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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191223032
Report Date: 10/09/2019
Date Signed: 10/09/2019 03:30:21 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:LA CRESCENTA PRESBYTERIAN CTR. FOR CHILDRENFACILITY NUMBER:
191223032
ADMINISTRATOR:CHAMBERS, PATRICIAFACILITY TYPE:
840
ADDRESS:2902 MONTROSE AVENUETELEPHONE:
(818) 249-8124
CITY:LA CRESCENTASTATE: CAZIP CODE:
91214
CAPACITY:60CENSUS: DATE:
10/09/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:10 PM
MET WITH:Patricia ChambersTIME COMPLETED:
03:45 PM
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Licensing Program Analyst (LPA) Justin Dorsey conducted an unannounced Annual Random Inspection. LPA met with Patricia Chambers, Director, who guided LPA on a tour of the facility. Licensee also has an infant center and preschool which operates on the same grounds. Per Director some children are brought to the facility then taken to school at around 7:30 am. Students are then transported back to the facility from school at around 1:30 pm to 4:00 pm.

LPA inspected all areas identified on the Facility Sketch. The following staff were observed in each classroom during this visit: Room 201: Staff #1 and Staff #2 with 14 children; Room 202: Staff #3 and Staff #4 with 12 children and Room 204: Staff #5 and Staff #6 with 10 children.

Students have access to the classrooms, restrooms and two outdoor play areas. Students of the program are signed in at their designated classrooms. Furniture and equipment are safe and in good repair. There is telephone service, heating, lighting and ventilation available at the facility. The Directors office and the staff restroom near the office has been designated for use of ill children waiting to get picked up.

Drinking water is available indoors and outdoors. Restrooms used were inspected for availability, good repair, water temperature, toilet paper, area safety and sanitation.

The kitchen, which the students don't have access to is in another building near the facilities entrance. The facility provides PM snack after the children are picked up from school. Per Director the children do not use the cafeteria with is near the kitchen, the snacks are taken to the classrooms. Containers used to discard food have tight fitting lid at this time. Snack menus were posted in each of the programs classrooms. Snacks were reviewed for availability, quantity and appropriateness to children in care. Poisons, Cleaning compounds and sharp items are inaccessible.
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 4
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: LA CRESCENTA PRESBYTERIAN CTR. FOR CHILDREN
FACILITY NUMBER: 191223032
VISIT DATE: 10/09/2019
NARRATIVE
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 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 reprehensive. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Director Patricia Chambers, The Notice of Site Visit and Appeal Rights were given.
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4
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: LA CRESCENTA PRESBYTERIAN CTR. FOR CHILDREN
FACILITY NUMBER: 191223032
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/09/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/06/2019
Section Cited

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Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
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Based on observation Staff #3 was missing proof of required immunizations, which poses a potential Health, Safety or Personal Rights risk to children in care.
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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: Ana ChicoTELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 10/09/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/09/2019
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: LA CRESCENTA PRESBYTERIAN CTR. FOR CHILDREN
FACILITY NUMBER: 191223032
VISIT DATE: 10/09/2019
NARRATIVE
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The program has an upper and lower outdoor play area. 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 and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard. A review of records was conducted for staff and participants.

On 10/09/19 while reviewing staff files LPA observed Staff #2, Staff #4 and Staff #7 did not have the LIC 503 completed.

On 10/09/19 while reviewing staff files LPA found that Staff #3 did not have proof of TDAP and MMR.

LPA observed that staff have current First Aid and CPR (Expires 06/2020). Staff has met all immunization requirements. Ratios were observed to be in compliance. First Aid supplies are available. Disaster drills are documented and all posting requirements have been met.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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
REMINDER: Failure to obtain a criminal record background check clearance prior to initial presence will result in an immediate $100.00 dollar or more.

LPA advised how to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov. Also, discussed new requirements for providers, including mandate reporting training for staff which can be found at: http:/www.mandatedreporterca.com/training /training.htm. This is a new regulatory requirement beginning January 2018. According to staff, training has been completed through Community Care Licensing. Please review all elements outlined in AB 1207- Mandated Reporting Training.
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4