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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197417482
Report Date: 07/26/2023
Date Signed: 07/26/2023 09:28:07 AM

Document Has Been Signed on 07/26/2023 09:28 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:SAINT VICTOR'S PRESCHOOLFACILITY NUMBER:
197417482
ADMINISTRATOR:JULIE ZARINGFACILITY TYPE:
850
ADDRESS:8634 HOLLOWAY DRIVETELEPHONE:
(310) 652-6843
CITY:WEST HOLLYWOODSTATE: CAZIP CODE:
90069
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 6DATE:
07/26/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Julie Zaring TIME COMPLETED:
09:35 AM
NARRATIVE
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On 07/26/23 at 8:13 AM, Licensing Program Analyst (LPA) Antonio Almanza was at the facility to conduct a case management visit to address information provided by the Reporting Party (RP) and the facility while investigating complaint control number 58-CC-20230426123052. LPA met with Director Julie Zaring and explained the purpose of the visit. During today’s visit, there were 3 staff providing care and supervision to 6 children in care.

The RP provided LPA a copy of an email sent from the facility to parents on 4/3/23. The facility notified parents that there were 6 children who became Ill between 3/31/23 and 4/2/23 with a “stomach bug” that had been moving around the classroom for the last 2 weeks; and the facility would be closed Tuesday April 4th and Wednesday April 5th.

The facility closure and outbreak should have been reported to the El Segundo Child Care Office and the Los Angeles Department of Public Health (LADPH) ((888) 397-3993 or http://www.publichealth.lacounty.gov/acd/Cdrs.htm). The facility violated Title 22, Division 12, Chapter 1, section 101212(d) Reporting Requirements, Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. In addition, a written report containing the information specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event.

On 05/04/23, while conducting a site visit, for the purpose of investigation complaint allegations, LPA was unable to review the file for Child 1. The facility director notified LPA that the facility did not have a file for C1. During the visit C1 was no longer enrolled in the Center.

SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE: DATE: 07/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/24/2023
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: SAINT VICTOR'S PRESCHOOL
FACILITY NUMBER: 197417482
VISIT DATE: 07/26/2023
NARRATIVE
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During site visit conducted on 05/04/23, the facility was in violation of Title 22, Division 12, Chapter 1, section 101221 (A) Child's Records, A separate, complete and current record for each child is maintained in the child care center.

Two Type B violations are being cited on the attached LIC809D.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative Julie Zaring.

SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE:

DATE: 07/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/26/2023 09:28 AM - It Cannot Be Edited


Created By: Antonio Almanza On 07/24/2023 at 11:31 AM
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: SAINT VICTOR'S PRESCHOOL
FACILITY NUMBER: 197417482

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/26/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/11/2023
Section Cited
CCR
101212(d)

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...the child care center of any of the events specified in (d)(1)...a report shall be made to the Department by telephone...within the Department's next working day.. In addition, a written report... submitted to the Department within seven days...This requirement is not met as evidenced by:
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Facility staff will watch videos on CCLD website regarding Care Reporting Requirements, https://ccld.childcarevideos.org/child-care-center-operators/
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Based on interviews conducted and records reviewed, the facility failed to notify CCLD and LADPH of facility closure & outbreak, which poses a potential Health or Safety, or Personal Rights risk to persons in care.
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Facility staff will write summary of understanding for video. Personnel roster with written statement summaries will be provided via email to CCL.
Type B
08/11/2023
Section Cited
CCR101221(A)

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Child's Records, A separate, complete and current record for each child is maintained in the child care center.
This requirement is not met as evidenced by:
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Director will provide written declaration of understading of maintaining a file with required documents for each child in care.
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Based on interviews conducted and records reviewed, the facility did not have a file for C1, which poses a potential Health or Safety, or Personal Rights risk to persons in care.
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LIC311A was provided and discussed with the Director.
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:Betty Bell
LICENSING EVALUATOR NAME:Antonio Almanza
LICENSING EVALUATOR SIGNATURE:
DATE: 07/26/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/26/2023


LIC809 (FAS) - (06/04)
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