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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191200048
Report Date: 01/31/2024
Date Signed: 01/31/2024 02:53:20 PM


Document Has Been Signed on 01/31/2024 02:53 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:HOGG'S HOLLOWFACILITY NUMBER:
191200048
ADMINISTRATOR:ROSE HOGGFACILITY TYPE:
850
ADDRESS:4490 CORNISHON AVENUETELEPHONE:
(818) 790-1700
CITY:LA CANADASTATE: CAZIP CODE:
91011
CAPACITY:26CENSUS: DATE:
01/31/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
12:23 PM
MET WITH:Rose HoggTIME COMPLETED:
03:00 PM
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On 01/31/2024, at 12: 15 am Licensing Program Analyst`s (LPA`s ) Shushanik Safaryan and Nolan Tcheng conducted an unannounced required 3-year inspection. A COVID-19 risk assessment was conducted prior to entering the facility. At 12:17 am LPA`s met with Facility Representative ,Rose Hogg, who guided the LPA`s on a tour of the facility. This is a preschool age program which operates Monday through Friday from 08:00am to 05:00PM. Program consists of 1 classroom and located on La Canada Unified School District property. Per Facility Representative there are 24 children enrolled.

During the visit LPA`s observed 10 children playing outside with 2 staff members . Teacher child ratios were observed to be in accordance with Title 22 Regulations. Staff names were recorded. Licensed facility is within the conditions, limitations, and capacity specified on the license.

The classroom furniture and equipment were inspected for good repair, free of sharp, loose, or pointed parts. All classrooms were inspected to ensure that the floors have a surface that is safe and clean. All materials and surfaces accessible to children are toxic free. Classroom has own bathroom accessible to the children. All toilets and washing facilities are in safe and sanitary operating conditions.

Napping equipment and bedding was inspected for good condition, appropriate storage, and cleanliness. Per Facility Representative parents take linens home on Friday and returned on Monday.



LPA observed that there are functioning smoke and carbon detectors in the facility. LPA observed a fully charged and serviced fire extinguisher with the service date 04/2023. Per Facility Representative Emergency disaster drills was last conducted on 10/19/2023.

Facility had a first-aid supplies in a location accessible to staff but inaccessible to children.



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SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Shushanik SafaryanTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 01/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/31/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: HOGG'S HOLLOW
FACILITY NUMBER: 191200048
VISIT DATE: 01/31/2024
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Snack menus are posted one week in advance in the kitchen . Kitchen located next to the classroom . Snacks were reviewed for availability, quantity and appropriateness to children in care. The facility only provides AM and PM snack and emergency lunch as needed. The kitchen was observed to be clean, and the cleaning compounds/solutions were found to be stored away from the food.

All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids. Drinking water is readily available both indoors and outdoors with water pitchers .In addition children bring their own water bottles. The facility was observed to be free of flies, other insects, and rodents.

The teacher’s office will be used for the ill children.


.Outdoor playground equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under high climbing equipment, slides, and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard.


Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. LPA`s observed sign in book outside next to the main entrance .

At 01:00 pm Children’s Records were reviewed to ensure that Identification and Emergency form and a medical assessment are on file. Children's records were complete .

At 1:20 pm LPA`s reviewed staff records; Criminal Records Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed. During the file review and interviews , LPA`s observed Mandated Reporter Certificates for director and 3 staff members were expired , which poses potential risk to the Health and Safety children's in care .

AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018, any person who works in a childcare facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers.

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SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Shushanik SafaryanTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2024
LIC809 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: HOGG'S HOLLOW
FACILITY NUMBER: 191200048
VISIT DATE: 01/31/2024
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At 1:25 pm during the staff file review LPA`s observed Health Screening Report( LIC 503 )were missing for 2 staff members , which poses potential risk to the Health and Safety children`s in care .

Per Facility Representative currently facility does not provide Incidental Medical Services (IMS) .

IMS policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: http://www.ada.gov/childqanda.htm

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 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.

Facility Representative 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.

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

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SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Shushanik SafaryanTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2024
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: HOGG'S HOLLOW
FACILITY NUMBER: 191200048
VISIT DATE: 01/31/2024
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To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.


Based on the LPA’s observations and records reviews, the following two deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health and safety.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the facility representative, Rose Hogg.
Appeal rights were explained and provided.

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SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Shushanik SafaryanTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2024
LIC809 (FAS) - (06/04)
Page: 4 of 5
Document Has Been Signed on 01/31/2024 02:53 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754


FACILITY NAME: HOGG'S HOLLOW
FACILITY NUMBER: 191200048

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/31/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations, interview and record review the licensee did not comply with the section cited above in 4 out of 4 staff members had expired Mandated Reporter Certificates , which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/15/2024
Plan of Correction
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Per Facility Represantative staff will complete the training and Director will email certificates to the LPA by POC date .
Type B
Section Cited
CCR
101216(g)(1)
Personnel Requirements
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations , record review and interview , the licensee did not comply with the section cited above , 2 staff members were missing health screening form LIC 503 which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/29/2024
Plan of Correction
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Per Facility Represantative , staff will have forms completed and emailed to the LPA by POC date .
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: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Shushanik SafaryanTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 01/31/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/31/2024
LIC809 (FAS) - (06/04)
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