Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419891
Report Date: 08/31/2015
Date Signed 11/02/2015 04:14:43 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:PASEO DEL REY STAR PRE-KFACILITY NUMBER:
197419891
ADMINISTRATOR:RODRIQUEZ, JOANNAFACILITY TYPE:
850
ADDRESS:7751 PASEO DEL REYTELEPHONE:
(310) 842-8040
CITY:PLAYA DEL REYSTATE: CAZIP CODE:
90293
CAPACITY:24CENSUS: 0DATE:
08/31/2015
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Amy SmithTIME COMPLETED:
04:25 PM
NARRATIVE
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Pre-Licensing Inspection was conducted by Licensing Program Analyst (LPA) Maureen Neal for an Pre-school Program ( STAR). The Applicant has requested a capacity of 24
pre school children. The Program is located on Paseo del Rey Elementary School.

The licensee has an existing school-age program on the same property for a capacity of 75 children. Currently room #8, #1 & #2 are licensed for the school-age program. Room #8 utilizes a bathroom located in this room. The preschool program will utilize room #7, both rooms are adjoining and separated by a door. The bathroom is also accessible from both rooms #7 & #8. Effective today the school-age will no longer use this bathroom. This bathroom will be for the exclusive use for the pre school program ONLY. The school age program will use the bathrooms located on the secondary yard which were already approved upon licensure in 2012. In addition room #7 has a sink and water fountain but the facility also has cups and a water dispenser available.
A Face to Face meeting was conducted. The measurements are as follows:

INDOOR SPACE -
Room # 7 32 x 27 = 864 divided by 35 = 24
Total-24 pre school children.
( see page 2)
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (310) 337-4826
LICENSING EVALUATOR NAME: Maureen NealTELEPHONE: (310) 337-4330
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2015
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: PASEO DEL REY STAR PRE-K
FACILITY NUMBER: 197419891
VISIT DATE: 08/31/2015
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The Center will administer medicine only when specific instructions are provided by a medical professional, this shall include instructions by a medical professional for over the counter medicines also. The Center will provide a medical log. The Center will administer asthma inhaler and nebulizer as required. The facility will administer an epi-pen as needed by staff that are properly trained. The facility will call paramedics as required.

Posting Board in room observed & included 1) License( when received) (2) Emergency Disaster Plan (3) Parents Rights Poster PUB 394 (4) Personal Rights LIC 613-A

The standard 850 fire clearance has been approved and received to the department. The facility may be licensed for a capacity of 24 children.
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (310) 337-4826
LICENSING EVALUATOR NAME: Maureen NealTELEPHONE: (310) 337-4330
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2015
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: PASEO DEL REY STAR PRE-K
FACILITY NUMBER: 197419891
VISIT DATE: 08/31/2015
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OUTDOOR SPACE -
The pre school program will utilize the play yard directly outside of rooms #7 & #8
The play yard is very large and has sufficient space to accommodate 24 pre school children. The school-age children currently have access to this yard. Effective today the school-age will utilize the LAUSD play area that is very large for which measurements are not required. Effective today the school age will NO longer have the ability to use the smaller gated yard as this will now be for the exclusive use for pre school children. Preschool and school-age programs are never to commingle at any time.

Play structure yard -Fenced & gated water fountain & hand washing sink
Large play ground area -. This is also a shared yard with LAUSD Youth Services. Licensee at all times is aware that the licensed program are never to commingle with the LAUSD program.

The classroom was observed with age appropriate chairs, tables, children's activities and
equipment. The children will bring a lunch and the program will provide the 2 required snacks. The refrigerator is located in room #8. The isolation area for ill children will be located beyond Director's desk and ill children will utilize the staff restroom. Napping mats and sheets observed. The facility will be storing the bedding in backpacks supplied by the parents and stored in cubbies or hooks in the cabinet. Parents will be responsible for laundering the bedding. The facility was reminded that extra clean bedding must be available and on site just in case bedding becomes soiled or parents do not return the bedding to the facility timely. Facility will post names of children that have allergies in the classroom

( see page 3)
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (310) 337-4826
LICENSING EVALUATOR NAME: Maureen NealTELEPHONE: (310) 337-4330
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2015
LIC809 (FAS) - (06/04)
Page: 3 of 3