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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494608
Report Date: 04/15/2025
Date Signed: 04/15/2025 04:04:29 PM

Document Has Been Signed on 04/15/2025 04:04 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:OUR LADY OF MALIBU CHURCH AND SCHOOLFACILITY NUMBER:
197494608
ADMINISTRATOR/
DIRECTOR:		REV MATHEW MURPHYFACILITY TYPE:
850
ADDRESS:3625 S WINTER CANYON RDTELEPHONE:
(310) 456-8071
CITY:MALIBUSTATE: CAZIP CODE:
90265
CAPACITY: 22TOTAL ENROLLED CHILDREN: 22CENSUS: 5DATE:
04/15/2025
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:ELISA ZIMMERMAN, PRINCIPALTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
NARRATIVE
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On 04/15/2025, Licensing Program Analyst (LPA) Lisa Clayton conducted an unannounced Required 3-year Inspection at Our Lady of Malibu Church and School. LPA Clayton met with Principal Elisa Zimmerman. LPA Clayton observed 5 children being supervised and cared for appropriately by 2 fingerprint cleared staff. Days and hours of operation are Monday- Friday from 8a.m. to 3:00p.m. The childcare center provides lunch and water.

LPA Clayton toured the facility indoors and outdoors for a Health and Safety Inspection. Capacity and limitations as specified on the license are being maintained.

All children are under visual supervision of a teacher at all times. The CCC is in compliance with Title 22 regulations regarding Staff to Student ratios.

There are no pools, ponds, or any other bodies of water on the property. There are no firearms or ammunition allowed or stored on the premises. LPA Clayton reminded staff to ensure that all disinfectants, cleaning solutions, medication and other hazardous items are made inaccessible, and kept in a locked cabinet area.

LPA Clayton inspected the classroom and observed age-appropriate toys, books and furnishings. Furniture and equipment in the classrooms are in good condition, free of sharp, loose, or pointed parts.

All hand washing facilities and toilets are in safe and sanitary operating condition. LPA inspected napping equipment placement, bedding and storage for safety. Water temperature, toilet paper, paper towels, safety and sanitation were inspected. Floors in the facility are clean and safe.

NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Lisa Clayton
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/15/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 04/15/2025 04:04 PM - It Cannot Be Edited


Created By: Lisa Clayton On 04/15/2025 at 03:25 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: OUR LADY OF MALIBU CHURCH AND SCHOOL
FACILITY NUMBER: 197494608

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/15/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
HSC
1596.871(c)(1)(A)
Administration of Child Day Care Licensing
Subsequent to initial licensure, a person specified in subdivision (b) who is not exempt from fingerprinting shall obtain either a criminal record clearance or an exemption from disqualification, pursuant to subdivision(f) of this section or Section 1522.7, from the State Department of Social Services prior to employment, residence, or initial presence in the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA Clayton's record review, the licensee did not comply with the section cited above in which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 04/18/2025
Plan of Correction
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Per Principal, Livescan Request will be processed with the support of the Los Angeles Archdiocese and proof of clearance will be submitted to LPA by April 28, 2025
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
Karren Starks
NAME OF LICENSING PROGRAM MANAGER:
Lisa Clayton
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/15/2025


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: OUR LADY OF MALIBU CHURCH AND SCHOOL
FACILITY NUMBER: 197494608
VISIT DATE: 04/15/2025
NARRATIVE
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The play structure is maintained in a safe condition and is free of hazards. The surface of the outdoor activity space under the play structure is in good condition, free of tears and holes.

LPA Clayton conducted a Health and Safety inspection of the food storage area and observed it to be free of litter/rubbish and free of rodents/vermin. All food is protected against contamination and any contaminated food is to be discarded immediately. Solid waste storage containers have tight-fitting covers and are in good repair.

The CCC had the water tested and received testing results – no Lead exceedances.



LPA Clayton observed 2 fully charged 2A10BC fire extinguishers in the preschool classroom. A fire clearance was granted in 2020. LPA Clayton observed smoke detectors in the classroom.

LPA Clayton reviewed 5 children’s files and observed files to be missing signed Parent’s Rights, signed Personal Rights receipts Physicians Reports and immunization records as required by Title 22 Regulations and/or Health and Safety Codes.

LPA Clayton reviewed 3 employee files and observed them to be missing Mandated Reporter training certificates, health screenings, medical training, employee rights, transcripts and immunization records and CPR/First Aid as required for opening and closing staff.

LPA Clayton reminded Principal Zimmerman that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Childcare Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.


Incidental Medical Services – IMS services are not currently being provided. LPA Clayton provided Director with the IMS sample plan and instructed her to forward copies to the Department immediately upon completion. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care­ centers/.
NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Lisa Clayton
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2025
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: OUR LADY OF MALIBU CHURCH AND SCHOOL
FACILITY NUMBER: 197494608
VISIT DATE: 04/15/2025
NARRATIVE
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LPA Clayton informed Principal Zimmerman of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

LPA Clayton reminded Principal Zimmerman to access the Community Care Licensing website www.ccld.ca.gov for 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. Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations and/or Health and Safety Codes, Deficiencies and Technical Violations were cited.

The following documents are to be made available to the department upon request no later than Monday April 28, 2025:

· Fingerprint clearance for Principal Elisa Zimmerman

· Mandated Reporter training certificates for all preschool staff

· Immunization records for Principal Zimmerman and preschool teacher Shari Latta (MMR, TB, Tdap, Flu)

· CPR/ First Aid certificates for Principal Zimmerman and preschool teacher Shari Latta

· Lead testing results

· Smoke alarm installation report

An exit interview was conducted, and the report was reviewed and provided to Principal Zimmerman.



LPA Clayton posted a Notice of Site Visit which must remain posted for 30 days.
NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Lisa Clayton
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2025
LIC809 (FAS) - (06/04)
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