197408155-10-18-2023-58-CC-KCHE-CWQUAT-20231018152516

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197408155
Report Date: 10/18/2023
Date Signed: 10/18/2023 03:25:27 PM

Document Has Been Signed on 10/18/2023 03:25 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	CHURCH OF THE VALLEY DEVELOPMENTAL PRESCHOOL		FACILITY NUMBER:	197408155
ADMINISTRATOR:	NANCY PACZKOWSKI		FACILITY TYPE:	850
ADDRESS:	6565 VESPER AVENUE		TELEPHONE:	(818) 786-2120
CITY:	VAN NUYS	STATE: CA	ZIP CODE:	91411
CAPACITY: 49	TOTAL ENROLLED CHILDREN: 26	CENSUS: 12	DATE:	10/18/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Nancy Paczkowski, Director		TIME COMPLETED:	03:45 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 10/18/2023 at 1:00 PM an unannounced Required – 1 Year Inspection was conducted by Licensing Program Analysts (LPAs) Katrina Chicote and Elicia Calvillo. LPAs announced purpose of visit and initially met with Nancy Paczkowski, Director, who granted entry to facility and provided LPAs guided tour of facility both indoors and outdoors. Facility is currently licensed for a capacity of 49, per Director and Facility Roster have 26 enrolled. The program currently operates Monday thru Friday from 9:00 AM to 12:30 PM with extended care offering until 3:00 PM. Required postings were observed in lobby, which includes Daily Activity schedule and snack menus. The facility is made up of three classrooms: Green Door, Blue Door, and Red Door. Upon arrival to facility, LPAs observed children playing outside and not in classrooms. At the initial start of the site visit, there is a total census of twelve children and six staff present. Beginning at 1:08 PM, furniture and equipment were inspected for age appropriateness and good repair in each classroom. LPAs observed surface of classrooms to be safe and clean, and child size tables and chairs available for children well maintained. LPAs observed variety of toys available for dramatic play, math, and science with toys free of loose and sharp parts and a library area available for quiet play. Telephone service, heating, lighting and ventilation were evaluated. There were cubbies observed as storage for children's belongings that was located in hallway to classrooms. Facility does not provide nap time due to part time program offering but a rest period is provided based on children's needs. Per Director, linens are provided by the facility and washed after each use. Availability of drinking water was reviewed. LPAs observed children's personal water bottles available to them which is refilled from Sparkletts water jug in lobby. Age appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, area safety and sanitation. LPAs observed bathroom available in Green Door classroom with one toilet and one sink, with additional sink in classroom. LPAs observed two children's bathrooms in hallway across from Red Door and Blue Door classroom that each had two toilets and one sink with an additional sink in each classroom. Report Continues - Page 1 of 3

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:	DATE: 10/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2023

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 5

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: CHURCH OF THE VALLEY DEVELOPMENTAL PRESCHOOL	FACILITY NUMBER: 197408155
	VISIT DATE: 10/18/2023

NARRATIVE

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A first aid kit is kept in Director's office, which LPA inventoried for supplies, with basic first aid such as band aids and ice packs inside each classroom. LPAs tested carbon monoxide detector which were observed to be in operable condition. LPA observed smoke detectors and fire extinguishers are present in the facility. Disaster drill log was available and reviewed, last drill conducted on 10/06/2023. Isolation area for sick children is in Director's office. Hazardous items including poisonous cleaning compounds were stored inaccessible to children. LPAs observed these items stored in locked cabinets in classroom and in Director's office.

Food and snacks were reviewed for availability, quantity and appropriateness to children in care which is stored in Director's office. Facility only provides snacks and children bring lunches from home.

At 1:31 PM, outdoor equipment was inspected for safety, cushioning material, good repair and age-appropriateness. Required shade and fencing were inspected. LPAs observed a variety of play areas available for children in outdoor play area such as a sand box area, mud kitchen, and outdoor dramatic play area with plastic play houses. LPAs observed an area with multi-level play structures and other metal play equipment with wooden chips below to absorb fall. LPAs advised that the children need to be within the direct care and supervision, including visual supervision of the teacher(s) at all times. The children have access to their water bottles for outside play. Play area was inspected for hazards and inaccessibility to bodies of water; no bodies of water or hazards observed.

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. Personal Rights of children were observed by LPAs.

Beginning at 2:25 PM, staff and children’s records were reviewed for completeness. Inspection of required forms was made and documented on the LIC 857 for children and the LIC 859 for staff. Criminal Record Clearances were reviewed for adults. CPR card expires on 05/18/2024 for Staff #2. Staff present did have proof of the AB 1207 Mandated Reporter Training certificate on file.

Facility Representative was reminded that all adults 18 and over in the facility, 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 licensed facility. 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.
Report Continues - Page 2 of 3

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:	DATE: 10/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2023

LIC809 (FAS) - (06/04)

Page: 2 of 5

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: CHURCH OF THE VALLEY DEVELOPMENTAL PRESCHOOL	FACILITY NUMBER: 197408155
	VISIT DATE: 10/18/2023

NARRATIVE

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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

CCC DID NOT COMPLETE TESTING PRIOR TO THEIR DEADLINE
Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.
For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your location. LPA advised of the requirement to report Unusual Incidents and/or injuries to the parent/guardian and to CCL within the time frame specified by the regulation.

LPA advised the licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

The facility was found in compliance per Title 22 regulations, there will be no deficiencies cited today only advisories. A notice of site visit was given and must remain posted for 30 days.
Exit interview was conducted and report was reviewed with the Facility Representative, Nancy Paczkowski.
Report Ends - Page 3 of 3

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:	DATE: 10/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2023

LIC809 (FAS) - (06/04)

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