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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191223032
Report Date: 08/28/2024
Date Signed: 08/28/2024 03:16:56 PM


Document Has Been Signed on 08/28/2024 03:16 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: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: 21DATE:
08/28/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Julie LarsonTIME COMPLETED:
03:30 PM
NARRATIVE
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On 08/28/24, at 2:00 pm Licensing Program Analyst (LPA ) Shushanik Safaryan conducted unannounced Case Management Inspection to follow up on an unusual incident report .Upon arrival at 2:00 pm , LPA met with the Facility Representative , Julie Larson ,to whom the purpose of the visit was explained. Tour was provided . During the tour LPA observed 21 children with 3 staff members .

On 0820/24 an incident was reported where a child's personal rights may have been violated . During this inspection LPA conducted interviews with 2 staff members and one child . The child who was allegedly involved with this incident was interviewed and did not make any disclosures. Staff members interviewed did not make any disclosures .

At this time, there is not a preponderance of evidence that shows that the facility was in violation with Title 22 Regulations when these incident occurred. Therefore, there are no deficiencies being cited.


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.

Exit interview conducted with the Director Assistant , Julie Larson and Copy of Report provided.

END OF REPORT

SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Shushanik SafaryanTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 08/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/28/2024
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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