197412130-7-6-2022-30-CC-SORS-CG3SXN-20220706141612

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197412130
Report Date: 07/06/2022
Date Signed: 07/06/2022 02:16:25 PM

Document Has Been Signed on 07/06/2022 02:16 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:	SAGE ACADEMY, INC.-EARLY CHILDHOOD CENTER		FACILITY NUMBER:	197412130
ADMINISTRATOR:	REED, KRISTI		FACILITY TYPE:	850
ADDRESS:	5901 LINDLEY AVENUE		TELEPHONE:	(818) 343-4600
CITY:	TARZANA	STATE: CA	ZIP CODE:	91356
CAPACITY: 110	TOTAL ENROLLED CHILDREN: 49	CENSUS: 41	DATE:	07/06/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Roza Shaolian - Assistant Director		TIME COMPLETED:	02:35 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 07/06/2022 Licensing Program Analyst (LPA) Suzette Ornelas, conducted an unannounced Annual Required Inspection for the preschool license. LPA met with Assistant Director, Roza Shaolian, and toured the facility indoors and outdoors. Days and hours of operation are Monday through Friday 8a to 5p. A review of the electronic sign in/out sheet showed that 34 children were on site. A census was taken, LPA observed 41 children and 7 teachers. Per assistant director, staff meeting will be held to ensure all children are signed in/out daily by parents, meeting log will be submitted to LPA via email. Current facility sketch reviewed and Licensee confirmed that there are 7 licensed rooms at the facility. "Pre K 1 Room", "Pre K 2 Room", "Rainbow Room", "Purple Room", "Yellow Room", "Blue Room", and "Green Room". All other rooms are off-limits and made inaccessible by use of locked doors. LPA also observed 6 bathrooms; 2 in the main quad grass area, 1 attached to the "Rainbow Room", 1 attached to the "Yellow Room", 2 inside the "Green Room", and 1 inside the "Purple Room". Per the Assistant Director, the "Yellow Room" is used as an "Isolation Area/Room" for sick children. LPA inspected 1 kitchen area and the "Sage Office". During the inspection, LPA observed that the facility is shared site with a church. All toilets and handwashing facilities are in safe and sanitary operating condition. Floors in the facility are clean and safe. All kitchen, food preparation and storage areas are clean, free of litter/rubbish and free of rodents/vermin. All foods/beverages capable of rapid spoiling are stored in covered containers at 45 degrees F or less. There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition allowed or stored on the premises. Disinfectants, cleaning solutions, medication and other hazardous items are made inaccessible to children in care. No poisons were observed during the inspection, per director, there are no poisons on site.

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:	DATE: 07/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2022

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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Document Has Been Signed on 07/06/2022 02:16 PM - It Cannot Be Edited

Created By: Suzette Ornelas On 07/06/2022 at 01:33 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: SAGE ACADEMY, INC.-EARLY CHILDHOOD CENTER	FACILITY NUMBER: 197412130
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/06/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101238.2(d)(2)

Outdoor Activity Space

(d) The surface of the outdoor activity space shall be maintained: (2) Free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, record review, the licensee did not comply with the section cited above LPA observed, multiple wooden boards with nails in them and metal posts located in the far rear corner garden area off the centralized play yard that includes a wooden play apparatus that the children do not use, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/13/2022
	Plan of Correction
1 2 3 4	Assistant director will ensure all hazards are removed and send LPA pictures via email of the cleared area.

Type B

Section Cited

CCR

101229.1(b)

Sign In and Sign Out

(b) The person who brings the child to, and removes the child from, the center shall sign the child in/out. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, record review, the licensee did not comply with the section cited above in 7 out of 41 children were not signed in for the day which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/13/2022
	Plan of Correction
1 2 3 4	Per assistant director, staff meeting will be held to ensure all children are signed in/out daily by parents, meeting log will be submitted to LPA via email.

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:

Lisa Rios

LICENSING EVALUATOR NAME:

Suzette Ornelas

LICENSING EVALUATOR SIGNATURE:

DATE: 07/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2022

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: SAGE ACADEMY, INC.-EARLY CHILDHOOD CENTER	FACILITY NUMBER: 197412130
	VISIT DATE: 07/06/2022

NARRATIVE

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Furniture and equipment are in good condition, free of sharp, loose or pointed parts. Playground equipment is in safe condition, free of sharp, loose or pointed parts.

LPA inspected 3 play yards; 1 yard that is the 3 and 4 year old yard that is accessible from the "Purple Room". This area includes a tanbark "wood-chips" area which is the centralized play area and includes the main play apparatus. LPA observed a garden area off the centralized play yard that includes a wooden play apparatus that the children do not use, a grass field area, and a "Black Top" asphalt paved area that the children use to ride their bikes. LPA observed, multiple wooden boards with nails in them and metal posts located in the far rear corner garden area off the centralized play yard that includes a wooden play apparatus that the children do not use. LPA informed assistant director the importance of ensuring that the entire play area is regularly inspected for hazards. Assistant director will ensure all hazards are removed and send LPA pictures via email of the cleared area.

LPA observed multiple solid waste storage containers in every classroom and restroom did not have tight-fitting covers; however, are in good repair. Per assistant director, tight fitting covers will be added to all that are missing. Assistant director will provide proof via email to LPA. Drinking water is available both indoors and outdoors. Areas around high climbing equipment, swings and slides have cushioning material to absorb falls. All materials and surfaces accessible to children are toxic free. The facility is free of flies, insects and rodents. Facility has one or more functioning carbon monoxide detectors and smoke detectors located in each building that meet statutory requirements. LPA observed Fire Extinguishers located outside and inside the facility that meet the requirements and have been serviced within the last year.

Prior to working or volunteering in a licensed child care facility, all individuals subject to a criminal record review have received a criminal record clearance or exemption. No individuals excluded by the Department are allowed to be present. Capacity and limitations as specified on the license are being maintained. At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at offsite activities. The name of the child care center director or fully-qualified teacher(s) designated to act in the director’s absence has been reported to the Department. All children are under supervision, including visual supervision, of a teacher at all times. Facility maintains a ratio of one teacher supervising no more than 12 children in care. LPA reviewed a sample of children’s files and observed files were complete with contact information for authorized representative or others who can assume responsibility for the child.

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:	DATE: 07/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2022

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: SAGE ACADEMY, INC.-EARLY CHILDHOOD CENTER	FACILITY NUMBER: 197412130
	VISIT DATE: 07/06/2022

NARRATIVE

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LPA reviewed a sample of staff files and observed files were incomplete with documentation of meeting qualification requirements, immunization records for influenza, pertussis and measles and current documentation of completed mandated reporter training. LPA observed 1 staff was missing proof of MMR immunization and a current Mandated Reporter Training Certificate. Once documentation is obtained, proof will be submitted to LPA via email. Menus are posted at least one week in advance where an authorized representative can view them.

Incidental Medical Services (IMS) are currently being provided. LPA observed medication stored in a safe area inaccessible to children with the appropriate form and unaltered labels. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are being cited:
Type B: 101229.1(b) – Sign In and Out
Type B: 101238.2(d)(2) – Outdoor Activity Space

(see next page, 809 D) Licensee was provided a copy of their appeal rights.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:	DATE: 07/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2022

LIC809 (FAS) - (06/04)

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