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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197402924
Report Date: 08/26/2024
Date Signed: 08/26/2024 11:49:38 AM

Document Has Been Signed on 08/26/2024 11:49 AM - 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:SAN FERNANDO VALLEY ACADEMY C. D. C.FACILITY NUMBER:
197402924
ADMINISTRATOR/
DIRECTOR:		WESLEY, ALMAFACILITY TYPE:
850
ADDRESS:17601 LASSEN STREETTELEPHONE:
(818) 206-2117
CITY:NORTHRIDGESTATE: CAZIP CODE:
91325
CAPACITY: 40TOTAL ENROLLED CHILDREN: 1CENSUS: 0DATE:
08/26/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
07:25 AM
MET WITH:Alma Wesley, DirectorTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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On 8/26/24, at 7:20 AM, Licensing Program Analysts (LPAs) Silva Garibyan and Amelia Morales conducted an unannounced Plan of Correction (POC) Visit. Upon arrival, LPA disclosed the purpose of the inspection and met with Director, Alma Wesley, who guided the LPAs on a tour of the facility. There was one child present during today’s inspection. Per Director, the child present is the only one enrolled at this time. LPAs observed only one staff member present.

During the Required - 3 Year inspection conducted on 7/24/24 by LPA Katrina Chicote, the following deficiencies were issued;
  • Type B - 101238(a)/Buildings and Grounds - Preschool 4-5 observed clutter throughout the room with items stacked and leaning unbalanced.
  • Type B- 101216(f)- staff did not have proof of current Pediatric First Aid/CPR (expired on 10/07/2021)
  • Type B-- 101238.2(d)(2)/Outdoor Activity Space---- variety of hazards in outdoor play area were observed, including a loose screw, dried out plants, and spider webs.
  • Type B---1596.7995(a)(1)/General Provisions and Definitions- Staff did not have immunization records against influenza, pertussis, and measles on file.
  • Type B---101220(a)/Child's Medical Assessments----- 2 of 4 children in care did not have a physician's report in the files.
  • Type B---101227(a)(1)/Food Service----- LPA Chicote did not observe any snacks available for children.


SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE: DATE: 08/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/26/2024
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 2
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: SAN FERNANDO VALLEY ACADEMY C. D. C.
FACILITY NUMBER: 197402924
VISIT DATE: 08/26/2024
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Corrections:
  • Type B - 101238(a)/Buildings and Grounds - Preschool 4-5 has been cleared, annual cleaning was conducted, furniture was wiped, cleaned and rearranged. Pictures were emailed to LPA Chicote on 08/23/2024
  • Type B- 101216(f)- Staff completed Pediatric First Aid/CPR on 08/17/2023. A copy of the certificate was provided. POC was submitted to CCL by the POC due date of 8/23/24.
  • Type B-- 101238.2(d)(2)/Outdoor Activity Space---- the outdoor play area was cleared, all play equipment and spider webs were hosed down, the wooden train was taken out of the facility. Pictures were emailed to LPA Chicote. POC was submitted to CCL by the POC due date of 8/23/24.
  • Type B---1596.7995(a)(1)/General Provisions and Definitions- A copy of the immunization records against influenza, pertussis was provided. The director provided their blood work which was meant to have shown results for MMR, However the lab results only present mumps and rubella with no results for measles. The director contacted the MD office who explained that they had ordered MMR including measles from the lab and do not understand why measles is missing. The MD office informed the director that they will contact the lab and will keep them informed with any updates. The conversation was on the phone, on speaker while LPAs were present.
  • Type B---101220(a)/Child's Medical Assessments----- The only child enrolled has Physician's Report (LIC701) on file
  • Type B---101227(a)(1)/Food Service----- LPAs observed snacks available and Menus posted.


LPAs did not observe any medication present or accessible to children during the visit. LPAs observed LIC9224 in child's file, signed on 07/29/2024.

Director will provide a copy of her measles lab result once provided by doctor's office.



The Notice of Site Visit was provided and must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.
Exit interview was conducted with Alma Wesley and Appeals Rights provided.
SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:

DATE: 08/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2024
LIC809 (FAS) - (06/04)
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