STATE OF CALIFORNIA.wHEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIA.L SERVICES COMMUNITY CARE LICENSING DMSION FACILITY EVALUATION REPORT CCLD Regional Office, 8167 BRISTOL PARKWAY 11400 CULVER CITY, CA 90230 FACILITY NAME: CRENSHAW TOT ACADEMY ADMINISTRATOR: LENOX, ROBERTJEAN D. ADDRESS: 5152 CRENSHAW BLVD. CITY: LOS ANGELES CAPACITY: 44 TYPE OF VISIT: Case Management Martha De Lara- teacher MET WITH: STATE:CA CENSUS:4 UNANNOUNCED FACILITY NUMBER: FACILITY TYPE: TELEPHONE: ZIP CODE: DATE: TIME BEGAN: TIME COMPLETED: 191804084 850 (323) 299-6705 90043 03/25/2014 04:30PM 05:25PM NARRATIVE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 The Licensing Program Analyst (LPA A. Tang went to the facility to observe the staffing and ratios and to have a few pages from a couple of previous reports amended and newly signed by the Director, Ms. Lenox. Also to discuss with her that the Community Care Licensing Department is requesting a new outdoor facility sketch showing the buildings as they are in proximity to the play yard. Also to request from Ms. Lenox that she obtain from the City or County Accessors Office the lot diagram to see their division of the play yard (whatever they have) to see if it was ever separated or divided between the two addresses. As described before, Ms. Lenox stated it is "only one lot" but the Department is requesting evidence from the city/ or county (whichever applies). Due to computer /printer malfunction and Ms. Lenox not being present during the time of the visit, the LPA Tang opted not to leave the amended reports as they should be readable, read and signed by Ms. Lenox. The LPA left a copy with the teacher Ms. De Lara and the LPA will return this week. 22 23 24 25 SUPERVISOR'S NAME: Scott Herring TELEPHONE: (310) 337-4331 LICENSING EVALUATOR NAME: Angela Tang TELEPHONE: (310) 337-4379 LICENSING EVALUATOR SIGNATURE: q,.S~ DATE: 03/25/2014 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. DATE: 03/25/2014 This report must be available at Child Care and Group Home facilities for public review for 3 years. UC809 (FAS) w (08104) Page: 1 of1 STATE OF CALIFORNIA~ HEALTH AND HUMAN SERVICES AGENCY CAUFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE UCENSING OMS ION FACILITY EVALUATION REPORT CCLD Regional Offictl, 6167 BRISTOL PARKWAY 11400 CULVER CITY, CA 90230 FACILITY NAME: CRENSHAW TOT ACADEMY ADMINISTRATOR: LENOX, ROBERTJEAN D. ADDRESS: 5152 CRENSHAW BLVD. LOS ANGELES CITY: CAPACITY: 44 TYPE OF VISIT: Case Management Robertjean Lenox, Director MET WITH: FACILITY NUMBER: FACILITY TYPE: TELEPHONE: STATE:CA ZIP CODE: CENSUS:5 DATE: UNANNOUNCED TIME BEGAN: TIME COMPLETED: 191804084 850 (323) 299-6705 90043 03/26/2014 04:10PM 05:18PM NARRATIVE 1 2 3 4 5 6 7 8 9 The Licensing Program Analyst (LPA) A. Tang met with Ms. Robertjean Lenox · (Robbiejean) for a follow-up to yesterday's visit by LPA A. Tang. During the visit there were four children with Ms. Lenox and Assistant Mr. Perez. The purpose of LPA's visit was to clarify the purpose of yesterday's visit was to amend some prior reports, discuss the usage of the yard and possible dividing it for use only directly behind the center and to discuss the need for the County Assessors diagrams of the lot and property lines. 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Today, the LPA is here to provide Ms. Lenox with a clear copy of the report that was left by LPA Tang at the facility yesterday afternoon. During the visit, Ms. Lenox provided zoning and property pictures, property lines, and Plat Map. She just obtained the documents from the internet from the County Accessors website. During the visit she explained that she has moved from her residence which is next door and it shares backyard space with the preschool. She still has personal items next door and has access to the address. The board has some plans for the building. She is part ofthe board. An exit interview was conducted and a copy of this report was given to Ms. Lenox. SUPERVISOR'S NAME: Scott Herring TELEPHONE: (310) 337-4331 LICENSING EVALUATOR NAME: Angela Tang TELEPHONE: (310) 337-4379 LICENSING EVALUATOR SIGNATURE: DATE: 03/26/2014 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/26/2014 This report must be available at Child Care and Group Home facilities for public review for 3 years. UC809 {FAS) ~ {Ofi/04) Page: 1 of1 STATE OF CALIFORNrA· HE.ALTfl AND HlJMAI4 81!RVICES AGENCY CAUFORHIA. DEPARTMENT OF SOCW. SERVICeS COUMUHJTYCARE IJCENSINO DIVISION FACILITY EVALUATION REPORT (Cont) CCLD Re;lomd Offlc:tr. 6187 BRISTOL PAAWHAY~ CULVER CIT'!, CA. 80230 FACILITY NAI\IE: CRENSHAW TOT ACADEMY DEFICIENCY INFORMATION FOR THIS PAGE: Daflclimcy 1)pe POC Due Date I FACILITY NUM8ER: 191804084 VISIT DATE: 03/1212013 DEFICIENCIES PLAN OF CORRECTIONS(POCs) 1 2 3 4 Teecher Aide Quallfloallons and Dullea: An aida shall work only under !he direct supervlolon of a teacher. The aide/Assistant Kevin Perez was loft alone wlth day care children and the Quallliad 5 Teechershowedupan hour later. 1 Thelloansee was lnfonned not to leli\IG !he chlld!$11 2 alone wlfh !he aeatstant. 3 4 6 5 6 Suction Number TypaA 03/1412013 Secllon Cltod 1D1216.2(e) 7 Type A 03/1412013 Section Cited 101216.3(1)(C) Type A 0311412013 S.cUon Cited 101227(8) Type A 03/14/2013 Seci!Ofl Cited 101238(8) 7 1 Teecher-<:hlld Ratio: Praachool (36 months to 2 enrollment In klndorgsrten)- 1:8 adult-child ratlo, 3 1:24 teacher-child raHo. Assistant Kevin Perez wa 4 loft alone at the facility wllh nine day care chftdren. 1 Tho Director was lnfonned to Immediately cease 2 leaving the asatstant alone wllhout a qualified 3 teacher. 5 6 4 5 6 7 7 1 Food Services: All food shall be selected, stored, 2 prepared and served In a safe and healthful 1 Asolslant Kevin Perez placed the chicken In the 2 refrigerator during the vfsiL 3 3 manner. CS Cocper and LPA Tang obseJVed 4 several pieces of raw chicken sitting on the kftchen 4 5 counter lor approximately an hour. 5 6 7 1 2 3 4 5 6 7 Buildings and GfllUIIds: The child care csnter shall be clean, safe, sanitary and In good repair at all times. CS Cooper and LPATangobsetved Unslde 1ha flloiDty, thellocrs, walls and carpets were unclean, had dabrist and some sticky substance 6 throughoutlho floOr. 7 1 The licensee agrees to clean the carpets, walls and 2 floom. 3 4 5 6 7 Failure to correct tha cited deflclency(les), on or before the Plan of Co1111ct1on (POC) due date, may result In a eM I penalty assessment SUPERVISOR'S NAME: Ca~a Caldwell TELEPHONE: (310) 337-4351 LICENSING EVALUATOR NAME: Cassandra Cooper TELEPHONE: (310) 337-4354 LICENSING EVALUATOR SIGNATURE: . UiJ DATE: 03/1212013 I acknowledge r<>e~~lpt of this form and understand my appeal rlghts as explained and Ncelved. FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/1212013 This NoUce must be posted for 30 days UC!:09 (J!ASj "{OGJG4) Pa:ge: 20fe CAUFORHIAPEPAR.mENTOftiOCIAL8£!MCE.S CO.MIWHIYY CARE UC£NBINO OMiiiON CCLD Regional OffiCG,81fiT BRISTOL PARKWAYf.COO CULVERcrrY, CAi0230 FACILITY EVALUATION REPORT FACILITY NAME: CRENSHAW TOT ACADEMY ADMINISTRATOR: LENOX, ROBERTJEAN D. ADDRESS: 5152 CRENSHAW BLVD. CITY: LOS ANGELES CAPACITY: 44 TYPE OF VISIT: Case Management MET WITH: Kevin Perez FACILITY NUMBER: FACILITY TYPE: TELEPHONE: STATE:CA CENSUS:9 ZIP CODE: DATE: UNANNOUNCED TIME BEGAN: TIME COMPLETED: 191804084 850 (323) 299-6705 90043 03/1212013 04:15PM 05:17PM NARRATIVE Investigator lllfany Brunelli, Detective Mel Campos, Delectlve D. Johnson, Licensing Program Analyst (LPA) Angela T11ng and Complaint Specialist (CS) Cassandra Cooper lnvsstlgaled complaint #30-Cc-20130311 085406 for the Crenshaw Tot Academy. During the Initial ten (1 0) dey delivery of the complaint, deficiencies were notload and c11ed. Assiatant Kevin Perez was left alone at the facility with nine (9) children upon Detectlvs's, lnvsstlgator, LPA and CS arrival at noon. The children were laying down on cots and one child was awake with the Asslatant. Owner/Director Robertjean Lenox arrived at the facility at 12:55 PM and FeHcla Sparks arrived a few minules later, who ata1ed she was a Qualified Teacher. The Director was unable to kloata a folder for Felicia, therefore, her credentials could not be verified nor her first aid and CPR. Assistant Kevin Perez's CPR expired on 12106/2011 andthsflrstald BKPired 12106/2012. The Owner/Director Robertjaan Lenox has an expired CPR card which eKPired on 12/08/2011 and First Aid expired on 12/08/2012. CS Cooper and LPA Tang conducted a walk through of the facility and notk:ed the fuilowfng: only six (6) out of the nine (9) children were signed In; the sign-In sheets did not have dates on \hem; several pisces of chicken were sltllng on the kitchen counter, a school bus is sltllng In ths playground with a flat tire and could be a potential hazard; the children's bathroom had urine and dirt on ths seats, and the sink had rust atalns; Ule In the children's bathroom Is curied up and mildewed; the melts In the beckyard are stained and curled up and some are broken; ths chid's gate was not placed up to block the children from having access to the kltohen area; ths ataff toilet seat was observed to have a large crack on ths seat the carpet In the play area for the . children WI'S curled up and lifted; and 1he licensee was unable to locate a Personnel Folder for her Qualified Teacher/sta1f. NAME: Ceria Caldwell UCENSING EVALUATOR NAME: Casssndra Cooper TELEPHONE: (310) 337-4354 UCENSING EVALUATOR SIGNATURE: (JJ DATE: 03/12/2013 I acknowledge receipt of this form and understand my licensing appeal rights as explained. and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/12/2013 This report must be available at Child Care and Group Home facilities for public review for 3 years. UCIOt (FAS)· (IH!I: cleo ned 1he toilets and sink 2 during the vlsll The licensee Is going to look Into 3 replacing and/or reglazlng 1he sink In the bathroom. 4 5 6 7 Failure to col'!'e(:! the cited de!lclency(les), on or before the Plan of Correcllon (POC) due date, may l'ellult in a civil penalty assessment. SUPERVISOR'S NAME: Calia Caldwell TELEPHONE: (31 0) 337-4351 UCENSING EVALUATOR NAME: Cassandra Cooper TELEPHONE: {310) 337-4354 LICENSING EVALUATOR SIGNATURE: {iJ DATE: 03/1212013 I acl'.nowledge receipt of this form and understand my appeal rights as axplalned and received. FACILITY. REPRESENTATIVE SIGNATURE: DATE: 03/12/2013 This Notice must be posted for 30 days UC80f (FAB) • (O'JO.<) · P.;ae:3of5 ITATE OF CALIFORNIA~ HEALm AND HUJIAN!ERVICESAQI:UCY CAUF0Rf8A DEPAR'TMfNT OF SOClALBERVICES FACILITY EVALUATION REPORT (Cont) COMMUNIT'f CARE UCENSJNQ DMSIOtf CCLD Reglonpl Oft'lco,l187 BRlSTCL PARKWAYtl400 CULVER cn'Y, CA IKIZ3D FACIUTY NAME: CRENSHAW TOT ACADEMY 1 2 3 4 5 6 7 FACILITY NUMBER: 191804084 VISIT DATE: 03/1212013 The licensee lives in the building next door which shares common grounds with the Child care center and the home was Inspected and this CS observed males clothing, deodorant and cologne In one of the bedrooms and the llcensae stated the llems belonged to her ad_ult son. The licensee Is advised If her son lives on the grounds and/or Is present or has frequent visits, he Is required kl be flngarprlnled. CS Cooper and LPA Tang observed loose hanging tile on the calling in the computar room and loose expHAW TOT ACADEMY ADMINISTRATOR: LENOX, ROBERTJEAN D. ADDRESS: 6152 CRENSHAW BLVD. CITY: LOS ANGELES CAPACITY: 44 TYPE OF VISIT: Case Management MET WITH: Robertjean Lenox 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 FACILITY NUMBER: FACILITYlYPE: ·TELEPHONE: STATE:CA ZIP CODE: CENSUS:2 DATE: UNANNOUNCED TIME BEGAN: TIME COMPLETED: 191804084 850 (323) 299-{1705 90043 03/1312013 08:15AM 10:33AM This Lenox to come over to 1l1e Child Care. During loday's visit this CS obssrved the baby gates were not blocking the computer room nor the kitchen area. This CS brought It to the attention of Licensee Lenox who stated sha did not have the opportunity to Inform her staff. The ncensee stated that the computer room is off limits to the day care ohlldnsn, however, while this CS was In the computer room, child #2 walked Into the computer room with this CS on two occasions. Licensee Robertjean Lenox was In the computer room with this CS on the second occasions. This CS reminded 1l1e licensee to put the bsby gate up to prevent children from having access to the room due to the loose tiles hanging from the ceiling and the exposed computer wires. This CS observed 1l1e sign-In sheet was not dated fortoday's date e[ld reminded the licensee to have the date placed on'the sign-In sheet. The ncensee located the file for Fellcis Sparks. This CS obtained a copy of the documents In the file. Fellcls has bsen working as a sub-teacher since 01/27/2003 with other teachars that had FirstAJd/CPR training and Felicia bscame the full time teeoher as of July 2012 to work with the children by herself. Licensee stated that Felicia has neverteken First Ald/CPR training since she's been working for the licensee. This CS left the licensee with a blank copy of the Children's Roster In order to provide the addresses and phone numbers for the children and to lax the Roster to this CS by the close of business day today, 03/13/2013. CS infomned the ficensee to post yesterday's report and provide a copy to each parent and have the parents sign the acknov.iedgement fonm and place the form In eaoh ohlid's file. the I LICENSING EVALUATOR NAME: Cassendre Cooper TELEPHONE: (310) 337-4354 LICENSING EVALUATOR SIGNATURE: (jJ DATE: 03/1312013 I acknowledge'recoipt of this form and understand my llconsing appeal rights as explained and rG<:elved. FACILITY REPRESENTATIVE SIGNATuRE: DATE: 03/13/2013 This report must be available at Child Care and Group Home faciiiOes for publicTevlewfor 3 years. UC&OO{FAS)- (D6104) PIQII:1 of 1 STATE OF CALIFORNIA •HEALTH AND HUMAN SERVICES AGENCY CAUFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DMSION FACILITY EVALUATION REPORT CCLD Regional Office, 6167 BRISTOL PARKWAY #«lO CULVER CITY, CA 90230 FACILITY NAME: CRENSHAW TOT ACADEMY FACILITY NUMBER: ADMINISTRATOR: LENOX, ROBERTJEAN D. FACILITY TYPE: ADDRESS: 5152 CRENSHAW BLVD. TELEPHONE: CITY: LOS ANGELES STATE:CA ZIP CODE: CAPACITY: 44 CENSUS:4 DATE: UNANNOUNCED TIME BEGAN: TYPE OF VISIT: POC MET WITH: Robert Jean Lenox and Kevin Perez TIME COMPLETED: 1 2 3 4 191804084 850 (323) 299-6705 90043 02/14/2014 02:45PM 03:00PM NARRATIVE The Licensing Program Analyst went to the facility on a plan of correction visit to see if her vehicle had been removed from the play yard area in back. It had. Correction has been made. Ms. Lenox has agreed not to park the car or any vehicle on the yard while she has day care children in care or civil penalties will be assessed. A copy of this correction report was given to Ms. Lenox. 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 SUPERVISOR'S NAME: Scott Herring TELEPHONE: (310) 337-4331 LICENSING EVALUATOR NAME: Angela Tang TELEPHONE: (310) 337-4379 LICENSING EVALUATOR SIGNATURE: DATE: 02/14/2014 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. DATE: 02/14/2014 This report must be available at Child Care and Group Home facilities for public review for 3 years. UC809 (FAS)- (Oii/04) Page: 1 of1 STATE OF CALIFORNIA • HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DMSION FACILITY EVALUATION REPORT CCLD RegJonal Office, 6167 BRISTOL PARKWAY#400 CULVER CITY,CA 90230 FACILITY NAME: CRENSHAW TOT ACADEMY ADMINISTRATOR: LENOX, ROBERTJEAN D. ADDRESS: 5152 CRENSHAW BLVD. CITY: LOS ANGELES 44 CAPACITY: TYPE OF VISIT: Annual/Required MET WITH: Robertjean Lenox FACILITY NUMBER: FACILITY TYPE: TELEPHONE: ZIP CODE: STATE:CA CENSUS: 4 DATE: UNANNOUNCED TIME BEGAN: TIME COMPLETED: 191804084 850 (323) 299-6705 90043 02/14/2014 03:00PM 04:12PM NARRATNE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 ~~ 21 22 23 24 25 The Licensing Program Analyst (LPA) A. Tang conducted an Annual Required visit and met with the licensee, Robert Jean Lenox. At the time of LPA's visit the children were being supervised by Kevin Perez and RobertJean Lenox. The LPA toured and inspected the preschool in accordance with the facility sketch. The furniture and equipment were inspected for age appropriateness and good repair. The telephone service, heating, lighting, and ventilation is adequate. There is a first aid kit in the office and an additional one available to take out on the playground. LPA observed several age appropriate toys and educational materials. The LPA also observed five cribs that were recently brought in to an unused classroom nearest the back door. There is no infant center at this time. The LPA observed drinking water available via drinking fountains indoors and out. check for indoor available water. The trash cans with any food stuffs had lids. The electrical outlets are covered or inaccessible. The medication policy is as follows: the medication is administered with parent's permission and has to be prescribed by the doctor's and only given once a day or won't even accept it. There is a form for parents and doctor to sign giving permission to administer prescription medication. The fomn is kept in the office in a separate file and a copy kept in the child's file. The children are inspected for illness, infections, contagious diseases, etc. as they arrive. There are several areas t-hat can be used as an isolation area including the office. There is a cot available for each ill child. [See next page.] SUPERVISOR'S NAME: Scott Herring TELEPHONE: (310) 337-4331 LICENSING EVALUATOR NAME: Angela Tang TELEPHONE: (310) 337-4379 LICENSING EVALUATOR SIGNATURE: DATE: 02/1412014 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/14/2014 This report must be available at Child Care and Group Home facilities for public review for 3 years. LICB09 (FAS} • (OOIG4) Page: 1 of2 STATE OF CAUFORNIA· HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE UCENSING DIVISION FACILITY EVALUATION REPORT (Cont) FACILITY NAME: CRENSHAW TOT ACADEMY CCLD Regional Office, 61$7 BRISTOL PARKWAY ;f.COO CULVER CITY, CA 90230 FACILITY NUMBER: 191804084 VISIT DATE: 02/14/2014 NARRATIVE 1 2 3 4 5 6 7 ~ 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 (page 2] There was toilet paper, soap and paper towels in restroom. The water temperature is safe from scalding. The faucet worked in all the sinks and all toilets work. The facility provides food and is stored on the premises. Children have been observed eating meals and taking naps. They're served breakfast, two snacks and lunch. The LPA observed food in the freezer and refrigerator enough for the enrolled children at this time. LPA observed 100% juice and milk in the refrigerator. The chemicals/ cleaning items are kept separate from the food. The menus are posted in the kitchen. Outdoor equipment was inspected for safety, adequate cushioning material, good repair and age appropriateness. The yard is a large open area with anchored play equipment and tricycles. There were no bodies of water on the premises. Drinking water is available while outside via a drinking fountain. There are shaded areas for rest on the play yard. Children's records were pulled and reviewed for form completeness. Care and supervision was evaluated to determine if the basic needs of children are being met. Children seemed energized, excited, active. Children's records are kept in the office. The facility keeps a documented record of emergency and fire drill and they're conducted once a month. A children's Facility Roster is posted on the wall. Sign in and out sheets were reviewed and following procedure. Every child is signed in accordingly. At the present the children are not transported off the premises for field trips. The director has current Pediatric CPR/first aid certificates that are current- expire on 3/22/2015. The parent's board has required documents. Additional forms and child care updates may be obtained at the department's website www.ccld.ca.gov. An exit interview was conducted and a copy of this report given to Ms. Lenox. SUPERVISOR'S NAME: Scott Herring TELEPHONE: (310) 337-4331 LICENSING EVALUATOR NAME: Angela Tang TELEPHONE: (310) 337-4379 LICENSING EVALUATOR SIGNATURE: DATE: 02/14/2014 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: ~~rif?4) Page: 3of6 STATE OF CALIFORNIA• HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVlCES COMMUNITY CARE UCENSING DMSION FACILITY EVALUATION REPORT (Cont) CCLD Regional Office, 6167 BRISTOL PAAKWA.Y lii4(Hl CULVER CrrY, CA 90230 FACIUTY NAME: CRENSHAW TOT ACADEMY FACILITY NUMBER: 191804084 VISIT DATE: 03/1212013 NARRATIVE 1 2 3 4 The licensee lives in the building next door which shares common grounds with the child care center and the home was Inspected and this CS observed males clothing, deodorant, and cologne in one of the bedrooms and the licensee stated the items belonged to her adult son. The licensee Is advised if her son Jives on the. grounds and/or is present, or has frequent visits, he is required to be fingerprinted. 5 6 7 8 9 CS Cooper and LPA Tang observed loose hanging ll1e on the ceiling in the computer room and loose exposed wires. The licensee uses the room for changing the children. 10 11 12 13 14 15 The overall facility requires cleaning and repairs to prevent injury to the children and to protect the health and safety of the children in care. Exit interview conducted and a copy of the report was left with the licensee. 16 17 18 19 20 21 22 23 .24 25 26 27 28 29 30 31 32 SUPERVISOR'S NAME: Carta Caldwell TELEPHONE: {31 0} 337-4351· LICENSING EVALUATOR NAME: Cassandra Cooper TELEPHONE: {310} 337-4354 LICENSING EVALUATOR SIGNATURE: OjJ DATE: 03/12/2013 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/12/2013 LICB09 (FASI· (06/1J4) Page: 4 ofS STATE OF CAUFORNIAaHEALTH AND HUMAN SERVICES AGENCY CAUFORNlA DEPARTMENT OF SOCIAL SERVICES COMMUNtTY CARE UCENSlNG DrYIStON FACILITY EVALUATION REPORT (Cont) CCLD R&glonal Office, 6167 BRISTOL PARKWAY #1400 CULVER CITY,CA 90230 FACIUTY NAME: CRENSHAW TOT ACADEMY FACILITY NUMBER: 191804084 VISIT DATE: 03/12/2013 DEFICIENCY INFORMATION FOR THIS PAGE: Deficiency Typo POC Due Date/ Section Number Type A 03/14/2013 Section Cited 101238(a) Type A 03/14/2013 Section CHed 101215.1(m) 1 Buildings and Grounds: The child care center shall 1 The licensee was informed to remove the school 2 be clean, safe, sanitary and In good repair at all 2 bus that she stated has a flat tire. The licensee 3 stated she will go buy a tire and move the bus on 3 times. CS Cooper and LPA Tang observed a 4 school bus sitting In the play area that also has a 4 the street. 5 5 child's ball underneath the school bus. 6 7 6 1 Child Care Center Director Qualifications and 2 Duties: A child cere center director shall complete 3 15 hours of Health and Safety training. The 4 Director/Licensee Robertjean Lenox did not have 5 current First Aid/CPR. 1 The licensee Is required to renew ihe first aid/CPR 2 cards and submit a copy to the Regional Office. 3 6 7 Type A 03/14/2013 Section CHad 101238(a) PLAN OF CORRECTIONS(POCs) DEFICIENCIES 7 4 5 6 7 1 Buildings and Grounds: The child care center shall 2 be clean, safe, sanitary and in good repair at all 3 times. CS Ccoper and LPA Tang observed the 4 carpet rolled back from the floor In several areas of 5 the facility and In the play area. · 5 6 7 6 7 1 The licensee is required to remove and or replace 2 the rolled up carpet to prevent tripping. 3 4 1 Buildings and Grounds: The child care center shall 1 The licensee was informed to replace the tile. Type A 03/14/2013 SocUon Cited 101238(a) 2 be clean, safe, sanitary and In good repair at all 2 3 times. CS Cooper and LPA Tang observed the tile 3 4 in the bathroom near the toilet rolled up and 4 5 mildewed. 5 6 6 7 7 Failure to correct the cited deflclency(ies), on or before the Plan of CorrecUon (POC) due date, may result In a civil penalty assessment. SUPERVISOR'S NAME: Caria Caldwell TELEPHONE: (310) 337-4351 LICENSING EVALUATOR NAME: Cassandra Cooper TELEPHONE: (310) 337-4354 UCENSING EVALUATOR SIGNATURE: DATE: 03/12/2013 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REf'RESENTATIVE SIGNATURE: DATE: 03112/2013 This Notice must ba posted for 30 days LICB09 {FAS) • (06104) Page: 5 of6 STATE OF CAUFORN!A.· HEALTH AND HUMAN SERVICES AGENCY CAUFORNIA.DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DMSION FACILITY EVALUATION REPORT (Cont) CCLD Regional otflca, 6167 BRISTOL PARKWAY #400 CULVER CITY, CA 90230 FACILITY NAME: CRENSHAW TOT ACADEMY FACILITY NUMBER: 191804084 VISIT DATE: 03/12/2013 DEFICIENCY INFORMATION FOR THIS PAGE: Deficiency Type POe Due Date/ Section Number DEFICIENCIES PLAN OF CORRECTIONS(POCs) 1 2 3 4 Type A 03114/2013 Section Cited 101217(a) 1 The licensee was Informed to get a personnel file Personnel Records: Personnel records shall be 2 for staff Felicia Sparks. maintained on the licen~ee. admlnlslrator, and 3 each employee, and shall contain specified Information. The licensee did not have a personne14 5 folder for her staff Felicia Sparks who she indicated 5 6 was a qualified teacher. 6 7 7 Type A 03/14/2013 Section Cited 101238(a) 1 Buildings and Grounds. The child care center shall 2 be clean, safe, sanitary and in good repair at all 3 times. The kitchen and the computer room were 4 made accessible. The licensee put up a baby gate 5 up to block the kitchen during the visit and the gate 6 was observed to be broken and unstable. 7 Type A 03/14/2013 Section Cltad 10123B(a) 1 2 3 4 1 The licensee provided a sturdy removable gate tq 2 keep the kitchen and the computer room 3 Inaccessible to the day care children. 4 5 6 7 Buildings and Grounds. The child care center shall be ciean, safe, sanitary and In good repair at all times. CS Cooper and LPA Tang observed loose hanging tile on the ceiling in the computer room 5 and loose exposed wires. The licensee uses the 6 room for changing the children. 1 The licensee stated she will replace the loose and 2 hanging tiles and remove the computers. 3 4 5 6 1 2 3 4 1 2 3 4 5 5 6 6 7 7 7 7 Failune to cornect the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may ne~;ult in a civil penalty assessment. SUPERVISOR'S NAME: Carla Caldwell TELEPHONE: (31 0) 337·4351 LICENSING EVALUATOR NAME: Cassandra Cooper TELEPHONE: (310) 337-4354 LICENSING EVALUATOR SIGNATURE: (jJ DATE: 03/12/2013 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACIUTY REPRESENTATIVE SIGNATURE: ·If{ DATE: 03/12/2013 This Notice must be posted for 30 days LICII\.'r' . DATE: 03/15/201 0 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: ;f~~~ This Notice must be posted for 30 days UCBDt (FAS)- (06104) DATE: 03/15/2010 STATE OF CALJFORNIA ~HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE UCENSING DIVISION LADAYCAR&NO.WEST, 6167 BRISTOLPARKWAYt1400 CULVER CJTY, CA 90230 This is an official report of an unannounced VisiVinvestigatlon of a complaint received in our office on 03/0412010 and conducted by Evaluator Angela Tang PUBLIC COMPLAINT CONTROL NUMBER: 30-CC-20100304101222 FACILITY NAME: CRENSHAW TOT ACADEMY ADMINISTRATOR: LENOX, ROBERTJEAN D. ADDRESS: 5152 CRENSHAW BLVD. CITY: LOS ANGELES 44 CAPACITY: MET WITH: Robeijean Lenox FACILITY NUMBER: FACILITY TYPE: TELEPHONE: ZIP CODE: STATE: CENSUS:30 DATE: UNANNOUNCED TIME VISIT BEGAN: TIME COMPLETED: 191a04084 850 (323) 299-6705 90043 03/15/2010 11:35AM 04:15PM ALLEGATION($): 1 Out of Ratio (adult to child) 2 3 4 5 6 7 8 9 INVESTIGATION FINDINGS: 1 Licensing Program Analyst (LPA) A. Tang went to the facility and met with licensee Ms. RobertJean Lenox for 2 the purpose of Investigating the above complaint allegation regarding OUT-OF-RATIO teacher to child. This 3 facility is required to abide by Title 5 ( Dept. of Education) Regulations as long as they are receiving Trtle 5 4 funding) . Community Care Licensing is required to enforce these ratios. Under Trtle 5, staffing/teachers are 5 required to supervise the groups of children. 1 Teacher to a children for the 3-5 yr olds group per Section 6 18290 ofTitle 5 Regulation. Findings today: Observed 1 teacher with 12 children eating inside while the 7 Director was not in the building. There was a cook who was helping to serve the food and going from the room a to the kitchen. He identified himself as cook and was observed by the LPA to be sweeping/mopping floor. 9 He did not identify hiself and a teacher or assistant and he does not show any units In his file. At the end of 10 the visit, (after three hours at the facility, Ms. Lenox stated he was an aide but by this time this lnfonnation was 11 not credible to the LPA. It appears he is wearing two (See next page· continued.) 12 13 Substantiated SUPERVISOR'S NAME: Mary Ruiz Estimated Days of Completion: TELEPHONE: (310) 337-4335 LICENSING EVALUATOR NAME: Angela Tang TELEPHONE: (310) 337·4379 LICENSING EVALUATOR SIGNATURE: DATE: 03/15/2010 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: tf'~~~ DATE: 03/15/2010 This report muat be available at Child Care and Group Home facilities for public review for 3 years. UC9099 (FAS) ~ (06104) Page: 1 of 4 STATE OF CAUFORNIA- HEAl.TH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE UCENSING DMSION COMPLAINT INVESTIGATION REPORT (Cont) t..A. DAYCARE-NO.WEST, 61fl7 BRISTOL PARKWAY #COO CULVER CITY, CA 90230 This Is an official report of an unannounced visit/Investigation of a complaint received in our office on 03/04/2010 and conducted by Evaluator Angela Tang PUBLIC COMPLAINT CONTROL NUMBER: 30-CC-20100304101222 FACILITY NAME: CRENSHAW TOT ACADEMY ADMINISTRATOR: LENOX, ROBERTJEAN D. ADDRESS: 5152 CRENSHAW BLVD. CITY: LOS ANGELES CAPACITY: 44 MET WITH: Ms. Robbiejean Lenox STATE: CENSUS: 30. UNANNOUNCED FACILITY NUMBER: FACILITY TYPE: TELEPHONE: ZIP CODE: DATE: TIME VISIT BEGAN: TIME COMPLETED: 191804084 850 (323) 299-6705 90043 03/15/2010 11:35 AM 04:15PM ALLEGATION(S): 1 Teacher Aide Qualifications and Duties - Aides been seen left in the classroom alone supervising children. 2 3 4 5 6 7 8 9 INVESTIGATION FINDINGS: 1 The Licensing Program Analyst (LPA) A. Tang went to the facility and met with Licensee Ms.Robertjean Lenox 2 for the purposes of investigating the complaint that came in 3/4/2010 regarding an allegations of alde(s)(Not 3 fully qualified teachers) left in a room{s) alone, supervising children alone. This would be against Title 22 4 Regulation as stated below. 5 Per Title 22 Section 101216.2 TEACHER AIDE QUALIFICATIONS AND DUTIES 6 (e) An aide shall work only under the direct supervision of a teacher. Based on interviews and information 7 taken this does happen sometimes. This practice is to immediately discontinue. This is a Type A 8 deficiency. 9 Whenever a Type A deficiency is cited -Upon receipt, licensee shall post and provide copies of this licensing 10 report to parents/guardians of the children in care at the facility and to parents/guardians of children newly 11 enrolled at the facility during the next 12 months. 12 13 Estimated Days of Completion: Substantiated TELEPHONE: (310) 337-4335 SUPERVISOR'S NAME: Mary Ruiz LICENSING EVALUATOR NAME: Angela Tang TELEPHONE: (310) 337-437g LICENSING EVALUATOR SIGNATURE: DATE: 03/15/2010 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: ;(~~~ DATE: 03/15/2010 This report must be available at Child Care and Group Home facilities for public review for 3 years. UC9099 (FAS) ~ (Ofill}4) Page: 2 of 4 Control Number 30-CC-20100304101222 CAUFORNJA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE UCENSING DIVISION STATE OF CALIFORNiA· HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont) L.A. DAYCARE..JIO.WEST, 6167 BRJSTOL PARKWAY 1400 CULVER CITY. CA 90230 FACILITY NAME: CRENSHAW TOT ACADEMY DEFICIENCY INFORMATION FOR THIS PAGE: FACILITY NUMBER: 191804084 VISIT DATE: 03/15/2010 Deficiency Type POC Due Date I Section Number Type A 03/15/2010 Section Cited 101216.3(0)(1) DEFICIENCIES PLAN OF CORRECTIONS(POCs) 1 TEACHER-CHILD RATIO· the Licensing Program 2 Analyst observed that according to Title 5 3 Regulation the teacher-to-child ratios were not 4 being followed at all times. It was observed that 1 5 teacher was supervising12 children in 1 group. 6 (Title 5 requles 1 teacher to 8 children In this age 7 group of 3- 5. ) 1 Licensee Ms. Lenox previously agreed (last yeat 2 2009) on a prior visit, to maintain appropriate 3 teacher-to-child ratios spadfied under Title 5 4 Regulations if she wants to continue keeping any 5 Title 5 funded children. Ms. Lenox had 6 previously agreed to write a short statement using 7 language in 8 THIS IS A TYPE A violation and a REPEAT 8 Section 101216.3 Teacher-Child-Ratio for Title 5 9 VIOLATION WITHIN 12 MONTHS therefore a civil 9 acknowledging that she has read this Section, Type A 03/15/2010 Section Cited 101216.2 10 penalty of$150. is being assassed today. 11 12 13 10 11 12 13 14 14 understands It and will abide by il As this agreement was broken again within 12 months, a monetary civil penalty is required to be imposed this time. 1 TEACHER AIDE QUALIFICATIONS AND DUTIES 1 Licensee Ms. Lenox agrees to read this section of 2 Title 22 and summarize the section that mentions 2 • LPA interviewed staff and coupled with the 3 what aides are permitted and not permitted to do 3 complainanats observations, there is enough 4 evidence to substantiate that Aides sometimes do 4 under Title ww. This plan of correct Is due by 5 3/25/10 to the Licensing Office, Atin, LPA. A. Tang 5 watch children alone which Is against State 6 Regulation. Further violations under this Section 6 7 7 Cited may lead to civil 8 penalties under this section. 8 9 9 10 11 10 12 12 13 14 14 11 1~ Failure to cornact the cited deflciency(les), on or before the Plan of Correction (POC) due date, may nasult In a civil penalty assessment. SUPERVISOR'S NAME: Mary Rulz TELEPHONE: {310) 337-4335 LICENSING EVALUATOR NAME: Angela Tang TELEPHONE: (310) 337-4379 LICENSING EVALUATOR SIGNATURE: a..--L""-'1.-- DATE: 03/15/2010 I acknowledge receipt of this fonn and understand my appeal rights as explained and nacelved. FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/15/2010 This Notice must be posted for 30 days UC9000 (FAS) • (06104) Pago: 3 of4 Control Number 30-CC-20100304101222 STATE OF CALIFORNIA~ HEALTH AND -HUMAN SERVICES AGENCY CAUFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE UCENSING DMSION COMPLAINT INVESTIGATION REPORT (Cont) L.A. DAYCARE-NO.WEST, 6167 BmSTOL PARKWAYt£400 CULVER CITY, CA 90230 FACILITY NA~E: CRENSHAW TOT ACADEMY FACILITY NUMBER: 191804084 VISIT DATE: 03/1512010 NARRATIVE 1 (continued from page 1 of Ratio allegation) 2 3 hats and he was observed only cooking, sweeping and emptying the trash today. 4 5 6 Per Title 22, "Persons employed for clerical, housekeeping and maintenance functions shall not be Included as teachers In the teacher-child retia." B 9 10 11 12 13 14 15 'Upon receipt of this report, the licensee shall post and provide copies of this licensing report to parents/guardians of tha children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. 7 A copy of this report & and appeal rights given to Ms. Lenox 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 SUPERVISOR'S NAME: Mary Ruiz TELEPHONE: (310) 337-4335 LICENSING EVALUATOR NAME: Angela Tang TELEPHONE: (310) 337-4379 LICENSING EVALUATOR SIGNATURE: q.,. \""-...,..'}- DATE: 03/15/2010 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/15/2010 LIC0099 (FAS) • (OGJ04) Page: 4of4 STATE OF CAUFORNIA- HEAL.TH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE UCENSING DMSION FACILITY EVALUATION REPORT L.A. DAYCARE-NO.WEST, 6167 BRISTOL PARKWAY ~MOO CULVER CITY, CA 90230 FACILITY NAME: CRENSHAW TOT ACADEMY ADMINISTRATOR: LENOX, ROBERTJEAN D. ADDRESS: 5152 CRENSHAW BLVD. CITY: LOS ANGELES STATE: CA CAPACITY: 44 CENSUS: 23 TYPE OF VISIT: Annual/Required UNANNOUNCED MET WITH: Director Robertjean Lenox and Teacher Emma Wakefield, Teacher Vanessa Adams and Assist. Lula Osson FACILITY NUMBER: FACILITY TYPE: TELEPHONE: ZIP CODE: DATE: TIME BEGAN: 191804084 850 {323) 299-6705 90043 09/09/2009 09:00AM TIME COMPLETED: 01:40PM NARRATIVE 1 Licensing Program Analyst {LPA) Angela Tang met with Director Robertjean Lenox and staff for the 2 purposes of an AnnuaURequired visit. There were 23 children together in the facility. There were four 3 teachers total. {Met the teacher-child rafios for Title 5 also.). The sign in sheets were checked and were in substantial compliance with the parents signing in their children. LPA A. Tang recommended Director Ms. 4 Lenox to more clearly designate the TiUe 22 from the Tile 5 children as there are different teacher-child ratio 5 6 requirements for Trtle 5 children. Per Ms. Lenox, there are only two Title 22 children at this time and one Is 7 leaving soon. She states she is trying to phase out the Title 22 children at this time at this facility and make 8 it all Title 5 for simplicity as she will try to open up the Trtle 22 facility in the near future. 9 10 Upon arrival LPA met with the staff including Vanessa Adams, Theresa Wadel!, Emma Wakefield and 11 Assistant Lula Osson. The teachers had the children all together when LPA arrived. Soon thereafier the 12 children were separated into groups of 7, 5 and 11 {with 2 teachers). The CPR and 1st Aid certificates were 13 current for the Director and staff. The director was next door, less than 1 minute away on the premises. 14 LPA toured the facility indoors and outdoons. The play yard was viewed for safety, cleanliness and 15 age-appropriate toys and no vehicles parked on the premises. A review of a sample of the children 16 records/staff records was made to see how records are kept. The children's files that were reviewed were 17 had the required documents. Ms. Lenox was informed that the forms must also be viewed for any obvious 18 omissions of information- {only one form was observed missing date of birth, ss# etc.) This will be 19 corrected when parent picks up child today. 20 21 Per discussion between LPA Tang and Ms. Lenox the toddler options is dissolved. The paperwork for this 22 request was turned in previously but not yet been processed, therefore the comments on the profilenicense 23 still states • toddler option" but there are no toddlers. This option will be deleted when LPA Tang is able to 24 change the comments next week. { SEE NEXT PAGE) 25 SUPERVISOR'S NAME: Mary Ruiz TELEPHONE: (310) 337-4335 LICENSING EVALUATOR NAME: Angela Tang TELEPHONE: {310) 337-4379 LICENSING EVALUATOR SIGNATIJRE: DATE: 09/09/2009 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: ~11f-- DATE: 09/09/2009 This report must be available at Child Care and Group Home facilities for public review for 3 years. UC809 (FAS) • (06104) Pane: 1 of3 STATE OF CAUFORNIA ·HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DMSlON FACILITY EVALUATION REPORT (Cont) L.A. DAVCARE-NO,WEST. 6167 BRISTOL PARKWAY#400 CULVER CITY, CA90230 FACILITY NAME: CRENSHAW TOT ACADEMY DEFICIENCY INFORMATION FOR THIS PAGE: Deficiency Type POC Duo Date I Section Number DEFICIENCIES Type A 09/14/2009 Section Cited 101238g 1 Buildings and Grounds- LPA observed cleaning 2 supplies under sink in kitchen cabinet that was 3 unlocked and the kitchen was accessible with no 4 gatos. Per Title 22 this is an immediate health 5 risk to chlldmn In care. Disinfectants, cleaning 6 solutions, poisons and other Items that could pose 7 a danger If readily available to 8 children shall be stored where inaccessible to 9 children. 10 11 12 13 14 TypeS 09/2512009 Section Cited 101217b 1 2 3 4 5 6 7 PERSONNEL RECORDS- LOA observed no Health ScreeningfrB Clearance for Teacher ·Earlene Wells. This tb. test and Health Screening form needs to be no older than 1 year old. 1 2 3 4 5 6 7 FACILITY NUMBER: 191804084 VISIT DATE: 09/09/2009 PLAN OF CORRECTIONS(POCs) 1 2 3 4 5 6 7 Director Lenox agrees to put a child safely lock or latch on the cabinet under the sink as soon as possible but no later than 9114/09 and to take a picture and submit tt to the Department by that date. 8 9 10 11 12 1o 14 1 Director Lenox states she will see that teacher 2 Wells has this medical done as soon as possible 3 but no later than Sept 25 th. Copy of both the 4 Health Scmening Report and the tb. test (may be 5 on the same document) shall be submitted to the 6 Licensing office by this date. 7 1 2 3 4 5 6 7 Failure to correct the cited deficlency(ies), on or before the Plan of Correction (POC) due date, may result In a civil penalty assessment. SUPERVISOR'S NAME: Mary Ruiz TELEPHONE: (310).337-4335 LICENSING EVALUATOR NAME: Angela Tang TELEPHONE: (310) 337-4379 LICENSING EVALUATOR SIGNATURE: DATE: 09/09/2009 I acknowledge receipt of this fonn and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/09/2009 This Notice must be posted for 30 days UC809 (FAS) ~ (00104) Page: 2 of3 STATE OF CALIFORNIA~ HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE UCENSING DIVISION FACILITY EVALUATION REPORT (Cont) L.A. DAYCA.R.E-NO.WEST, 8167 BRISTOL PARKWAY 11-100 CULVER CITY. CA 90231l FACIUTY NAME: CRENSHAW TOT ACADEMY FACILITY NUMBER: 191804084 VISIT DATE: 09/09/2009 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 The inside of facility was checked. The refrigerators and freezers checked for temperature, storage and expiration dates/ freshness on food packages. The refrigerator Temp. was 33 degrees Fahrenheit and the freezer Temp 12 degrees Fahrenheit. The kitchen Is in a separate room from the refrigerator and freezer. Food preparation areas were Inspected and separate storage of food vs. cleaning compounds/toxins. The cabinet that stores the cleaning Items under the kitchen sink Is accessible and off of the hallway. Children use that hallway to reach the rest-room or to go outside. Detergent, bleach and other cleaning supplies are stored there. Although Director Lenox states children do not go in the kitchen it Is still accessible. The children's bathroom were Inspected for running water, temperature of water (not too hot}, flushing toilets, soap and presence of paper towels. The children's bathroom was In compliance at the time of the visit. The staff bathroom needed soap replacement which was done during the visit. The smoke detectors checked. The large fire extinguisher charge and mounted. LightingNentilation and temperature were evaluated and were satisfactory during the summer. There were separate storage cubbies for all children. Our website address to get forms and see the regulations is: www.ccld.ca.gov Outdoor equipment Inspected for cushioning material, age appropriateness and good repair. available In a water fountain In the hallway. There were plenty of cots for the children. Drinking water Exit Interview will be mailed to the Director due to printer problems. APpeal rights also given to Ms. Lenox. This report, UC 809, 809C and 609D are to be kept on file for a minimum of 3 years. 27 28 29 30 31 32 SUPERVISOR'S NAME: Mary Ruiz TELEPHONE: (310} 337-4335 LICENSING EVALUATOR NAME: Angela Tang TELEPHONE: (310} 337-4379 LICENSING EVALUATOR SIGNATURE: DATE: 09/09/2009 I acknowledge recelpt,of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/09/2009 LIC609(FAS) ·106104) Page: 3 of3 STATE OF CALIFORNIA~ HEALTH AND HUMAN SERVICES AGENCY CAUFORNJA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE UCENSING DMSION FACILITY EVALUATION REPORT LA. DAYCARE-NO.WEST. 6161 BRISTOL PARKWAY #.COO CULVER CITY, CA 10.230 FACILITY NAME: CRENSHAW TOT ACADEMY ADMINISTRATOR: LENOX, ROBERTJEAN D. ADDRESS: 5152 CRENSHAW BLVD. CITY: LOS ANGELES CAPACITY: 44 TYPE OF VISIT: Case Management MET WITH: RobertJean Lenox 1 2 3 4 5 6 7 8 9 10 11 12 13 FACILITY NUMBER: FACILITY TYPE: TELEPHONE: STATE:CA ZIP CODE: CENSUS: 10 DATE: UNANNOUNCED TIME BEGAN: TIME COMPLETED: 191804084 850 (323) 299-6705 90043 06/30/2009 09:20AM 05:15PM NARRATIVE (This Is a copy of a report typed electronically at the facility on 6/30/2009 which erased during the visit after 5:00 pm, but a copy had been printed before It eresed that Director, RobertJean Lenox signed at the facility. Original signature is In the public file.) Licensing Program Analyst A. Tang met with Director RobertJean Lenox for a case management visit deficiencies during a visit concerning other issues. During the visit it was observed that the back play yard had a carpet that children were playing on that appeared unclean and a bench near the carpet by the wall that had trash under it. Also the changing table in the toddler room In the back" was not near arms length of the sink. Also the vlnyVplastic on the changing table was so wom that it will not clean effectively. This should be replaced so it can be cleaned properly to prevent contamination. See Corrections on following page, lie 8090. 14 15 16 17 18 19 20 21 22 23 24 25 SUPERVISOR'S NAME: Mary Rulz TELEPHONE: (310) 337-4335 LICENSING EVALUATOR NAME: Angela Tang TELEPHONE: (310) 337-4379 LICENSING EVALUATOR SIGNATIJRE: DATE: 06/30/2009 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/30/2009 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC009 {FAS) ~ {00104) Pag111: 1 of2 STATE OF CALIFORNIA ~HEALTH AND HUMAN SERVICES AGENCY CAUFORNIA DEPARTMENT OF SOCIAL SERVICES COUMUNITY CARE LICENSING DMSION FACILITY EVALUATION REPORT (Cont) LA OAVCAR.E·NO.WEST, G1&7 BfUSTOL PJJUl Pkwy, #400 Culver City, CA. 90230 FACILITY NAME: CRENSHAW TOT ACADEMY POC Due Date I Section Number 1 2 3 Licensee Is instructed to replace throwing items within 3 4 fveeks, throwing away the play equipment with sharp edges 5 mmediately. 6 7 08/03/2006 Date Cleared I Comments PLAN OF CORRECTIONS(POCs) 08/03/2006 Section Cited FACILITY NUMBER: 191804084 VISIT DATE: 07/13/2006 1 4 removed 1 2 3 ~censee Is to clean the mats with soap and water and the 4 g~unds swept and all trash/debris removed from the 5 playground. . 6 7 08/03/2006 1 Section Cited 2 4 5 6 08/13/2006 1 Cleared By Visit- Mats were obseJVed to ~ be cleans/wiped down and all trash and papers removed from playground. 4 08/13/2006 1 Cleared By Visit- There were no trash 3 lcensee will cover all trash cans with tightiy fitted tops. ~ cans observed that were uncovered with 4 7 1 SecUon Cited 08/11/2006 · 2 Cleared By Visit· Observed all play equipment that was damaged had been 3 2 3 4 5 6 7 1 2 3 4 trash. Control Number 30-CC-20060703111532 STATE OF CALIFORNIA- HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE UCENSING DMS«lN FACILITY EVALUATION REPORT LA Northwast CCL, 6167 Bristol Pkwy, #400 Culver City, CA 80230 FACILITY NAME: CRENSHAW TOT ACADEMY ADMINISTRATOR: LENOX, ROBERTJEAN D. ADDRESS: 5152 CRENSHAW BLVD. CITY: LOS ANGELES CAPACITY: 44 TYPE OF VISIT: Complaint MET WITH: Emma Wakefield STATE:CA CENSUS: 12 UNANNOUNCED FACILITY NUMBER: FACILITY TYPE: TELEPHONE: ZIP CODE: DATE: TIME BEGAN: TIME COMPLETED: 191804084 850 (323) 299-6705 90043 07/13/2006 02:15PM 06:30PM NARRATIVE 1 LPA Tang and Edwards made the following observations while on complaint visit. 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 The teacher, Emma Wakefield's fingerprints were not associated with the facility or active in the LIS system. The was not aware she was not active. As she was not active nor associated, this involves a civil penally assessment Also LPA's observed were trash cans uncovered. One in particular that had old food items and milk cartons near the water fountain in the back play area. All trash cans that are used for disposing food items need tightly fitting covers Also LPA Tang observed, a container of alcohol and hydrogen peroxide found in toddler room within reach accessible to a taller child. These items were removed from the room by teacher and put in storage cabinet where it belonged while LPA's were present.. 22 23 24 25~------------------------------------------------------SUPERVISOR'S NAME: Bill Mayeda TELEPHONE: (310) 337-4335 LICENSING EVALUATOR NAME: Angela Tang TELEPHONE: (310) 337-4379 LICENSING EVALUATOR SIGNATURE: ... SIGNED*** DATE: 07/13/2006 I acknowledge receipt of this form and understand my licensing appeal righta as explained and received. FACILITY REPRESENTATIVE SIGNATURE: ... SIGNED ... DATE: 07/13/2006 This report must be available at the facility for public review (3 years). UCBOO (FAS)- (011104) Page: 1 of 2 Control Number 30-CC-20060703111532 STATE OF CALIFORNIA~ HEALTH AND HUMAN SERVICES AGENCY CAUFORNJA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DMstON FACILITY EVALUATION REPORT (Cont) LA Northwest CCL. 6167 Bristol Pkwy,l400 Culver City, CA 10230 FACILITY NAME: CRENSHAW TOT ACADEMY DEFICIENCY INFORMATION FOR THIS PAGE: Deficiency Type POC Due Date I Section Number Type A 08/15/2006 Section Cited 101170 TypeS 08/03/2008 Section Cited 101238.2(c)(dXe) FACILITY NUMBER: 191804084 VISIT DATE: 07/13/2006 PLAN OF CORRECTIONS(POCs) DEFICIENCIES 1 The teacher, Emma Wakefield's fingerprints were 2 not associated with the facility or active in the LIS 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 system. The was not aware she was not active. AS she was not active nor associated, this Involves 4 5 a civil penalty assessment. 6 7 AJso LPA's observed were trash cans uncoverGd. One in particular that had old food items and milk cartons near the water fountain in the back play area. All trash cans that are used fur disposing food nems need tightly fitting covers 1 Licensee shall purchase or find the tops to the 2 trash cans and cover the ones used for food items 3 (non paper only Items ). 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 1 2 3 4 5 6 7 4 5 6 7 Emma Wakefield, teacher should be fingerprinted (Uve Scan) immediately. She neads to be fingerprinted before she returns to child care In August 15th. (she will be on vacation unm then). Failure to correct the cited deficlency(les), on or before the Plan of Correction (POC) due date, may result In a civil penalty assessment. SUPERVISOR'S NAME: Bill Mayeda TELEPHONE: (310) 337-4335 LICENSING EVALUATOR NAME: Angela Tang TELEPHONE: (310) 337-4379 LICEI\ISING EVALUATOR SIGNATURE: ... SIGNED*"* DATE: 07/13/2006 I acknowledge receipt of this fonm and understand my appeal righte as explained and received. FACILITY REPRESENTATIVE SIGNATURE: ... SIGNED*'* This Notice must be posted for 30 days DATE: 07/13/2006 STATE OF CAUFORNJA· HEALTH AND HUMAN SERVICES AGENCY CAUFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE UCENSING DMSJON CIVIL PENALTV ASSESSMENT (Crimin~l Background Clearance) LA Northweat CCL, 6167 Bristol Pkwy, 1400 CulverCify,CA 9023D FACIUTY NAME DATE CRENSHAW TOT ACADEMY 07/1312006 FACILITY ADDRESS CITY 5152 CRENSHAW BLVD. LOS ANGELES STATE ZIP CODE CA 90043 UCENSEE{S)IOPERATOR FACILITY NUMBER 191804084 ECONOMIC SERVICES INC. Immediate civil penaltles can be assessed against any licansaa for failure to comply with criminal background check requirements and against family child care ucensaas for failure to comply with parent/guardian notification and visit report posting requlrements.See the back of this fonn for specifics. On this date you have been found in violation of one or more requirements for which an Immediate civil penalty Is warranted. See the Facility Evaluation Report (UC 809) issued on this date. You are hereby notitied that a civil penalty has been assessed. [g) $100 immediate Civil Penalty i>er person for allowing any person (who Is subject to a background check) to work, reside or volunteer without a criminal record clearance or exemption. Maximum 5 daya for first violation. 0 $100 Immediate Civil Penalty per person for allowing any person (who Is subject to a background check) to work, reside or volunteer without a criminal record clearance or exemption. Maximum of 30 days for subsequent violations. 0 $100 Immediate Civil Penalty per person for allowing a cleared or exempted person to work, reside or volunteer before requesting a clearance transfer or before receiving approval of an exemption transfer. 0 $100 Immediate Civil Penalty per parent/authorized representative for failure to provide 'Family Child Care Home Addendum to Notification of Parents' Rights (Regarding Exclusion)'. 0 $100 immediate Civil Penalty per parent/authorized representative for failure to provide "Family Child Care Home Addendum to Notification of Parents' Rights (Regarding Reinstatement)". 0 0 0 $100 Immediate Civil Penalty per parent/authorized representative for failure to obtain signature indicating receipt of Addendum. $100 immediate Civil Penalty for failure to provide signed addendum to the Department when requested. $100 immediate Civil Penalty for failure to post the "Notice of Site Visit Report" for 30 consecutive days. X$100 = $100.00 Penalty number of days X$100 = $0.00 Penalty number of daya X$100= $0.00 Penalty Individual #1 Emma Wakefield number ofdaya Individual #2 Individual #3 1 Total $100.00 YOU WILL RECEIVE A BILL IN THE MAIL. DO NOT SEND MONEY UNTIL YOU RECEIVE YOUR B1LL! NAME OF LICENSING PROGRAM ANALYST Angela Tang SIGNATURE OF LICENSING PROGRAM ANALYST NAME OF FACILITY REPRESENTATlVEJTITLE SIGNATURE OF FACILITY REPRESENTATIVE SUPERVISOR REVIEW SIGNATURE (FOR INTERNAL USE ONLY) DATE 11TLE ucma (FAS). (05/06) Page: 1 of2 STATE OF CALIFORNtA ·HEALTH AND HUMAN SERVICES AGENCY CAUFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE UCENSING DMSION FACILITY EVALUATION REPORT LA Northwest CCL, 6167 Bristol Pkwy.IMOO CutverC , CA 90230 FACILITY NAME: CRENSHAW TOT ACADEMY ADMINISTRATOR: LENOX, ROBERTJEAN D. ADDRESS: 5152 CRENSHAW BLVD. CITY: LOS ANGELES CAPACITY: 44 TYPE OF VISIT: MET WITH: Robert Jean Lenox & M. Broussard STATE:CA CENSUS: 21 UNANNOUNCED FACILITY NUMBER: FACIUTY TYPE: TELEPHONE: ZIP CODE: DATE: TIME BEGAN: TIME COMPLETED: 191804084 850 (323) 299-6705 90043 09/15/2005 09:45AM 12:15 PM NARRATIVE 1 2 3 4 5 6 7 8 LPA Jennifer Hua conducted a site evaluation for the purposes of an annual required visit Upon·arrival LPA met with head teacher M. Broussar, director was on her way to facility. LPA tour the facility indoors and outdoors. Sample review of children records/staff records. Observance of the children were as follows: There ·were 11 children In classroom #1 supervised by teacher M. Broussard, in the toddler classroom there were 10 children, supervised by teacher T. Waddell. This classroom Is out of ratio. LPA also observed cook, Dionesha Simmons at facility, who does not have fingerprint clearance on file. The children have access to all the facility with the exception of the staff bathrooms, storage area & kitchen. The outside play area is enclosed with chain link fence. 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Furniture/Equipment inspected for cleanliness, age appropriateness, good repair. LlghtlngNentilation were evaluated. Napping/Bedding equipment were inspected for cleanliness, age appropriateness, good repair and storage. Storage for children's belonging's, bathroom facilnies were inspected. CPR/First aid, supplies, lunch/snack menu available for review, fire extinguishers and evacuation plans were reviewed. Food preparation area inspected for cleanliness, proper equipment and protection against contamination. Storage area inspected for toxins/cleaning compounds inaccessibility. Outdoor equipment Inspected for cushioning material, age appropriateness and good repair. Required shaded areas, drinking water availablltty and fencing were inspected. Play area inspected for safety, potential hazards and Inaccessibility to bodies of water. LPA explained criminal records/child abuse index clearances, child abuse reporting requirements, recent regulatory ci]anges including any exemptions. Deficiencies are cited on 8090. NOTICE of Site Visit form was provided and explained. SUPERVISOR'S NAME: Bill Mayeda TELEPHONE: (310) 337-4341 UCENSING EVALUATOR NAME: Jennifer Hua TELEPHONE: (310} 337-4365 LICENSING EVALUATOR SIGNATURE: ... SIGNED- DATE: 09/15/2005 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: ***SIGNED*** DATE: 09/15/2005 This report must be available at the facility for public review (3 years). UC809 (FAS). (06104) Pago:1 of3 STATE OF CAUFORNIA·HEALTH AND HUMAN SERVICES AGENCY CAUFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DMSION FACILITY EVALUATION REPORT (Cont) LA Northwest CCL, 6167 Bristol Pkwy. f.tOO Culver C , CA 90230 FACILITY NAME: CRENSHAW TOT ACADEMY DEFICIENCY INFORMATION FOR THIS PAGE: Deficiency Type POC Due Date I Section Number Type A 09/15/2005 Section Cited 101170(c) Type A 09/16/2005 Section Cited 101216.4(a)(4) TypeS 09/30/2005 Section Cited 101221 TypeB 09/30/2005 Section Cited 101217 FACILITY NUMBER: 191804084 VISIT DATE: 09/15/2005 PLAN OF CORRECTIONS(POCs) DEFICIENCIES 1 Criminal Record Clearance. Subsequent to 2 licensure, all individuals subject to criminal record 3 review shall, prior to employment or Initial presence 4 in the facility, be fingerprint cleared. LPA observed 5 ccok Dlonesha Simmons do not have fingerprint 6 clearance on file. Immediate civil penallty of 7 $100.00 was assessed. 1 Preschool Program with Toddler Component. A 2 ratio of six children to one teacher shall be 3 maintained. During "the visit, LIPA observed teacher 4 Waddell supervising 10 toddlers by herself in the 5 classroom. 1 Licensee stated that Individual shall not return to 2 facility until fingerprint cleared. 3 4 5 6 7 1 Licensee stated that will correct immediately, will 2 hire additional staff to ensure proper ratio. 3 4 5 6 6 7 7 1 Child's Records. LPA observed children flies are 2 incomplete. see (LIC 857) 3 1 Licensee stated will correct and submit proof to 2 Licensing by POC due date. 3 4 5 6 7 4 ' 1 Personnel Records. LPA observed staff files are 2 Incomplete. SEE (UC 859). 3 4 5 6 7 5 6 7 1 Licensee stated will correct and submit copies of 2 correction by POC due date. 3 4 5 6 7 Failure to correct the cited deflclency(ies), on or before the Plan of Correction (POC) due date, may result In a civil penalty assessment. SUPERVISOR'S NAME: Bill Mayeda TELEPHONE: (310) 337-4341 LICENSING EVALUATOR NAME: Jennifer Hue TELEPHONE: (310) 337-4365 LICENSING EVALUATOR SIGNATURE: ... SIGNED.,. DATE: 09/15/2005 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: ""*SIGNED"** DATE: 09/1512005 This Notice must be posted for 30 days Page: 3 of3 To Clear Additional POC's Use Button on 809-D STATE OF CALIFORNIA a HEALTH AND HUMAN SERVICES AGENCY CAWFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DMSION CLEARED POC's LA Northwest CCL, Sf07 Bristol Pkwy.l/400 Culver City, CA80230 FACILITY NUMBER: VISIT DATE: 09/15/2005 FACILITY NAME: CRENSHAW TOT ACADEMY POC Due Date I Section Number 09/15/2005 101170(c} 1 2 ! ~ngerprint Licensee stated that Individual shall not retum to facility until cleared. 5 6 7 09/16/2005 Section Cited 101216.4(a}(4} 09/30/2005 Section Cited 101221 1 2 ~ Licensee stated that will correct Immediately, will hire 5 .ddltlonal staff to ensure proper ratio. 6 7 1 2 ! :icensee stated will correct and submit proof to Licensing by POC due date. 5 6 7 09/30/2005 Section Cited 101217 Date Cleared I Comments PLAN OF CORRECTIONS(POCs) 1 2 3 1 09/20/2005 2 Individual is In LIS system,associated to 3 facilty and Is pending exemptlon. 4 1 2 3 4 1 2 3 4 1 2 Licensee stated will correct and submit copies of correction by 4 3 5 POC due date. 4 6 7 CALIFORNIA DEPARTMENT OF SOClAL SERVICES STATE OF CAliFORNIA .. HEALTH AND HUMAN SERVICES AGENCY COMMUNITY CARE UCEHS!NG DMSION FACILITY EVALUATION REPORT (Cont) LA Northweat CCL, 6167 Brfatol Pkwy.l400 Culnr C • CA 90230 FACILITY NAME: CRENSHAW TOT ACADEMY DEFICIENCY INFORMATION FOR THIS PAGE: Deficiency Type POC Due Date I Section Number TypeB 09130/2005 Section Cited 101216.1(cXAl FACILITY NUMBER: 191804084 VISIT DATE: 09/15/2005 PLAN OF CORRECTIONS(POCs) DEFICIENCIES 1 Teacher Qualifications and Duties. Teacher 2 Waddell lack 3 core child development units in 3 child. family and community. 4 5 6 7 1 2 3 1 Licensee stated will have teacher enrolled and 2 complete class. Licensee will submit Proof of 3 enrollment to licensing by POC due date. 4 5 6 7 1 4 5 2 3 4 5 6 7 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 1 2 3. 4 2 3 5 6 7 5 4 6 7 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: Bill Mayeda ·TELEPHONE: (310) 337-4341 LICENSING EVALUATOR NAME: Jennifer Hua TELEPHONE: (310) 337-4365 LICENSING EVALUATOR SIGNATURE: -SIGNED*** DATE: 09/15/2005 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: ... SIGNED ... UCS09 (FAS) -(OGIM) DATE: 09/15/2005 Page: 2 of3 STATE OF CAUFORHIA ·HEALTH AND HUMAN SERVICES AGENCY CAUFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUMTYCARE LICENSiNG DMSlON CIVIl PENALTY ASSESSMENT (Unlicensed and Criminal Background) L4. NorthWest CCL, 8167 Brietol Pkwy,INOO Culver City, CA 90230 FACILITY NAME DATE 09/15/2005 CRENSHAW TOT ACADEMY FACIUTY ADDRESS CITY 5152 CRENSHAW BLVD. LOS ANGELES STATE ZIP CODE 90043 CA FAC!UTY NUMBER UCENSEE(S)IOPERATOR ECONOMIC SERVICES INC. 191804064 UNLICENSED FACILITY Civil penalties can be assessed against any unlicensed facillly which fails to take corrective action within prescribed time periods, per Callfomla Health and Safety Code Sections 1547, 1568.03, 1568.0821, 1559.48, and 1598.891. You are hereby notified that a civil penalty has been assessed. Your facilily has been found operating without a license. This is in violation of the Callfomla Health and Safety Code Sections 1508, 1568.03, 1569.10, or 1596.80. A Notice of Operation in Violation of Law or Denial of Application was lssuadon giving notice that failure to submit a completed application or cease operation could rasult In a civil penalty. Because you failed to flle a completed application or cease operation, a civil penalty of ~ Is assessed for the pertod from through . 0 0 Residential Care Facility for the Elderty (RCFE): Since a completed application was not submitted by the 15th day, on day 16 from date of notice or letter, $100 per resident per day Is baing assessed retroactively. From day 16, $200 per residant per day Is being assessed untll a completed application Is submitted or operations cease (if you have not had a previous · application denied). 0 Residential Care Facility for the Chronically Ill (RCF-CI): An Immediate civil penalty of $100 per resident per day is being assessed. If a completed application is not submitted by the 15th day, on day 16 from date of notice or letter, $200 per resident per day Is being assessed until a completed application is submiltad or operations oaase (~you have not had a previous application danled). 0 Child Care Center, Family Child Care Home, Community Care Facility: since a completed application was not submitted by the 15th day, on day 16 from the date of notice or letter, $200 per day is being assessed until a completad application Is submitted or operations cease (If you have not had a previous application denied). CRIMINAL BACKGROUND CLEARANCE (Immediate) Civil penalties can be assessed for failure to comply with the requirement for fingerprtnting and other ortmlnal background requirements, per California Health and Safety Code Sections 1522, 1568.09, 1569.17, 1596.871 and 1596.8712. You are hereby notified that a civil penalty has been assessed. A Facillly Evaluation Report (LIC 809) was Issued on 09/1512005 giving notice that your facllily has bean found In violation of the fingerprtnting ortmlnal background clearance requirements. [gJ $100 Immediate Civil Penally per person for failure to obtain a DOJ ortmlnal record clearance or an examption. 0 $100 Immediate Civil Penalty per person for failure to request that a previously cleared or exempted person be associated to the facility. 0 $100 immediate Civil Penalty per parent/authorized raprasentatlve for failure to provide 'Family Child Care Home Addendum to Notification of Parents' Rights (Regarding Exclusion)'. 0 0 0 $100 immediate Civil Penally per perent/authorized representative for failure to provide 'Family Child Care Home Addandum to Notification of Parents' Rights (Regarding Reinstatement)'. $100 Immediate Civil Penalty par parent/authorized rapresentatlve for failure to obtain signature Indicating receipt of Addendum. $100 immediate Civil Penally for failure to provide signed addendum to the Department when requastad. ! Number of Persons X $100 = $100.00 Total Penalty YOU WILL RECEIVE A BILL IN THE MAIL. DO NOT SEND MONEY UNTIL YOU RECEIVE YOUR BILL! NAME OF LICENSING PROGRAM ANALYST NAME OF FACIUTY REPRESENTATlVEITITLE Jenn!(er Hua SIGNATURE OF LICENSING PROG~ ANALYST SIGNATURE OF FACILITY REPRESENTATIVE -SIGNEDNAUE OF DEPARTMENTAL REVIEWER AND TITLE rTLE Page:1 of2 UC421A (FAS} ~ (10/03) CIVIL PENALTY ASSESSMENT FORM CALfFORNIA DEPARTMENT OF SOCIAl. SERVICES COMMtJNtTY CARE UCENSING DMSION STATE OF CAUFORNIA- HEALTH AND HUMAN SERVICES AGENCY FACILITY EVALUATION REPORT LA Chlld Care West, 6187 Briatol Pkwy., #400 CUlver CHy• CA 90230 FACILITY NAME: CRENSHAW TOT ACADEMY ADMINISTRATOR: LENOX, ROBERTJEAN D. ADDRESS: 5152 CRENSHAW BLVD. CITY: LOS ANGELES CAPACITY: 44 TYPE OF VISIT: MET WITH: Thresa Wadel! FACILITY NUMBER: FACILITY TYPE: TELEPHONE: ZIP CODE: STATE:CA CENSUS: 8 DATE: UNANNOUNCED TIME BEGAN: TIME COMPLETED: 191804084 850 (323) 299·6705 90043 06/22/2004 12:00 PM NARRATIVE 1 2 3 4 5 6 LPA La Wonya Brown conducted a site evaluation for the purposes of an annual comprehensive visit. LPA met with Thresa Wadel!, Teacher/Acting Director who accompanied LPA on a tour of the facility inside/outside. Sample review of children records/staff records. Observance of the children were as follows: There were 8 children present under the supervision of one teacher and one cook. The children have access to all the facility with the exception of the staff bathrooms, storage area & kitchen. The outside play area is enclosed with chain link fence. 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Furniture/Equipment Inspected for cleanliness, age appropriateness, good repair. LightingNentilation were evaluated. Napping/Bedding equipment were inspected for cleanliness, age appropriateness, good repair and storage. Storage for children's belonging's, bathroom facilities were inspected. CPR/First aid, supplies, menu, fire extinguishers and evacuation plans were reviewed. Food preparation area Inspected for cleanliness, proper equipment and protection against contamination. Storage area inspected for toxins/cleaning compounds inaccessibility. Outdoor equipment Inspected for cushioning material, age appropriateness and good repair. Required shaded areas, drinking water availability and fencing were inspected. Play area inspected for safety, potential hazards and inaccessibility to bodies of water. LPA explained criminal records/child abuse index clearances, child abuse reporting requirements, recent regulatory changes including any exemptions. Deficiency cited for not transferring criminal record clearance for employee Celeste "Vickie" Scott. No other deficiencies cited. Civil penalty assessed. See 809-D for deficiency cited per Trtle 22, California Code of Regulations. Exit interview conducted, copy of report given to teacher Thresa Wadel! forDirector Robert Jean Lenox. SUPERVISOR'S NAME: Joan Hayes TELEPHONE: (310) 337-4333 LICENSING EVALUATOR NAME: LaWonya Brown TELEPHONE: (310) 337-3753 LICENSING EVALUATOR SIGNATURE: ***SIGNED*** DATE: 06/22/2004 I acknowledge receipt of this fonn and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATIJRE: -·SIGNED- DATE: 06/22/2004 This report must be available at the facility for public review (3 years). LIC809 (FAS) • (OOJ(I4) Page: 1 of2 STATE OF CALIFORNIA- HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE UCENSING DMSION FACiliTY EVALUATION REPORT (Cont) LA Child Caro West. 6161 Bristol Pkwy., MOO Cufver Cl , CA 90230 FACILITY NAME: CRENSHAW TOT ACADEMY DEFICIENcY INFORMATION FOR THIS PAGE: Deficiency Type POC Due Date I Section Number Type A 06/23/2004 Section Cited 101170 FACiLITY NUMBER: 191804084 VISIT DATE: 06/2212004 DEFICIENCIES 1 2 3 4 5 6 7 CRIMINAL RECORD CLEARANCE: The Department shall conduct a criminal record review of all persons specified in Health and Safety Code Section 1596.871(b). LPA observed staff/cook Celeste 'Vickie" Scott working In facility, further investigation reveals no criminal record clearance association. Civil penalty assessed. PLAN OF CORRECTIONS(POCs) 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 1 2 3 4 5 6 7 2 3 4 5 6 7 Ucensee will submit Criminal Background Clearance Transfer Request for employee. Licensee will ensure all employees meet clearance requirements prior to working In facility. Failure to correct the cited deficiency(les), on or before the Plan of Correction (POC) due date, may result In a civil penalty assessment. SUPERVISOR'S NAME: Joan Hayes TELEPHONE: (310) 337-4333 LICENSING EVALUATOR NAME: LaWonya Brown TELEPHONE: (310) 337-3753 LICENSING EVALUATOR SIGNATURE: ... SIGNED ... DATE: 06/22/2004 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: "**SIGNED ... DATE: 06/2212004 This Notice must be posted for 30 days Page: 2 of2 STATE OF CA.UFORNIA·HEAI.TH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DMSION CIVIL PENALTY ASSESSMENT (Unlicensed and Criminal Background) LA Chlkl Care West,. 6167 Bristol Pkwy.,WD Culvor City, CA. 90230 DATE FAClUTY HANIE 06/2212004 CRENSHAW TOT ACADEMY FACILITY ADDRESS CITY 5152 CRENSHAW BLVD. LOS ANGELES ZIP CODE STATE 90043 CA UCENSEE(S)/OPERATOR FACILITY NUMBER ECONOMIC SERVICES INC. 191804084 UNUCENSED FACILITY Civil penalties can be assessed against any unlicensed facility which falls to take corrective action within prescribed time periods, per calnomia Health and Safety Code Sections 1547, 1568.03, 1568.0821, 1569.48, and 1598.891. You are hereby notified that a civil penalty has bean assessed. Your facility has been found operating without a license. This Is In violation of the California Health and Safety Coda Sections 1508, 1568.03, 1569.10, or 1596.80. A Notice of Operation In Violation of Law or Denial of Application was issued on giving notice that failure to submit a completed application or cease operation could result in a civil penalty. Because you failed to file a completed application or cease operation, a civil penalty of $0.00 is assessed fur the period from through • 0 0 Residential care Facility for the Elderly (RCFE): Since a completed application was not submitted by the 15th day, on day 16 from date of notice or letter, $100 per resident per day Is being assessed retroactively. From day 16, $200 per resident per day Is being assessed until a completed application is submitted or operations cease (ffyou have not had a previous application denied). 0 Residential Care Facility fur the Chronically Ill (RCF-CI): An immediate civil penalty of $100 per resident per day is being assessed. if a completed application Is not submitted by the 15th day, on day 16from date of notice or letter, $200 per resident per day is being assessed until a completed application Is submitted or operations cease (if you have not had a previous application denied). 0 Child care Center, Family Child care Home, Community Care Facility: since a completed application was not submitted by the 15th day, on day 16 from the date of notice or letter, $200 per day Is being assessed until a completed application is submitted or operations cease (if you have not had a previous application denied)•. CRIMINAL BACKGROUND CLEARANCE (Immediate) Civil penalties can be assessed fur failure to comply with the requirement for fingerprinting and other criminal background requirements, per california Heallh and Safety Code Sections 1522, 1568.09, 1569.17, 1596.871 and 1596.8712. You are hereby notified that a civil penalty has been assessed. A Facility Evaluation Report (LIC 809) was issued on 06/2212004 giving notice that your facility has been found In violation of the fingerprinting criminal background clearance requirements. 0 $100 Immediate Civil Penalty per person fur failure to obtain a DOJ criminal record clearance or an exemption. ~ $100 Immediate Civil Penalty per person fur failure to request that a previously cleared or exempted person ba associated to the facility. 0 $100 Immediate Civil Penalty per parent/authorized representative fur failure to provide "Family Child care Home Addendum to Notification of Parents' Rights (Regarding Exclusion)". 0 $100 Immediate Civil Penalty per parent/authorized representative fur failure to provide "Family Child Care Home Addendum to Notification of Parents' Rights (Regarding Reinstatement)". 0 0 $100 immediate Civil Penalty per parent/authorized representative fur failure to obtain slgnatuna Indicating receipt of Addendum. $100 Immediate Civil Penalty fur falluna to provide signed addendum to the Department when requested. = 1 Number of Persons X $100 $100.00 Total Penalty YOU WILL RECEIVE A BILL IN THE MAIL. DO NOT SEND MONEY UNTIL YOU RECEIVE YOUR BILL! Page: 1 of2 UC421A (FAS) • (101(13) CIVIL PENALTY ASSESSMENT FORM STATE OF CALIFORNIA· HEALTH AND HUMAN SERVlCES AGENCY CAUFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE UCENSING DIVISION CIVIL PENALTY ASSESSMENT (Unlicensed and Criminal Background) LA Child Can~ Weat, 6167 Bristol Pkwy., tiMID Culver City, CA. 90230 DATE FACILITY NAME CRENSHAW TOT ACADEMY 06/2212004 FACIUTY ADDRESS CITY 5152 CRENSHAW BLVD. LOS ANGELES STATE ZIP CODE 90043 CA LICENSEE(S)IOPERATOR FACIUTY NUMBER ECONOMIC SERVICES INC. 191804084 UNLICENSED FACILITY Civil penalfles can be assessed against any unlicensed facility which falls to take corrective action within prescribed time periods, per California Health and Safety Code Sections 1847, 1568.03, 1568.0821, 1569.48, and 1598.891. You are hereby notified that a civil penalty has been assessed. Your facility has baen found operating without a license. This Is In violation of the California Health and Safety Coda Sections 1508, 1568.03, 1569.10, or 1596.80. A Notice of Operation In VIolation of Law or Denial of Application was Issued on giving notice that failure to submit a completed application or cease operation could result In a civil penalty. 0 Because you failed to flle a completed application or cease operation, a civil penalty of }!!J!!! Is assessed for the period from through • · D Residential Care Facility for the Elderly (RCFE): Since a completed application was not submitted by the 15th day, on day 16 from date of notice or letter, $100 perresldentperday is being assessed retroactively. From day 16,$200 per resident per day is being assessed until a completed application is submitted or operations cease (if you have not had a previous application denied). 0 Residential Care Facility for the Chronically Ill (RCF..CI): An Immediate civil penalty of $100 perresident per day Is being assessed. If a completed application Is not submiHed by the 15th day, on day 16 from date of notice or letter, $200 per resident per day Is being assessed until a completed application is submitted or opel'l!tions cease (If you have not had a · previous application denied). D Child Care Center, Family Child Care Home, Community Care Facility: since a completed application was not submitted by the 15th day, on day 16 from the date of notice or letter, $200 per day Is being assessed until a completed application Is submitted or operations cease (W you have not had a previous application denied). CRIMINAL BACKGROUND CLEARANCE (Immediate) Civil penalties can be assessed for failure to comply with the requirement for flngerprtnting and other criminal background requirements, per California Health and Safety Code Sections 1522, 1568.09, 1569.17, 1596.871 and 1596.8712. You are hereby notified that a civil penalty has been assessed. A Facility Evaluation Report (LIC 809) was Issued on 06/2212004 giving notice that your facility has been found In violation of the fingerprinting crfmrnal background clearance requfrements. 0 $100 Immediate Civil Penalty per person for failure to obtain a DOJ criminal record clearance or an exemption. 121 $100 Immediate Civil Penalty per person for failure to request that a previously cleared or exempted person be associated to the facility. 0 $100 immediate Civil Penalty per parenVauthorlzed representative for failure to provide "Family Child Care Home Addendum to Notification of Parents' Rights (Regarding Exclusion)'. 0 $100 immediate Civil Penalty per parent/authorized representative for failure to provide 'Family Child Care Home Addendum to Notification of Pa.rents' Rights (Regarding Reinstatement)". 0 0 $100 Immediate Civil Penalty per parent/authorized representative for failure to obtain signature indicating receipt of Addendum. $100 immediate Civil Penalty for failure to provide signed addendum to the Department when requested. 1 Number of Persons X $100 • $100.00 Total Penalty YOU WILL RECEIVE A BILL IN THE MAIL. DO NOT SEND MONEY UNTIL YOU RECEIVE YOUR BILL! Page: 1llf2 UC421A (FAS) • (10103) CIVIL PENALTV ASSESSMENT FORM State of California Department of Social Services Facility Number: 191804004 Total Capacttr- 44 Effective Date: 09/06/1993 In accordance with applicable provisions of the Health and Safety Code of California, and Its rules and regulations; the Department of Social Services hereby Issues this License to ECONOMIC SERVICES INC. to operate and maintain a DAY CARE CENTER Name of Facility CRENSHAW TOT ACADEMY 5152 CRENSHAW BLVD. LOS ANGELES, CA 90043 · This License Is not transferable and is gran~d solely upon the following: PRE-5CHOOL PROGRAM, AMBULATORY CHILDREN ONLY. MAXIMUM CAPACITY: 44 PRESCHOOL CHILDREN (AGES TWO TO SIX YEARS OLD).· Client Groupe Served: CHILDREN Complaints regarding services provided In this facility should be directed to: CCLD Regional Office Jeffrey Hlmtsuka Deputy Director, Community Care Ucensing Division UC2ll3A (lXW1) FAS Print Date DBJ071201S (310) 337-4333 Autho[lzed Representative of Licensing Agency POST IN A PROMINENT PLACE CU-lAOHib LIS055 LICENSING INFORMATION SYSTEM - FACILITY PROFILE DATE: 03/ll/13 EVALUATOR:. Z205 DO: 30 FAC NBR: 19 1804084 STATUS: LICENSED FAC NAME: CRENSBAH TOT ACADEMY CAPACITY: 0044 FAC ADDR: 5152 CRENSHAW BLVD., LOS ANGELES, CA 90043 FAC MAIL: 51~C CRENSHAW BLVD., LOS ANGELES, CA 90043 FAC TYPE: DAY CARE CENTER CLIENT SERVED: CHILDREN FAC FIRST LICENSED: 09/06/90 APP REC'D: 08/14/90 COUNTY: LOS ANGELES DIRECTOR: LENOX, ROBERTJEAN D PHONE: (323)299-6705 DATE CAP CHG: DATE CAP APPR: ANNUAL FEES CURRENT:· YES LICENSEE N~~: ECONOMIC SERVICES INC. LIC MAIL: 5150 CRENSHAW BOULEVARD, LOS ANGELES, CA 90043 LIC.EFF DATE: 09/06/93 TYPE: INDIVIDUAL FAC DUAL IDENTIFIER: N DUAL LICENSE NBR: FCRB: COMMENTS PRE-SCHOOL PROGRAM, AMBULATORY CHILDREN ONLY. MAXIMUM CAPACITY: 44 PRESCHOOL CHILDREN (AGES TWO TO SIX YEARS OLD). FAC CLOSED DATE: E-MAIL: LAST VISIT DATE: 11/09/12 TYPE: ANNUAL LAST DEFERRED VISIT DATE: 05/02/01 TYPE: ANNUAL SUPPLEMENTARY PERSONAL HISTORY: 000 REQUIRED VIStT: Y R =MENU, Y • DATES, F = SUMMARY, .H = PAYMENT HISTORY, E= EMERGENCY Enter> STATE OF CALIFORNIA· HEALTH AND HUMAN SERVICES AGENCY CAUFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DMSION FACILITY EVALUATION REPORT LA Child Care West. 6167 Brl&tol Pkwy., f.400 Culver C , CA 90230 FACIUTY NAME: CRENSHAW TOT ACADEMY ROBERTJEAN D. ADDRESS: 5152 CRENSHAW BLVD. CITY: LOS ANGELES 44 CAPACITY: TYPE OF VISIT: MET WITH: Thresa Wadell FACILITY NUMBER: FACILITY TYPE: TELEPHONE: ZIP CODE: STATE:CA DATE: CENSUS: 8 UNANNOUNCED TIME BEGAN: TIME COMPLETED: ADMINISTRATO~:LENOX, 191804084 850 (323) 299-6705 90043 06/22/2004 12:00 PM NARRATIVE 1 2 3 4 .5 6 LPA La Wonya Brown conducted a site evaluation for the purposes of an annual comprehensive visit. LPA met with Thresa Wadell, Teacher/Acting Director who accompanied LPA on a tour of the facility Inside/outside. Sample review of children records/staff records. Observance of the children were as follows: There were 8 children present under the supervision of one teacher and one cook. The children have access to all the facility with the exception ofthe staff bathrooms, storage. area & kitchen. The outside play area is enclosed with chain link fence. 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Furniture/Equipment inspected for cleanliness, age appropriateness, good repair. LlghtingNentllation were evaluated. Napping/Bedding equipment were inspected for cleanliness, age appropriateness, good repair and storage. Storage for children's belonging's, bathroom facilities were inspected. CPR/First aid, supplies, menu, fire extinguishers and evacuation plans were reviewed. Food preparation area inspected for cleanliness, proper equipment and protection against contamination. Storage area inspected for toxins/cleaning compounds inaccessibility. Outdoor equipment inspected for cushioning material, age appropriateness and good repair. Required shaded areas, drinking water availability and fencing were inspected. Play area inspected for safety, potential hazards and inaccessibility to. bodies of water. LPA explained criminal records/child abuse index clearances, child abuse reporting requirements, recent regulatory changes including any exemptions. Deficiency cited for not transferring criminal record clearance for employee Celeste 'Vickie" Scott. No other deficiencies cited. Civil penalty assessed. See 809-D for deficiency cited per Title 22, California Code of Regulations. Exit Interview conducted, copy of report given to teacher Thresa Wedell forDiractor Robert Jean Lenox. SUPERVISOR'S NAME: Joan Hayes TELEPHONE: (310) 337-4333 LICENSING EVALUATOR NAME: LaWonya Brown TELEPHONE: (310) 337-3753 LICENSING EVALUATOR SIGNATURE: *'*SIGNED*** DATE: 06/22/2004 I acknowledge receipt ofthls fonn and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: -SIGNED*** DATE: 06/22/2004 This report must be available at the fsclllty for public review (3 years). UC009 (FAS)- (0