191200190-6-27-2023-33-CC-CGRN-CT7QQT-20230627122253

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191200190
Report Date: 06/27/2023
Date Signed: 06/27/2023 12:23:02 PM

Document Has Been Signed on 06/27/2023 12:23 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	CHILDREN'S COUNTRY HOUSE		FACILITY NUMBER:	191200190
ADMINISTRATOR:	NIELSON, DEBERA		FACILITY TYPE:	850
ADDRESS:	2821 SANTA ROSA		TELEPHONE:	(626) 798-8083
CITY:	ALTADENA	STATE: CA	ZIP CODE:	91001
CAPACITY:	34	CENSUS: 24	DATE:	06/27/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:09 AM
MET WITH:	Rebecca Robledo		TIME COMPLETED:	12:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Crystal Green conducted an unannounced required 1-year inspection. LPA met with Director, Rebecca Robledo. Facility hours of operation are Monday through Friday from 7:30 a.m. to 6:03 p.m. The following was observed during this visit. At 11: 00 am, LPA was provided a tour of the facility. This preschool program consists of 3 classrooms (RM 1, RM 2, and RM 3). LPA observed 7 children with 1 staff in RM 1. There were 9 children with 1 staff in RM 2 and in RM 3 there were 8 children with 2 staff. Teacher-child ratios were observed, and staff names were recorded. All children were observed by licensing staff to be under the visual supervision of a teacher at all times. Licensing staff observed that the facility was clean, safe, sanitary, and in good repair. Furniture and equipment were inspected for good repair, free of sharp, loose, or pointed parts. All indoor classrooms were inspected to ensure the floors had a safe and clean surface. LPA observed cots available within the classroom. Napping equipment was inspected for good condition, appropriate storage, and cleanliness. Bedding is stored separately in each child’s storage cubbies. LPA observed the children restroom accessible from the hallway. All toilets and hand washing facilities are in safe and sanitary operating conditions. Water is available indoors via water bottom, or the children use their own sippy cups. The isolation area will continue to be in the Director’s Office, which has a chair for ill children. Parents are contacted immediately when children are determined to be ill, and staff ensure that children with obvious symptoms of illness are not being accepted. Facility provides meals and snack. All kitchen, food preparation, and storage areas are clean, free of litter, rubbish, and rodents/vermin. All storage containers for solid waste, including moveable bins, have tight fitting covers on and are in good repair.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Crystal Green	TELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:	DATE: 06/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2023

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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: CHILDREN'S COUNTRY HOUSE	FACILITY NUMBER: 191200190
	VISIT DATE: 06/27/2023

NARRATIVE

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Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are stored in an area inaccessible to children. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. The licensee takes measures to keep the facility free of flies, other insects and rodents.

Yard is fenced and divided into two spaces. The upper yard has push toys and tricycles. The lower yard slopes downward, while the bottom of the yard flattens out to an area which offers opportunity for additional play. Rabbit hutch and pen in the upper yard is clean. Pony coral and goat pens observed to be well maintained. All animals were observed to have clean food and water.

LPA reviewed the sign-in and out sheets to ensure that parents were providing their signatures. LPA reviewed with the facility representative the LIC 311A, Records to Be Maintained at The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. LPA verified that the lead testing was completed in accordance with 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.

This facility provides Incidental Medical Services – IMS. Per Director, there are no children enrolled that require IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Crystal Green	TELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:	DATE: 06/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2023

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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: CHILDREN'S COUNTRY HOUSE	FACILITY NUMBER: 191200190
	VISIT DATE: 06/27/2023

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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.

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.

No citations are being issued today.

Exit interview conducted and report was reviewed with the facility representative, Rebecca Robledo. A notice of site visit was given to facility representative and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Crystal Green	TELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:	DATE: 06/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2023

LIC809 (FAS) - (06/04)

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