Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197418475
Report Date: 12/10/2015
Date Signed 12/10/2015 01:03:14 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:CRYSTAL STAIRS INC.- SULLIVANFACILITY NUMBER:
197418475
ADMINISTRATOR:JONES-LOWE, CONNIEFACILITY TYPE:
850
ADDRESS:725 W. RAYMOND STREETTELEPHONE:
(310) 933-0760
CITY:COMPTONSTATE: CAZIP CODE:
90220
CAPACITY:120CENSUS: 80DATE:
12/10/2015
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:25 AM
MET WITH:Kimberly Hargrave, Site SupervisorTIME COMPLETED:
01:15 PM
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Licensing Program Analyst (LPA), Tiffanie Tran and Licensing Program Manager (LPM), Scott Herring, conducted an unannounced annual random visit. LPA and LPM met with Kimberly Hargrave, Site Supervisor and toured the facility inside and outside.

LPA and LPM observed all posting requirements for operation on the posting board LIC 203A-License, LIC-9213-Notice of site visit, LIC 610 A-Emergency Disaster Plan, LIC 9148-Earthquake Preparedness Check List, PUB 394-Notification of parent’s rights poster, , LIC 613A- Personal Rights, PUB 269- Child Car Seat Law, Menus, Activity Schedule. The facility obtained current pediatric CPR and First Aid for all staff members.

The facility operates double sessions. (8:00 AM- 11:30 AM) and (1:00 PM - 4:30 PM) and one full day program (8:00 AM - 4:30 PM). LPA inspected the furniture and equipment for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Storage for children's belongings, isolation area was inspected. The full day program cots were observed to be clean and good condition. Part day program, children do not nap since they are only at the facility for half a day (3.5 hours). Age appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, paper towels, area safety and sanitation. All classrooms has trash can with tight lids, first aid supplies, smoke detectors; carbon monoxide/fire extinguishers were observed. A review of medication policy, including administering, labeling, storage, and records was made. Sign in and out sheet procedures were reviewed.

All food items and snacks are delivered daily to the facility from the licensee main kitchen. Water is accessible indoor and outdoor by use of cups and pitchers. Outdoor play area was all fenced. Equipment was inspected for safety, cushioning material, good repair and age appropriateness. LPA and LPM observed shade as well as drinking water was provided. Play area was inspected for hazards and inaccessibility to bodies of water.

SUPERVISOR'S NAME: Scott HerringTELEPHONE: (310) 337-4313
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: 310-337-4335
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2015
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: CRYSTAL STAIRS INC.- SULLIVAN
FACILITY NUMBER: 197418475
VISIT DATE: 12/10/2015
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Children's records were reviewed and in good order. Staff's files are located at the Licensees main office. A collateral visit will be arranged at another visit. The facility roster was up to date and all staff has fingerprint associations to the designated license number. LPA and LPM observed a fire and emergency disaster drills were conducted monthly.

Incidental Medical Services were discussed.

There were no deficiencies cited during this visit.

Exit interview conducted the following was discussed with the licensee:

Licensee was informed of responsibility to report suspected Child Abuse by calling the Child Abuse Hotline at 1-800-540-4000. Also call the Community Care Licensing office and follow up with a written Unusual Incident/Injury Report (LIC 624B). Licensee is reminded that smoking is prohibited on the premises.

The facility was informed that the presence of teachers in the facility without Criminal Record Clearance or Exemption will be cited and civil penalty assessed for $100 per day. The facility may find additional information and forms on the Department’s website at www.ccld.ca.gov including information on the Live Scan application (LIC 9163). Appointments can be made for Live Scan at 1-800-315-4507.



LPA discussed AB633 and informed the center director that, upon receipt of a Type A deficiency, the facility shall post and provide copies of this licensing report to parent/guardians of children in care at the facility and to
parents/guardians of children newly enrolled at the facility during the next 12 months.
SUPERVISOR'S NAME: Scott HerringTELEPHONE: (310) 337-4313
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: 310-337-4335
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2015
LIC809 (FAS) - (06/04)
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