191205095-8-14-2019-33-CC-CGRN-BF2RML-20190814130854

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191205095
Report Date: 08/14/2019
Date Signed: 08/14/2019 01:08:58 PM

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:	ALTADENA CHILDREN'S CENTER		FACILITY NUMBER:	191205095
ADMINISTRATOR:	BOUCHER, TONI		FACILITY TYPE:	850
ADDRESS:	2326 NORTH EL MOLINO		TELEPHONE:	(626) 797-6142
CITY:	ALTADENA	STATE: CA	ZIP CODE:	91001
CAPACITY:	44	CENSUS: 34	DATE:	08/14/2019
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Toni Boucher		TIME COMPLETED:	01:10 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 case management inspection to follow up on an incident that was reported to the Department on 07/12/2019. This case management inspection is also a follow-up to the visit conducted on 07/16/19. LPA met with Toni Boucher, Director. Census was taken. On 07/12/2019, an unusual incident report was made to the department where a parent alleges that their child's personal rights were violated while in care. Based on information reported by the facility, the child is now in their teens and the alleged incident may have occurred between 2006 to 2009. Director was able to confirm that the child had attended the facility however facility is unable to provide a facility roster relating to the time frame of the child’s attendance at the facility. According to the Health and Safety Code 1596.841 facilities are only required to maintain facility records for a period of three (3) years. During the last inspection conducted on 07/16/19, LPA obtained the contact information of the parent. LPA attempted on several occasions to contact the parent of child to obtain additional information regarding the specific time frame of the alleged incident however LPA was unsuccessful in attempts to make contact with the parent.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Crystal Green	TELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:	DATE: 08/14/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2019

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: ALTADENA CHILDREN'S CENTER	FACILITY NUMBER: 191205095
	VISIT DATE: 08/14/2019

NARRATIVE

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During this inspection, Director was able to provide LPA with additional documentation regarding the allegation. Based on the documentation reviewed, the parent was contacted by their local law enforcement agency. However, their local law enforcement agency has now suspended their investigation due to the child's refusal to speak with the authorities and child’s own disclosure to detective that they are unable to recall alleged incident. Due to the parents’ local law enforcement agency suspension of their investigation and parents' refusal to communicate with licensing staff in providing additional information, at this time, the alleged incident is deemed unfounded. Per California Code of Regulations Title 22, Division 12, no deficiency cited during today's visit.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Director.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Crystal Green	TELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:	DATE: 08/14/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2019

LIC809 (FAS) - (06/04)

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