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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191603520
Report Date: 01/18/2023
Date Signed: 01/18/2023 02:25:12 PM

Document Has Been Signed on 01/18/2023 02:25 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:TEMPLE AKIBA OF CULVER CITYFACILITY NUMBER:
191603520
ADMINISTRATOR:BISHOFF, RANDEEFACILITY TYPE:
850
ADDRESS:5249 S. SEPULVEDA BLVD.TELEPHONE:
(310) 398-5783
CITY:CULVER CITYSTATE: CAZIP CODE:
90230
CAPACITY: 90TOTAL ENROLLED CHILDREN: 82CENSUS: 63DATE:
01/18/2023
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
09:56 AM
MET WITH:Randee Bishop- DirectorTIME COMPLETED:
02:30 PM
NARRATIVE
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On 1/18/2023 Licensing Program Analysts (LPA) Jillinda Chandler and Doris Whitmoore made an announced visit to the Temple Akiba of Culver City, for the purpose of conducting a Case Management - Licensee Initiated Increase in capacity with a toddler option. The licensee is requesting to increase their capacity to 90 preschool children ages 2- 5 years with a toddler option of 10 children, ages 18 -24 months.
The center has seven classrooms dedicated to preschool activities rooms; (see facility sketch) 1,2,3,5,6,7 will be used for preschoolers age 2- 5, room 4 will be used for the toddler option; ages 18-24 months.

The following was observed;
The indoor activity space measured 331.87 divided by 35 sq. ft. for a total of 9 toddlers.
The outdoor space measured 1167.55 divided by 75 sq.ft. for a total of 15 toddlers.

The following deficiencies were observed:
  • Licensee observed chemicals under an unlocked cabinet in class room #4, children were observed in the classroom during the visit, a type A citation will be issued.
  • The mats on the toddler play yard need to be arranged as to prevent a tripping hazard
  • There needs to be a gate at the top and bottom of the stairwell leading to the multipurpose room. This room shall be made inaccessible to children until gates are installed.
  • outlets in the outdoor area are recommended to have plug covers
  • latch on the stairwell on the toddler yard needs to be repaired.
  • A plan shall be devised to secure the gate leading to the main entry
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE: DATE: 01/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/18/2023
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: TEMPLE AKIBA OF CULVER CITY
FACILITY NUMBER: 191603520
VISIT DATE: 01/18/2023
NARRATIVE
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  • during todays visit LPAs observed two push bar exit gates with inoperable alarm systems; in play yard #1 upstairs and the exit gate upstairs, the exits led to a parking lot and a residential alley. During the visit the alarm system was made operable. A "B" citation shall be issued .
  • The right side of the structure in play yard #1 upstairs shall be made inaccessible to children in care.
  • LPA observed two stacks of weights and a shovel on the toddler play yard, that were removed during the visit. LPA's observed a sandbox in need of maintenance. Water tables shall be emptied immediately when not in use.
  • Changing tables shall be within arms reach of a sink, LPAs observed a changing table next to the blue restroom without a sink.
  • LPAs observed 1 inoperable sink in the blue and 1 in the yellow restroom. Out four urinals in the blue restroom, # 2 was inoperable. In stall #4 in yellow rest room, the cover for the drain pipe needs to be replaced.
  • Items stored in the refrigerator shared with child care children and staff, shall be labeled
  • LPAs observed the outdoor tables, the edges were in need of sanding or covered to prevent splintering
Based on todays observations a plan of correction visit will be conducted prior to granting a capacity increase.

The licensee was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If facility was cited type A violations or complaint is found to be substantiated or unsubstantiated, a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Licensee must inform the parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months via form LIC-9224 Acknowledgement of Receipt of Licensing Reports.

An exit interview was conducted, a copy of this report was provided along with the appeal rights.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:

DATE: 01/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/18/2023 02:25 PM - It Cannot Be Edited


Created By: Jillinda Chandler On 01/18/2023 at 01:44 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: TEMPLE AKIBA OF CULVER CITY
FACILITY NUMBER: 191603520

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/18/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/18/2023
Section Cited
CCR
101238.4(d)

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101238.4(d)StorageSpace:Combustibles, cleaning equipment and cleaning agents shall be stored in an area separate from food supplies in a locked cabinet or in a location inaccessible to children. This was not
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The solutions were removed during todays visit. Licensee was informed that parents shall receive and return, a copy of the LIC. 9224 by the next business day or when the child reurns to school.
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met as evidence by; LPAs observered bottles of cleaning solutiona in an unlocked cabinet in room #4. which poses an immediate safety risk to children in care.
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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:Claudia Escobedo
LICENSING EVALUATOR NAME:Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:
DATE: 01/18/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/18/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/18/2023 02:25 PM - It Cannot Be Edited


Created By: Jillinda Chandler On 01/18/2023 at 02:07 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: TEMPLE AKIBA OF CULVER CITY
FACILITY NUMBER: 191603520

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/18/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/18/2023
Section Cited
CCR
101238.2(g)

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101238.2(g) Outdoor Activity Space.The playground shall be enclosed by a fence to protect children and to keep them in the outdoor activity area. The fence shall be at least four feet high. This regulation was not met as evidence
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During todays visit the alarm systems battery were replaced and the alarm systems were engaged. Licensee was informed that the alarm systems shall be maintained in operable condition at all times.
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by: LPAs observed two exit gates whose alarms were inoperable. One on play yard #1 and one leading to an alley behind the center. No children were present. This posed a possible safety hazard to children care
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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:Claudia Escobedo
LICENSING EVALUATOR NAME:Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:
DATE: 01/18/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/18/2023


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