191222104-1-15-2020-33-CC-AEIN-BKUTZB-20200115141005

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191222104
Report Date: 01/15/2020
Date Signed: 01/15/2020 02:10:15 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:	SAHAG-MESROB ARMENIAN CHRISTIAN SCHOOL		FACILITY NUMBER:	191222104
ADMINISTRATOR:	MARAL AROYAN BOYADJIAN		FACILITY TYPE:	850
ADDRESS:	2501 N. MAIDEN LANE		TELEPHONE:	(626) 798-5020
CITY:	ALTADENA	STATE: CA	ZIP CODE:	91001
CAPACITY:	48	CENSUS: 50	DATE:	01/15/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Maral Aroyan Boyadjian, Director		TIME COMPLETED:	02:20 PM

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Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced random inspection. LPA met with Maral Aroyan Boyadjian, director who guided analyst on tour of facility. This is a preschool program which consists of 4 classrooms; RM K2 - Red (2 years old), RM K3- Blue (3 years old), and RM K4- Orange (4-5 years old), and nap/ free activity room which is adjacent to Blue room. There is a private elementary school on the premises. Facility operation hours are from Monday to Friday from 8:00 AM to 2:30 PM.

All areas identified on the Facility Sketch were inspected. The following staff was present during this inspection: RM K2-Red: 14 preschoolers with 2 staff, RM K3-Blue: 18 preschoolers with 3 staff, and RM K4-Orange: 18 preschoolers with 3 staff.

During the tour of the facility LPA counted 50 preschoolers were present in the facility, however the facility is licensed for capacity of 48 preschoolers. Per director, currently there has been 55 preschoolers enrolled in the program . Facility was observed not to be operating within required Limitation on Capacity and Ambulatory Status on the license at this time. During this inspection LPA Eivazian contacted Monterey Park Regional Office and discussed this issue with LPM Gabelman. Per LPM Gabelman approval and Maral Aroyan Boyadjian, director agreement, a capacity increase application will be submitted to the department no later than Friday, 01/17/2020 in order to prevent additional 7 preschoolers dismissal from the program. Director agreed new enrollment will not take place until capacity increase application approval will be granted. A written declaration was submitted.

The following was observed during tour of facility:

PHYSICAL PLANT: Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Director states that there are no poisons on the premises. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts.

REPORT CONTINUES ON THE NEXT PAGE 1 OF 4

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

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: SAHAG-MESROB ARMENIAN CHRISTIAN SCHOOL	FACILITY NUMBER: 191222104
	VISIT DATE: 01/15/2020

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All toilets and hand washing sinks are safe, sanitary and are operating properly. Bathrooms are located between K2 and K3 classrooms. All floors are clean and safe.

All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish and rodents and/or any other vermin. Food preparation area is located between K3 and K4 classrooms. LPA observed a microwave and refrigerator in food preparation area. Trash cans used to discard food have tight fitting lids. Drinking water is readily available both indoors and outdoors. The facility was observed to be free of flies, other insects and rodents.

Napping equipment and bedding was inspected for good condition, appropriate storage and cleanliness. Storage for children's belongings was inspected. Parents take linens home on Friday and returned on Monday. The Director's office will be used by ill children. There is a napping cot available for an ill child. The staff restroom will used by ill children.

Teacher child ratios were observed and staff names recorded. Sign in and out sheets were reviewed.

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. Preschoolers have their own separated playground. Also, preschoolers use basketball court for outdoor activity on a staggered schedule, waiver on file. Per Director no pool, fire arms and pet on the premises.

FACILITY RECORDS:
All individuals present have obtained a criminal record clearance or criminal record exemption. There is at least one person trained in CPR and Pediatric First Aid present during this inspection. The name of the child care center director or fully qualified teacher(s) designated to act in the director's absence is on file. Educational background, mandated reporter training, training, and/or experience, proof of immunization against influenza, measles and pertussis, and health screening form for each staff present are on file and were reviewed.

REPORT CONTINUES ON THE NEXT PAGE 2 OF 4

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

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

FACILITY NAME: SAHAG-MESROB ARMENIAN CHRISTIAN SCHOOL	FACILITY NUMBER: 191222104
	VISIT DATE: 01/15/2020

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In review of children’s records, files contain information including, but not limited to the following: Name, address and telephone number of the child's authorized representative and of relatives or others who can assume responsibility for the child if the authorized representative cannot be reached when necessary.

Children's roster was reviewed and is current. Disaster drill log was available, last drill was conducted on 12/18/19.

Snack menus are posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request. Snacks were reviewed for availability, quantity and appropriateness to children in care. Facility provides Breakfast, Lunch and PM snack. The lunch is catered into the facility.

Medication: There are no children enrolled that require IMS at this time. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (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

Staff and Children’s Records were reviewed for completeness; Inspection of required forms was made. LPA issued the Confidential Names List (LIC 811) to the Director during this inspection. The Confidential Names List documents the staff and children’s files that were reviewed during this inspection.

LPA advised the licensee to access forms, providers information notices, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

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SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

LIC809 (FAS) - (06/04)

Page: 3 of 5

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: SAHAG-MESROB ARMENIAN CHRISTIAN SCHOOL	FACILITY NUMBER: 191222104
	VISIT DATE: 01/15/2020

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Based on this information, the following deficiencies listed on the attached LIC 809d 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 & safety.

Upon receipt of this report, the Licensee shall post the Notice of Site visit and any licensing report documenting a type “A” deficiency. The report and the Notice of Site visit shall be posted for 30 consecutive days. Failure to maintain posting as required, will result in an immediate $100 civil penalty. A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent.

Exit interview was conducted with Maral Aroyan, Director, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role. A copy of this report and all other Licensing reports must be made available to the public for 3 years.

REPORT END 4 OF 4

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

LIC809 (FAS) - (06/04)

Page: 5 of 5

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: SAHAG-MESROB ARMENIAN CHRISTIAN SCHOOL	FACILITY NUMBER: 191222104
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/15/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 01/17/2020 Section Cited	1 2 3 4 5 6 7	Limitations on Capacity and Ambulatory Status. The licensee shall not exceed the conditions, limitations and capacity specified in the license. This requirement has not been meet as evidenced by LPA personal observation. During this inspection, the facility was found to have a total of 50 children present and only being
	8 9 10 11 12 13 14	licensed for 48 preschoolers. Per director, currently 55 preschoolers are enrolled in the program. This poses an immediate risk to the health and safety of children in care.	8 9 10 11 12 13 14	dismissals from the program. Director agreed new enrollment will not take place until capacity increase application approval will be granted.
	1 2 3 4 5 6 7
	1 2 3 4 5 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: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

LIC809 (FAS) - (06/04)

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