<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197495324
Report Date: 07/02/2024
Date Signed: 07/02/2024 03:42:26 PM

Document Has Been Signed on 07/02/2024 03:42 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 RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:PINES CHRISTIAN PRESCHOOLFACILITY NUMBER:
197495324
ADMINISTRATOR/
DIRECTOR:		PAUL INGERSOLLFACILITY TYPE:
850
ADDRESS:25200 S WESTERN AVENUETELEPHONE:
(310) 325-1011
CITY:HARBOR CITYSTATE: CAZIP CODE:
90710
CAPACITY: 75TOTAL ENROLLED CHILDREN: 75CENSUS: 0DATE:
07/02/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:04 AM
MET WITH:Paul Ingersoll (applicant) and Michelle Ponciano(director)TIME VISIT/
INSPECTION COMPLETED:
04:00 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 7/2/2024 Licensing Program Analyst (LPA) Jillinda Chandler made an announced visit to Pines Christian Preschool, located at 25200 S. Western Avenue, Harbor City, CA. 90710, for the purpose of conducting a Pre-Licensing inspection. LPA met with Paul Ingersoll (applicant) and Michelle Ponciano (director) who provided a tour of the facility, also located on the same campus is " The Pines Christian School" for elementary age children. Elementary class rooms are identified as rooms O and P according to the provided facility sketch dated 7/2/2024. The applicant is requesting a preschool license with a capacity of 75 children, ages 2 years – until entry into first grade. There are 5 classrooms dedicated to day care activity; rooms J,I,H Q & R as identified on the facility sketch dated 7/2/2024 Day care operational days and hours will be Monday – Friday/ 6:00 A.M. – 6:00 P.M. There is an approved fire clearance on file approved on 6/4/2024 by Henry Medina of the L.A. City Fire Department Institution Unit.

The following was observed of the:


INDOOR ACTIVITY SPACE
Fire extinguishers were 2AB10C or larger, last serviced 9/23/2023. Applicant was informed that emergency drills shall be conducted quarterly or Bi-annually and logged, the log shall be readily available upon request of any licensing analyst.
pg.1
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE: DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/02/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: PINES CHRISTIAN PRESCHOOL
FACILITY NUMBER: 197495324
VISIT DATE: 07/02/2024
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
26
27
28
29
30
31
32
Carbon monoxide detectors were observed in operable condition inside of the classrooms.

First aid kits were available with the required essentials: scissors, bandages, tweezers, ointments, and thermometer.

Age-appropriate furniture and equipment was observed in good repair.

Cots were observed for napping, applicant was informed that beddings must be removed when cots are stacked.

Cubbies and backpack hooks were observed for children’s belongings.

Children will bring their water canisters and the center will provide water from a filtered water faucet

The facility has covered wall heaters and fans, for heating and cooling.

Windows were in good repair free of chipping paint, dirt, insects, or debris.

Adequate lighting was observed.

No cameras were observed during todays inspection

The classrooms were clean in good repair. Applicant shall fill or cover the crack in room and make classroom door entries identifiable as a tripping hazard pg.2

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024
LIC809 (FAS) - (06/04)
Page: 2 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: PINES CHRISTIAN PRESCHOOL
FACILITY NUMBER: 197495324
VISIT DATE: 07/02/2024
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
26
27
28
29
30
31
32
Trash cans used for solid waste were observed with tight fitting lids.

Disinfectants and cleaning solutions and other toxins or poisons were made inaccessible to children in care.

Isolation area for ill children will be the in the sign-in lobby and the restroom in room J, applicant was advised that when using the lobby, outside traffic shall be re-routed and the toilet and sink shall be sanitized after each use by the ill children.

Parents and authorized adults will sign children in and out, using an electronic devise. Applicant was informed that the sign in sheets shall be readily available for printing and retained for a minimum of 30 days.

The required postings were posted in a prominent area for viewing.

Applicant was informed that the facility number must be added to all advertisements.

Measurements for the indoor activity space were 2464.94 square feet, which did not accommodate the requested capacity

FOOD SERVICE:

Meals will be provided by the on campus cafeteria. The kitchen was clean, and free of litter and rubbish; measures shall be taken to keep all such areas free of rodents and other vermin, none were observed during todays inspection.

pg.3

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024
LIC809 (FAS) - (06/04)
Page: 3 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: PINES CHRISTIAN PRESCHOOL
FACILITY NUMBER: 197495324
VISIT DATE: 07/02/2024
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
26
27
28
29
30
31
32
LPA observed storage for foods and a refrigerator with a thermometer, foods and toxins or chemicals were stored separately, and LPA did not observe any expired or contaminated foods.

Children will be served meals in the cafeteria, applicant shall devise a plan to make the kitchen area and coffee maker inaccessible to children in care.

Center has devised an Incidental Medical Service (IMS) plan to provide to parents of children with allergies (epi-pen), asthmatic (inhalers), glucose monitoring (diabetics) and children needing G-tube feeding. IMS was discussed with the applicant.

RESTROOMS

THERE WERE:

6 sinks, 10 toilets and three urinals for a total of 11 toilets available for childrens use. Rooms J,I,and H have restrooms inside of the classrooms, Children in rooms Q and R shall be escorted to the restroom located on the benched outdoors area. This restroom will not be shared by the private elementary school, there are two gender identified restrooms for the elementary use, per the applicant staff uses a separate stall inside of the elementary school's restroom, only when children aren't present.

The restrooms were clean and sanitized with the necessary toiletries, sinks and toilets were operable and in good repair. Faucets delivered cold water.

pg.4

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024
LIC809 (FAS) - (06/04)
Page: 4 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: PINES CHRISTIAN PRESCHOOL
FACILITY NUMBER: 197495324
VISIT DATE: 07/02/2024
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
26
27
28
29
30
31
32
OUTDOOR ACTIVITY SPACE
Age-appropriate toys and equipment were observed in fair condition. Toys were in need of cleaning.
The play yard was gated with a 4 foot or higher gate.

Resilient cushioning was observed in good condition under the climbing apparatus.

LPA observed sail shades for shade and benches for resting.

LPA recommends that the hole in the wall on the cushioned yard be repaired and all poles on the black top shall be padded including the basket ball pole.

No hazardous conditions or equipment was observed during today’s visit.

Measurements for the combined outdoor activity areas were 4788.15, which will not accommodate the requested capacity. Applicant shall request a waiver from Title 22, section 101238.2 Outdoor Activity Space;


(a)There shall be at least 75 square feet per child of outdoor activity space based on the total licensed capacity, and to use the play yard on a alternating schedule and to share the black top with the private elementary school.

Based on today’s inspection the facility shall be recommended for a capacity of 70 children determined by the measurements of the indoor activity space following the recommended corrections approval of the requested waiver. pg.5
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024
LIC809 (FAS) - (06/04)
Page: 5 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: PINES CHRISTIAN PRESCHOOL
FACILITY NUMBER: 197495324
VISIT DATE: 07/02/2024
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
26
27
28
29
30
31
32
Applicant was reminded 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 Child Care 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.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.
For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).
LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. PIN 22-05-CCP Page Four
LPA referred facility representative to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.
pg. 6
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024
LIC809 (FAS) - (06/04)
Page: 6 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: PINES CHRISTIAN PRESCHOOL
FACILITY NUMBER: 197495324
VISIT DATE: 07/02/2024
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
26
27
28
29
30
31
32
LPA also informed applicant of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Applicant was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

LPA reviewed with applicant the LIC. 311A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

An exit interview was conducted, a copy of this report was discussed and provided to applicant Paul Ingersoll

pg. 7

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024
LIC809 (FAS) - (06/04)
Page: 7 of 7