197493838-9-10-2024-58-CC-TBIM-D8Z26C-20240910170656

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197493838
Report Date: 09/10/2024
Date Signed: 09/10/2024 05:07:09 PM

Document Has Been Signed on 09/10/2024 05:07 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:	PEAK PROGRAMS INC.		FACILITY NUMBER:	197493838
ADMINISTRATOR/ DIRECTOR:	BARTHOLOMEW, SCOTT		FACILITY TYPE:	840
ADDRESS:	6170 LOCKHURST DRIVE		TELEPHONE:	(661) 713-2601
CITY:	WOODLAND HILLS	STATE: CA	ZIP CODE:	91367
CAPACITY: 94	TOTAL ENROLLED CHILDREN: 94	CENSUS: 32	DATE:	09/10/2024
TYPE OF VISIT:	Case Management - Annual Continuation	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:30 PM
MET WITH:	Jennifer Berrios, Director		TIME VISIT/ INSPECTION COMPLETED:	05:21 PM

NARRATIVE

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Licensing Program Analyst (LPA) Tatiana Bickham conducted an unannounced random annual continuation inspection on 09/10/2024. LPA arrived at the facility at 1:30 PM. LPA met with Director Jennifer Berrios, who guided LPA on tour of the facility. This is a school-age program and consists 1 classroom. Facility is licensed for 2 classrooms, rooms #1 and #36, Facility is currently only using room #1. The staff takes turns with the children using the room, Tk-1st will use the room while 2nd-5th grade, later they will switch. Facility operation hours are Monday, Wednesday- Friday 2:00 PM - 6:00 PM, and Tuesday's 1:00 PM- 6:00 PM.

All areas identified on the Facility Sketch were inspected. The following staff were present during this visit: Room #1: 3 Staff with 39 preschoolers.

Teacher/child ratios were observed to be in accordance with Title 22 regulations. The center lost 2 of their classrooms and per Title 22 Regulation the capacity per room for a school-age child- care program shall not exceed the number of children for which a room of this size is commonly approved for school use during the school day. The school-age room capacity for the room during the school day is 33 children, the center is not in compliance with Title 22 Regulations. The Director got permission from the Principal of the school to use the library, the center will use classroom 1 and the library temporarily until they get another classroom.

Staff names were recorded. All children were observed to be under visual supervision of a teacher at all times.

Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Children have their own cubby to store their belongings. Per Director, the isolation area is located in the office. Age-appropriate sinks and toilets were inspected for

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SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Tatiana Bickham
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024

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 09/10/2024 05:07 PM - It Cannot Be Edited

Created By: Tatiana Bickham On 09/10/2024 at 04:13 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: PEAK PROGRAMS INC.	FACILITY NUMBER: 197493838
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/10/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101212(c)

Reporting Requirements

(c) The licensee shall notify the Department in writing of his/her intent prior to making any structural changes that reduce the total amount of indoor or outdoor activity space. Such structural changes shall include, but not be limited to, room additions. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, the licensee did not comply with the section cited above which posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/10/2024
	Plan of Correction
1 2 3 4	Notify Licensing of any changes made to the center.

Type B

Section Cited

CCR

101538.3(d)

(d) The capacity per room for a school-age child care program that meets the requirements of Health and Safety Code Section 1596.806 shall not exceed the number of children for which a room of this size is commonly approved for school use during the school day. This rquirement was not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, the licensee did not comply with the section cited above in which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/01/2024
	Plan of Correction
1 2 3 4	The center will temporarily use the Library room. Submit LIC 200 with room that will be prementately used by the date listed above.

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:

Raul Navarro

LICENSING EVALUATOR NAME:

Tatiana Bickham

LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024

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: PEAK PROGRAMS INC.	FACILITY NUMBER: 197493838
	VISIT DATE: 09/10/2024

NARRATIVE

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availability and good repair in all restrooms.

General sanitation was observed. Children bring their own water bottle and before entering the classroom and before going outside, the children fill their water bottles with water from the water fountain located outside of the classroom. LPA did not observe during file review a lead test for the center.

Disinfectants and cleaning solutions were accessible to children. Carbon monoxide detector were observed in the classroom and is operable.

The center does not have a kitchen and does not prepare snacks for the children. The children bring snacks from home. First Aid supplies were observed. Per Director, medication is not administered at the facility.

Outdoor playground equipment is in a safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under high climbing equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard. Availability of outdoor drinking water was observed. LPA advised that no children shall be left without the supervision of a teacher at any time.

All floors were observed to be clean and safe. All materials accessible to children were observed to be toxic-free There are no firearms stored on the premises. There are no pools or bodies of water at the facility.

Children’s records were reviewed for Admission Agreement, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, LIC 613-Personal Rights, LIC 702-Health History, and LIC 701 Physicians Report, and Immunization Records.

Staff records were reviewed for Education, LIC-501: Personnel Record, LIC 508-Criminal Record Statement, LIC 9052- Employee Rights, LIC503- Health Screening, Proof of immunization against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate. There is at least one person trained in CPR and Pediatric First Aid present during this inspection. 3 out of 4 staff is missing LIC 503- Health Screening, 1 staff is missing proof of immunization's against measles, pertussis and influenza, and 1 staff has a finger-print clearance but is not associated to the facility.

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SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Tatiana Bickham
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024

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: PEAK PROGRAMS INC.	FACILITY NUMBER: 197493838
	VISIT DATE: 09/10/2024

NARRATIVE

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Director was reminded that all adults 18 and over, 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 Child Care Center. 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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

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.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/tion-process.

A notice of site visit was given to Licensee and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Exit interview was conducted with Director Jennifer Berrios, a copy of the report was given.

SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Tatiana Bickham
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024

LIC809 (FAS) - (06/04)

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