195700031-2-17-2023-58-CC-DLOE-CP5W4U-20230217155808

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 195700031
Report Date: 02/17/2023
Date Signed: 02/17/2023 03:58:19 PM

Document Has Been Signed on 02/17/2023 03:58 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	BOULEVARD SCHOOL, THE		FACILITY NUMBER:	195700031
ADMINISTRATOR:	CARRIE ZUCKERMAN		FACILITY TYPE:	850
ADDRESS:	23022 VICTORY BLVD		TELEPHONE:	(818) 863-0607
CITY:	WOODLAND HILLS	STATE: CA	ZIP CODE:	91367
CAPACITY: 203	TOTAL ENROLLED CHILDREN: 202	CENSUS: 121	DATE:	02/17/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	02:34 PM
MET WITH:	Carrie Zuckerman and Jennifer Will		TIME COMPLETED:	04:10 PM

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On 02/17/2023 Licensing Program Analyst (LPA) Deborah Lowe met with Applicant, Carrie Zuckerman, Director Jennifer Will. The purpose of the visit was a second announce pre-licensing inspection at the facility to ensure that health, safety and personal rights as requires by Title 22 and Health and Safety Regulations governing California Child Care Centers will be met. This is a change of ownership application for 203 children, ages 18 months to entry into 1^st grade. The child care center will operate Monday – Friday 7:30 a.m. – 5:30 p.m. A revised fire clearance was approved on 02/08/2023.

At 2:42 pm LPA Lowe observed 121 children present during this inspection under supervision of 18 staff.

The first pre-licensing visit was conducted on 02/02/2023. LPA Lowe is conducting a second pre-licensing visit to evaluate the facility corrections needed before a license will be considered.

On 02/02/2023 the following items needed corrections:

· Verify age-appropriate use of outdoor climbing structures on Toddler yard, 3-year-old yard, and 4–5-year-old yard.

· Trolly located on 4-5-year-old yard is in need of repair.

· Fire Extinguisher in need of service. Last service date was observed as 01/18/2022.

· Pool gate near toddler yard have spring in gate looked at due to is has a slow close.

On 02/13/2023 LPA Lowe was notified by the applicant that the requested corrections have been completed.

On 02/17/2023 LPA Lowe observed the following:

At 2:56 pm LPA Lowe observed Director open the pool emergency gate and released the gate. LPA observed the gate close securely with an increased close speed in comparison to the visit on 02/02/2023.

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Deborah Lowe
LICENSING EVALUATOR SIGNATURE:	DATE: 02/17/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2023

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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: BOULEVARD SCHOOL, THE	FACILITY NUMBER: 195700031
	VISIT DATE: 02/17/2023

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Applicants provided LPA Lowe with a letter from My Playground stating the outdoor playground equipment was not labeled correctly and the manufacture has provided the proper age stickers. LPA Lowe observed the outdoor climbing structure on the Toddler yard with a sticker from Playground Equipment stating for ages 6 to 23 months. LPA Lowe observed the outdoor climbing structure on the 3-year-old yard with a sticker from Playground Equipment stating for ages 2 to 5. LPA Lowe observed the outdoor climbing structure on the 4-year-old yard with a sticker from Playground Equipment stating for ages 2 to 12.

LPA Lowe observed the wooden tolly located on the 4-5-year-old yard has been repaired with a new front panel and the tolly has been repainted.

LPA Lowe observed the fire extinguishers with a new service date completed on 02/03/2023.

Applicant and Facility representative was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with applicant and facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant and facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A 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

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Deborah Lowe
LICENSING EVALUATOR SIGNATURE:	DATE: 02/17/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2023

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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: BOULEVARD SCHOOL, THE	FACILITY NUMBER: 195700031
	VISIT DATE: 02/17/2023

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LPA reviewed with applicant and facility representative the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

An exit interview was conducted with the above items discussed and a copy of appeal rights and this report was provided to the Applicant, Carrie Zuckerman, Director Jennifer Will. Final license determination will be made upon review by the Licensing Program Manager.

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Deborah Lowe
LICENSING EVALUATOR SIGNATURE:	DATE: 02/17/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2023

LIC809 (FAS) - (06/04)

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