and equipment is in good condition and is free of loose pointed parts. The children have access to the playground but do not access the area while elementary school children (children who are not part of the program) are on the yard. There are no pools or bodies of water in the facility.

LPA observed age appropriate sinks and toilets for availability, good repair, water temperature, toilet paper, paper towels, area safety and sanitation. LPA inspected the heating, lighting and ventilation of the site/classrooms. Due to the age of the children in care, they do not nap. However, LPA was told that they will have some mats in case younger children will want to rest or take a nap. LPA observed appropriate storage for the children's belongings. Disinfectants, cleaning solutions and other items that are dangerous to the children, are inaccessible to the children in care, they are located under the sink which was latched. LPA advised all storage areas with poisons shall be locked at all times. Medication will be housed in the after-school bungalows.
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Marina PilossianTELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:

DATE: 04/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2019
LIC809 (FAS) - (06/04)
Page: 2 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: RIVERSIDE STAR
FACILITY NUMBER: 197493531
VISIT DATE: 04/16/2019
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Medication shall be inaccessible to the children. LPA reminded Director of the requirements for criminal records/child abuse index clearances, child abuse reporting, inspection authority, and capacity limitations. Director was also reminded of incident/medication documentation.

Director Qualifications and verification of CPR/First Aid and Health and Safety preventative practices documentation. LPA Pilossian observed CPR/First Aid expires 01/2020. All Staff members are currently associated to the campus where they are assigned to work.

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

Facility was provided Department web site www.ccld.ca.gov

Fire Department granted the additional capacity of 30 making the total capacity of 90.

The facility will be licensed with the total capacity of 90.


Exit interview conducted and a copy of this report was printed and provided to Carlos Hernandez.
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Marina PilossianTELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:

DATE: 04/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2019
LIC809 (FAS) - (06/04)
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