Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191610250
Report Date: 01/24/2017
Date Signed 01/24/2017 03:39:22 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:MATTEL CHILD DEVELOPMENT CENTER - INFANTFACILITY NUMBER:
191610250
ADMINISTRATOR:HAWANI NEGUSSIEFACILITY TYPE:
830
ADDRESS:333 CONTINENTAL BLVD.TELEPHONE:
(310) 252-3311
CITY:EL SEGUNDOSTATE: CAZIP CODE:
90245
CAPACITY:43CENSUS: 15DATE:
01/24/2017
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:43 PM
MET WITH:Amy Fougy/DirectorTIME COMPLETED:
03:44 PM
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Licensing Program Analysts (LPA) Trevino Cochran conducted an Annual Random Visit of the infant program. Upon arrival LPA met with Director Amy Fougy and proceeded to tour the facility. All required notices, forms and license were posted. While touring the facility, LPA observed that the facility was operating within the approved licensed ratio. There were a total of 15 infants present with 5 staff supervising. The infant program is separated into two programs for non walking infants and crawling infants. LPA observed 7 awake and crawling infants (0-15 months) present with 2 staff supervising in Classroom #1 and 8 napping infants (9-15 months) present with 2 staff supervising in Classroom #2.

Feeding, diapering, napping logs reviewed. Refrigerator inspected, infants food labeled & dated. There are no bodies of water or weapons at this facility. LPA observed toys not to have sharp points, edges or splinters, or made of small parts that can be pulled off. There is sufficient infant napping equipment. LPA observed infant napping room. Infant cribs with padding and sheets observed. Infant changing tables have padded surface no less than one inch thick, covered with washable vinyl, and raised sides at least 3 inches high. There are no walkers, bouncy seats, exer-saucers or jumpers observed in the room. Rooms observed to have adequate heating, lighting, and ventilation. Solid waste storage vessels, including moveable bins, have tight-fitting covers on, and observed to be in good repair. LPA observed changing tables within arm's reach of a sink. Disinfectants, hazardous items and medications are inaccessible to children through latches and locks. Infant room has a refrigerator used for infant food storage which is properly labeled by child name and date. LPA observed bottle warmers, a sink, cabinets and refrigerator in the kitchen. There is an Individual Daily communication sheet for each child that was reviewed by LPA. Menus are posted. Drinking water is readily accessible inside and outside the classroom.

Outdoor play area is physically separate from the space used by other day care children. LPA observed safe cushioning around the play structure and fall zones. LPA observed age appropriate toys and equipment for active play.
SUPERVISOR'S NAME: Sharon GreeneTELEPHONE: (310) 337-4313
LICENSING EVALUATOR NAME: Trevino CochranTELEPHONE: (310) 337-4335
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2017
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: MATTEL CHILD DEVELOPMENT CENTER - INFANT
FACILITY NUMBER: 191610250
VISIT DATE: 01/24/2017
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Staff and Children records were reviewed for required CCLD forms. Pediatric CPR/First Aid are current and expire 07/2018. Sign in/sign out sheets are well maintained.

The following forms were observed to be posted. The facility license, Parent's Rights Poster (PUD 393), Personal Rights (LIC 613A), Emergency Disaster Plan (LIC 610).

Incidental Medical Services were discussed. Licensee stated that at this time she does not have any children in her care that require IMS.

For additional information and forms visit our website at: www.ccld.ca.gov
A copy of this report must be made available to the public for 3 years.

Per the Title 22 regulations, on 01/24/2017, the above facility was found to be operating in substantial compliance.

An exit Interview was conducted, a copy of this Report and a Notice of Site visit was provided

SUPERVISOR'S NAME: Sharon GreeneTELEPHONE: (310) 337-4313
LICENSING EVALUATOR NAME: Trevino CochranTELEPHONE: (310) 337-4335
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2017
LIC809 (FAS) - (06/04)
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