Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197407016
Report Date: 01/19/2018
Date Signed 01/19/2018 04:38:20 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:JEFFREY FOUNDATION, THEFACILITY NUMBER:
197407016
ADMINISTRATOR:MORRIS, ALYCEFACILITY TYPE:
830
ADDRESS:5443 W. WASHINGTON BLVD.TELEPHONE:
(323) 965-7536
CITY:LOS ANGELESSTATE: CAZIP CODE:
90016
CAPACITY:11CENSUS: 6DATE:
01/19/2018
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
02:10 PM
MET WITH:Alma SaldivarTIME COMPLETED:
04:45 PM
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Licensing Program Analysts (LPA) Karren Starks and Lourdes Cuevas made an unannounced visit for the purpose of conducting a 3 yr Req. inspection. LPAs met with and toured the facility with Alma (Porras) Saldivar, Site Supervisor.
All areas of the facility that are used for Infant Care were inspected. The bathrooms that are designated for the infant program were inspected and found to be operating properly with a sufficient supply of toilet paper, paper towels and soap. There was a changing table observed in the bathroom area as well as potty's for toilet training. LPAs observed proper department postings, smoke detectors & fire extinguishers. First aid kit was observed. Infants do not have access to toxins or cleaning compounds. Furniture and equipment was inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. There is drinking water available in the classroom and outside play area for children in care.

The food preparation area is located near the rear of the building inaccessible to children in care. Facility does not prepare food at the location, food and formula is brought in by the parents on a daily basis with the children's items being labeled. Food preparation area was inspected for safety, cleanliness, proper equipment, and storage. Disposal of food and debris was discussed.

Outdoor equipment was inspected for cushioning material, safety, age appropriateness & good repair. Required shaded areas, drinking water availability & fencing were inspected. Play area was inspected for safety and potential hazards. There are no bodies of water.

Proper teacher/child ratios were observed. Emergency/Fire Drill Log and Roster were observed.
SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (310) 337-4332
LICENSING EVALUATOR NAME: Karren StarksTELEPHONE: (310) 337-3753
LICENSING EVALUATOR SIGNATURE:

DATE: 01/19/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2018
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: JEFFREY FOUNDATION, THE
FACILITY NUMBER: 197407016
VISIT DATE: 01/19/2018
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Staff and children's files were reviwed.

Licensee informed to review updates/regulations for 2016 on the department website. Licensee can also review the Fall/Winter Quarterly Updates 2015 and Spring 2016 Quarterly Update which includes information on: AB 290 - for each new license issued, at least one director or teacher at a child care center or family child care home to have at least one hour of childhood nutrition training; AB 1207 - all child care employees must complete mandated reporter training beginning January 1, 2018; AB 1387 - and AB 2236 process to request a formal review of deficiency and establishes an appeal process for civil penalties; SB 277 - require all children attending day care or school based programs to be immunized and will eliminate personal/religious belief exemptions; SB 792 - requires all staff and volunteers to show proof of immunization against influenza, pertussis and measles, and TB clearance, beginning September 1, 2016; Summer 2015 - Incidental Medical Services information; Summer 2016. Winter/Spring 2015 Healthy Schools Act – Pesticide use reporting and training.

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

No deficiencies cited.

Copy of report and Notice of Site Visit Issued.

SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (310) 337-4332
LICENSING EVALUATOR NAME: Karren StarksTELEPHONE: (310) 337-3753
LICENSING EVALUATOR SIGNATURE:

DATE: 01/19/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2018
LIC809 (FAS) - (06/04)
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