Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191871500
Report Date: 08/12/2016
Date Signed 08/12/2016 03:55:59 PM

COMPREHENSIVE INSPECTION
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:F.K.C. PRICE III, CHILD CARE CTRFACILITY NUMBER:
191871500
ADMINISTRATOR:KRISTINA MITCHELLFACILITY TYPE:
850
ADDRESS:7901 SO. VERMONT AVE.TELEPHONE:
(323) 758-3777
CITY:LOS ANGELESSTATE: CAZIP CODE:
90044
CAPACITY:80CENSUS: 44DATE:
08/12/2016
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
08:20 AM
MET WITH:Akilah Saunders, Lead teacherTIME COMPLETED:
04:10 PM
NARRATIVE
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LPA Sharalyn Jenkins-Sweeten conducted an unannounced annual required visit. Upon arrival, LPA met with Akilah Saunders, lead teacher. All areas identified on the facility sketch were inspected. The furniture and equipment including high chairs and changing tables were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Individual storage for children's belongings was inspected. Availability of drinking water was reviewed inside and outside of the facility. The changing tables, sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, paper towels, area safety and sanitation. The First Aid supplies were inventoried.

The menus were reviewed along with the individual feeding plans. Food and snacks were reviewed for availability, quantity and appropriateness to children in care. Food preparation areas were toured for safety, cleanliness and proper equipment. A review of cleaning and food supply storage areas was made.

Outdoor equipment was inspected for safety, cushioning material, good repair and age appropriateness. Required shade, drinking water and fencing were inspected. Play area was inspected for hazards and inaccessibility to bodies of water.

Teacher-child ratios were observed and staff names recorded. Care and supervision was evaluated to determine if the basic needs of children are met and appropriate. Sign in/sign out sheets and procedures were reviewed with staff.

Staff and children's records were reviewed for completeness including but not limited to Criminal Record Clearances for adults and verification of Pediatric CPR and Pediatric First Aid training certification. An inspection of required forms was made.
SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (310) 337-7332
LICENSING EVALUATOR NAME: Sharalyn Jenkins-SweetenTELEPHONE: (310)568-2448
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2016
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 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, 6167 BRISTOL PARKWAY #400
CULVER CITY, CA 90230
FACILITY NAME: F.K.C. PRICE III, CHILD CARE CTR
FACILITY NUMBER: 191871500
VISIT DATE: 08/12/2016
NARRATIVE
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Incidental Medical Service (IMS) is the ability for a licensee to provide care for children with unusual medical conditions that need services beyond first aid, which can be done by a non-skilled medical professional given that certain criteria are met, documents are available for review and they have submitted an update to the facility’s plan of operation(P of O) describing the policies and procedures in place to ensure safe practices. Refer to Title 22 Regulations Section 102417. Ms. Saunders stated IMS services are not being provided at the facility.

The deficiency observed and cited during this visit is as follows:

1) The Parent's Right receipt was missing or incomplete in one child's file

A copy of this report was explained and issued to Ms. Saunders and a Notice of Site Visit was issued.
SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (310) 337-7332
LICENSING EVALUATOR NAME: Sharalyn Jenkins-SweetenTELEPHONE: (310)568-2448
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2016
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, 6167 BRISTOL PARKWAY #400
CULVER CITY, CA 90230
FACILITY NAME: F.K.C. PRICE III, CHILD CARE CTR
FACILITY NUMBER: 191871500
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/12/2016
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/19/2016
Section Cited
101218.1(e)(1)
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Admission Procedue–Parents Right. During the children's record review, LPA determined a child was missing a Parents Rights Receipt from the file. Per Title 22 Regulatons, the bottom portion of this form must be kept in the child's file as proof that the parent or authorized representative has been notified of his or her rights by the child care center
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The facility shall ensure all children have a completed and signed Parents Rights receipt on file and will submit a copy of the missing receipt to the department no later than the close of business on 8/19/16.
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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: Jennie FerreiraTELEPHONE: (310) 337-7332
LICENSING EVALUATOR NAME: Sharalyn Jenkins-SweetenTELEPHONE: (310)568-2448
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2016
LIC809 (FAS) - (06/04)
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