Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419929
Report Date: 06/28/2016
Date Signed 06/28/2016 03:40:57 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:20CENSUS: DATE:
06/28/2016
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Sapir Adani/Adani RazlaTIME COMPLETED:
03:45 PM
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Licensing Program Analyst (LPA ) met with the licensee, for the purpose of conducting an annual random visit. LPA toured/inspected the facility indoor and outdoor. The facility utilizes 4 classrooms. Today was pupil free day. Licensee indicated that the facility will be closed from August 15 till August 19. The facility will be closed on all Jewish holidays in observance of these holidays. Furniture and equipment were observed to be age appropriateness and good repair . Telephone service, heating, lighting and ventilation were evaluated and were in compliance with Title 22 Division12 Chapter 1 regulations. Storage for children's belongings was noted to be proper and individualized. LPA inspected the Isolation area located in the director’s office which is by a restroom and the area was orderly and clean. The bathrooms that had age appropriate sinks and toilets which were inspected for availability, good repair, water temperature, toilet paper, paper towels, soap, area safety and sanitation and all were in order. First Aid supplies were inventoried and smoke detectors/fire extinguishers/smoke detectors 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. 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 and the facility provides snacks and lunch for children. Food preparation area was inspected and it met Title 22 regulations. Storing of toxins/cleaning compounds were in order, inaccessible to children. Cleaning supplies were stored out of children’s reach. 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 ( water fountain/filtered water) and fencing were inspected and they were in compliance with Title 22 regulations. Climbing structures/slides and other large play equipment were 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.
SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (310) 337-4332
LICENSING EVALUATOR NAME: Myriam LugaTELEPHONE: (310) 337-4365
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2016
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: 06/28/2016
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LPA reviewed 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 .
LPA discussed with facility director in depth incidental medical services . The facility director indicated the facility does not provide incidental medical services.
LPA addressed with the facility director Senate Bill 277- eliminating the exemption to immunizations for children attending public school and child care based facilities upon personal beliefs, leaving the medical exemption in place, and Senate Bill 792 that addresses that any person employed or volunteering at a child care facility , has to be immunized against influenza, pertussis and measles.
LPA reminded the facility director of child abuse index clearances, child abuse reporting requirements ( mandated child abuse reporter), inspection authority (allow the Department in the facility for inspection including, facility staff//children record review, during facility operation hours), capacity limitations (licensee is required to stay within the guidelines of the facility licensed capacity), process of exemptions/exclusions of staff if needed(parents’ notification), qualifications of teachers/teacher aides including verification of education via obtaining copies of official academic transcripts/child development teacher/Associate Teacher permit, etc., maintaining children’s and staff personnel records at all times, updating children’s roster (LIC9040) as needed, reporting of unusual incident/injury documentation (if an unusual incident or injury occurs, director shall notify the Department within 24 hours via telephone and within 7 days by a written report). LPA provided director with the Department’s website: www.ccld.ca.gov.
The director was reminded that the Notice of Site Visit must be posted to be visible for a period of 30 days.
No deficiency was noted and no citation was issued during this visit.
Exit interview was conducted and a copy of this report was submitted to facility director.
SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (310) 337-4332
LICENSING EVALUATOR NAME: Myriam LugaTELEPHONE: (310) 337-4365
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2016
LIC809 (FAS) - (06/04)
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