Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017951
Report Date: 10/30/2017
Date Signed 10/30/2017 03:48:39 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:GRANDVIEW HOUSE PRESCHOOLFACILITY NUMBER:
198017951
ADMINISTRATOR:HAIEK, LENAFACILITY TYPE:
850
ADDRESS:1212 N. PACIFIC AVE.TELEPHONE:
(818) 245-6963
CITY:GLENDALESTATE: CAZIP CODE:
91202
CAPACITY:60CENSUS: 76DATE:
10/30/2017
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:51 AM
MET WITH:Lena Haiek, DirectorTIME COMPLETED:
04:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced Case Management- Licensee Initiated inspection for the purpose of a capacity increase inspection. LPA met with Lena Haiek, Director who guided analyst on tour of facility. This is a preschool program which consists of 3 classrooms; RM Monkeys (2 years old), RM Lion (3-4 years old), RM Elephants (4-5 years old). This facility is located on Temple Sinai property. Facility operation hours are from Monday to Friday from 8:00 AM to 6:00 PM.

At this time they have a capacity of 60 preschoolers and which to increase to 80. They have added another two rooms for the additional space which is the Elephants (4-5 years old).



Licensing staff inspected and measured the additional two classrooms, front and back outdoor playgrounds.

All areas identified on the Facility Sketch were inspected. The following staff was present during this inspection: RM Monkeys: 4 Staff with 24 preschoolers; RM Lion: 4 Staff with 33 preschoolers; and RM Elephants: 2 staff with 19 preschoolers.

Facility has been licensed for capacity of 60, however during this inspection there were total of 76 children present in the facility. Licensee was observed not to be incompliance with Title 22 Regulations License Limitation requirements. The following was observed during tour of facility:

Today's measurements were as follows:


INDOOR: Elephants 1 & 2 -- 556.86 Divided by 35 (SQ FEET) = 16
OUTDOOR Front and Back play grounds: 7549.20 Divided by 75 (SQ. FEET) = 101
4 Toilet and 4 Sinks
REPORT CONTINUES ON THE NEXT PAGE 1 OF 3
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh EivazianTELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2017
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 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: GRANDVIEW HOUSE PRESCHOOL
FACILITY NUMBER: 198017951
VISIT DATE: 10/30/2017
NARRATIVE
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Medication: Medication: Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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. Facility will submit Incidental Medical Services plan of operation by 11/30/17.

REMINDER: Failure to obtain a criminal record background check clearances prior to initial presence in the home will result in an immediate $100.00 dollar or more per day Civil Penalty.
Check our website at: www.ccld.ca.gov. for regulations and quarterly updates.

Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

Upon receipt of this report documenting a substantiated complaint allegation and a Type A deficiency, the Licensee shall do the following:
1. Post the Notice of Site visit and any licensing report documenting a Type “A” deficiency.
2. The report and the Notice of Site visit shall be posted for 30 consecutive days. Failure to maintain posting as required, will result in an immediate $100 civil penalty.
3. A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year).
4. The Acknowledgement form (LIC 9224) must be maintained in each child’s file immediately upon receipt from parent. A copy of the parent Acknowledgement of Receipt of Licensing Reports Form was provided during this inspection.

Fire clearance has been granted on 09/05/2017 for Capacity of 80. LPA received via email on 10/17/17.
Per Licensee/Director Lena Haiek one sink and one toilet will be added before or by 11/30/17.
Exit interview was conducted with Lena Haiek, Director; including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.
REPORT END 3 of 3
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh EivazianTELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2017
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: GRANDVIEW HOUSE PRESCHOOL
FACILITY NUMBER: 198017951
VISIT DATE: 10/30/2017
NARRATIVE
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Building/Rooms are centrally heated and air conditioned. Overhead lights as well as natural light is used. Children have their own cubbies with a tote bag to store their belongings (linens blankets). A sick child is sent to the director's office , a mat is available for the child to rest. The sick child will use the staff restroom.

A center shall be equipped to isolate and care for any child who becomes ill during the day.
The isolation area shall be located to afford easy supervision of children by center staff.
The isolation area shall be equipped with a mat, cot, couch or bed for each ill child.

Furniture and equipment was inspected for age appropriateness and good repair. Napping equipment and bedding was inspected for good condition, appropriate storage and cleanliness. Storage for children's belongings was inspected. Age appropriate sinks and toilets were inspected for availability, good repair, toilet paper, area safety and sanitation.

Snack menus were reviewed. Snacks were reviewed for availability, quantity and appropriateness to children in care. The facility provides breakfast, lunch, AM and PM snack. There are drinking water available indoors and outdoors. Containers used to discard food have tight fitting lids. Cleaning compounds are inaccessible to the children.

Areas around and/or under climbing equipment have cushioning material to absorb a fall. There is also cemented area for children to ride their bikes. Outdoor play equipment was observed to be in good repair.
There is outside shade for resting and required fencing was also observed. There is a sandbox on the playground and is raked every morning by staff before school starts. LPA did not observe any bodies of water during this inspection.

Medication policy is as follows: Facility only administers prescription medication. A form must completed by parent and the same form is completed by staff once medication administered.

REPORT CONTINUES ON THE NEXT PAGE 2 OF 3
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh EivazianTELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2017
LIC809 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GRANDVIEW HOUSE PRESCHOOL
FACILITY NUMBER: 198017951
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/30/2017
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/31/2017
Section Cited
CCR
101161(a)
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Limitations on Capacity and Ambulatory Status, which states that the licensee shall not exceed the conditions, limitations and capacity specified in the license.

During this inspection LPA observed 76 preschoolers in the facility.
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Per Licensee/Director effective tomorrow she will dis-enroll 16 children. Licensee will operate within her licensee limitation at all the times effective tomorrow.
A written declaration will be submitted by due date.
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Per Licensee/Director there are total of 84 preschoolers enrolled in this program since mid September 2017, however they are part-timers and never 83 children are present in the facility at the same time.
This poses an immediate Health and Safety risk to the children in care.
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Licensee has submitted a capacity increase application since August 2017, and it is in pending until one sink and a toilet be installed in the facility.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh EivazianTELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2017
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2017
LIC809 (FAS) - (06/04)
Page: 4 of 4