Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419929
Report Date: 09/04/2015 12:00:00 AM
Date Signed 09/04/2015 12:36:40 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:MUSICAL GANFACILITY NUMBER:
197419929
ADMINISTRATOR:HAGBI,RUCHAMAFACILITY TYPE:
850
ADDRESS:13624 BURBANK BLVDTELEPHONE:
(818) 786-7800
CITY:SHERMAN OAKSSTATE: CAZIP CODE:
91401
CAPACITY:35CENSUS: 29DATE:
09/04/2015
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:19 AM
MET WITH:Ruchama Hagbi/Sapir AdaniTIME COMPLETED:
12:40 PM
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Licensing Program Analyst(LPA) conducted a visit initiated by licensee to have LPA review all qualification of teachers and teachers assistant working at the facility and tour the facility to ensure compliance with regulations. LPA toured the facility indoor and outdoor. There were 29 children and 5 teachers/teacher aides present during the visit. Currently , the facility utilizes 3 out of the 5 licensed classrooms. Furniture and equipment was inspected for age appropriateness and good repair and all was in order. The facility was observed to operate within the license capacity . Telephone service, heating, lighting and ventilation were evaluated and were in compliance with Title 22 Division 12 Chapter 1 regulations. Storage for children's belongings was noted to be proper and individualized. Isolation area is in the director’s office which is by a restroom and it was inspected and was orderly. There was one bathroom that had 3 Age appropriate sinks and 3 age appropriate toilets which were inspected for availability, good repair, water temperature, toilet paper, paper towels, soap, area safety and sanitation. First Aid supplies were inventoried and smoke detectors/fire extinguishers were observed to be well serviced. A review of medication policy, including administering, labeling, storage, and records was completed. Sign in and out sheets were reviewed and were complete. Napping equipment was inspected and was in good repair. Documentation of Fire and Earthquake drills, Emergency disaster plan were posted. Activity Schedule was posted in all classrooms. Snack/lunch menus were observed. Disposal of food/debris was discussed/ trash cans had lids on. Snacks were stored in kitchen area which was clean. Food preparation area was inspected and was orderly. Storing of toxins/cleaning compounds were in order. Cleaning supplies were stored out of children’s reach .
SUPERVISOR'S NAME: Scott HerringTELEPHONE: (310) 337-4313
LICENSING EVALUATOR NAME: Myriam LugaTELEPHONE: (310) 337-4365
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2015
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: MUSICAL GAN
FACILITY NUMBER: 197419929
VISIT DATE: 09/04/2015
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During the visit, all Classrooms had drinking water via water pitcher and cups available for children as needed. Outdoor equipment was inspected for safety, cushioning material, good repair and age appropriateness. Required shade, drinking water ( filtered water) and fencing were inspected and they were in compliance with Title 22 regulations. Climbing structures/slides and other large play equipment is found to be securely anchored with adequate resilient cushioning material underneath and around the perimeter. Play area was inspected for hazards, miscellaneous debris such as branches, trash or leaves or accessibility to bodies of water and none was observed. Facility director was reminded to keep the playground maintained at all times. LPA reviewed sample children’s files during this inspection and all were complete. Teachers' personnel records were reviewed and were complete. All teachers and the facility director have current certificates of pediatric first aid and CPR that expire in 12/16. LPA provided licensee with the following information regarding teachers/teacher Aides qualifications and duties , for future reference; 1) Title 22, Division 12, Chapter 1, Article 06. Continuing Requirements, section 101216.2 ,Teacher Aide Qualifications and Duties , and 2) Title 22, Division 12, Chapter 1, Article 06. Continuing Requirements, 101216.1 , Teacher Qualifications and Duties.
No deficiency was noted during the visit. An Exit interview was conducted and a copy of this report was submitted to licensee.
SUPERVISOR'S NAME: Scott HerringTELEPHONE: (310) 337-4313
LICENSING EVALUATOR NAME: Myriam LugaTELEPHONE: (310) 337-4365
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2015
LIC809 (FAS) - (06/04)
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