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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197416358
Report Date: 01/26/2023
Date Signed: 01/26/2023 12:55:31 PM

Document Has Been Signed on 01/26/2023 12:55 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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:NU BUILDING BLOCKS DAY CARE CENTER-SCH.AGE.FACILITY NUMBER:
197416358
ADMINISTRATOR:PAIGE SOLOMONFACILITY TYPE:
840
ADDRESS:2313 W JEFFERSON BLVDTELEPHONE:
(323) 732-5439
CITY:LOS ANGELESSTATE: CAZIP CODE:
90018
CAPACITY: 18TOTAL ENROLLED CHILDREN: 18CENSUS: 1DATE:
01/26/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Peyton Solomon, DirectorTIME COMPLETED:
01:15 PM
NARRATIVE
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On January 26, 2023, at 12:00p.m., Licensing Program Analysts (LPAs) Denise Gibbs and Franchesca White conducted an case management inspection and met with Director Peyton Solomon. LPA disclosed the purpose of the inspection and was granted entry into the facility by office staff.

At 9:20 p.m. during an inspection of the preschool program at the facility, LPAs observed one school-age child in the Director's office with Staff One (S1), who is a Teacher's Assistant. No other school age children were present.

Per Staff Two (S2), Parents work schedule changed and Child One (C1) will need care for two weeks, 1/23/23 to from 7:40a.m - 3:00pm. LPA observed that facility does not have a fully qualified school age teacher for that time frame. Per S2, Director Paige Solomon was assigned to temporarily care for C1 during this time frame to accommodate parent. Director was not at facility when LPAs arrived. Per S2, C1 and S1 were not in the school age room upstairs so they could be supervised downstairs by preschool staff. C1 and S1 were observed in the office (with the door open) in the preschool program across from the Main room where there were qualified staff. In order to be directly supervised by a qualified teacher, C1 temporarily joined classroom preschool classroom 4/5 with S1.

Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

A notice of site visit will be given and must remain posted for 30 days.



Exit interview was conducted. A copy of this report and appeal rights were discussed and left with Director, Paige Solomon, whose signature on this form confirm receipt of these documents.
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE: DATE: 01/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/26/2023
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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Document Has Been Signed on 01/26/2023 12:55 PM - It Cannot Be Edited


Created By: Denise Gibbs On 01/26/2023 at 12:17 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
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: NU BUILDING BLOCKS DAY CARE CENTER-SCH.AGE.
FACILITY NUMBER: 197416358

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/26/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/27/2023
Section Cited
CCR
101216.2(e)

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101216.2(e) Teacher Aide Qualifications and Duties
(e) An aide shall work only under the direct supervision of a teacher.

This requirement is not met as evidenced by:
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Per Director. Paige Solomon will be a the facility to receive child at 7:30am and stay with him unitl the School Age Teacher takes over.
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Based on observation and interview, the licensee did not comply with the section cited above. This poses a potential Personal Rights 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:Trevino Cochran
LICENSING EVALUATOR NAME:Denise Gibbs
LICENSING EVALUATOR SIGNATURE:
DATE: 01/26/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/26/2023


LIC809 (FAS) - (06/04)
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