Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198013177
Report Date: 03/09/2018
Date Signed 03/14/2018 08:54:57 AM

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:MARY ALICE O'CONNOR CCLCFACILITY NUMBER:
198013177
ADMINISTRATOR:AMANDA EDWARDSFACILITY TYPE:
830
ADDRESS:401 N. BUENA VISTA STREETTELEPHONE:
(818) 846-1063
CITY:BURBANKSTATE: CAZIP CODE:
91506
CAPACITY:20CENSUS: 18DATE:
03/09/2018
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:38 PM
MET WITH:Amanda EdwardsTIME COMPLETED:
03:45 PM
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LPA Majarian conducted Annual/Random visit at the facility. LPA met with Director Amanda Edwards and informed her the reason of this visit. Ms. Edwards guided analyst tour of the facility. Infant program has two classrooms, one for young infants and the second one for children 1 -2 year old. LPA observed 18 Infant/Toddlers in 2 rooms with 6 teachers supervising.

All areas identified on the Facility Sketch were inspected and checked the following: Infant classroom and toddler classrooms were inspected. LIS clearances, staff/child ratio, children and staff records, food preparation area, storage and refrigeration, rest rooms, equipment, outside play area and over all conditions of facility.

Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Storage for children's belongings and an isolation area with a sink, toilet was inspected. Availability of drinking water was reviewed. Age appropriate sinks and toilets were inspected for availability, good repair, water temperatures, toilet paper, towels, area safety and sanitation.
Failure to obtain a criminal record background check clearances prior to initial presence at the facility will result in an immediate $100.00 dollar or more per day Civil Penalty.

Snack, lunch menus, food and snacks were reviewed for availability, quantity and appropriateness to children in care. Some infants have breast milk which mothers provide and some have formula. Facility utilizes an outside vendor who provides lunches for older infants. Service needs plan were observed and reviewed. LPA observed appropriate cribs/mats for napping equipment for infant/toddlers. Infants/toddler food items were labeled and stored properly. Food preparation areas were toured for safety, cleanliness and proper equipment. A review of cleaning and food supply storage areas was made.

Report continued on page 2:
SUPERVISOR'S NAME: Carla CaldwellTELEPHONE: (951) 337-4351
LICENSING EVALUATOR NAME: Victoria MajarianTELEPHONE: (310) 337-4367
LICENSING EVALUATOR SIGNATURE:

DATE: 03/09/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2018
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: MARY ALICE O'CONNOR CCLC
FACILITY NUMBER: 198013177
VISIT DATE: 03/09/2018
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The infant bottles, diapers and wipes are labeled with children's names. Licensee maintains a log for diaper changes and feedings. LPA observed children’s needs and services plan for each child's file to record the infant's care.

Teacher child ratios were observed and staff names recorded. Care and supervision was evaluated to determine if the basic needs of children are met and appropriate. Sign in and out sheets and procedures were reviewed with staff policy of checking children for illnesses. Personal Rights of children were discussed and observed by LPA.

Children and staff records were reviewed for completeness. Teachers updated their Pediatric CPR/First Aid cards. The web side for quarterly updates: http://www.ccld.ca.gov/PG413.htm.

Sign in and out sheets and procedures were reviewed with staff policy of checking children for illnesses. Personal Rights of children were discussed and observed by LPA.
Director is aware of the regulatory updates and the staff has proof of immunization against influenza, pertussis and measles.

New Immunization Requirement: Law enacted by SB 277, beginning January 1, 2016, personal beliefs exemptions will no longer be an option for the vaccines that are currently required for entry into child care or school in California. Personal beliefs exemptions already on file will remain valid until the child reaches the next immunization checkpoint.

Children Records were reviewed for completeness. Teacher's CPR/First Aid cards were renewed and updated. Web site for incident medical services was provided: http://ccld.ca.gov/PG511.htm. LPA also provided licensee with the web side for quarterly updates: http://www.ccld.ca.gov/PG413.htm.



The facility Provides IMS and updated it's Plan of Operation to reflect that.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

Community Care Licensing website address: http://www.ccld.ca.gov.



Facility was in substantial compliance as of today.
SUPERVISOR'S NAME: Carla CaldwellTELEPHONE: (951) 337-4351
LICENSING EVALUATOR NAME: Victoria MajarianTELEPHONE: (310) 337-4367
LICENSING EVALUATOR SIGNATURE:

DATE: 03/09/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2018
LIC809 (FAS) - (06/04)
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