191223376-5-28-2019-33-CC-JDOY-BCLU7E-20190528151948

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191223376
Report Date: 05/28/2019
Date Signed: 05/28/2019 03:19:55 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:	ABILITY FIRST		FACILITY NUMBER:	191223376
ADMINISTRATOR:	BARKYOUMB, MICHAEL		FACILITY TYPE:	840
ADDRESS:	201 SOUTH KINNELOA AVENUE		TELEPHONE:	(626) 449-5661
CITY:	PASADENA	STATE: CA	ZIP CODE:	91101
CAPACITY:	47	CENSUS: 9	DATE:	05/28/2019
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME BEGAN:	01:05 PM
MET WITH:	Michael Brkyoumb		TIME COMPLETED:	03:35 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) Justin Dorsey and Licensing Program Manager Adriana Hernandez conducted an unannounced Annual Random Inspection. LPA met with Michael Barkyoumb, Director, who guided LPA on a tour of the facility. Licensee also has an adult day program license (#198602059) which operates on the same grounds. Currently, the adult day program and school age program do not have shared areas. LPA inspected all areas identified on the Facility Sketch. Students have access to the large recreation room, rewards room, restrooms (across from recreation room), patio and outdoor play area. Students of the program are signed in at the main entrance and escorted to their assigned classrooms. Students are dropped off in the morning and bussed or picked up (certified transportation only) in the afternoon. Furniture and equipment are safe and in good repair. There is telephone service, heating, lighting and ventilation available at the facility. The locker room in the back of the children's restroom 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 snack and breakfast, lunch is provided by parents. Containers used to discard food have tight fitting lid at this time. Snack menus were posted in the kitchen and large recreation room. Snacks were reviewed for availability, quantity and appropriateness to children in care. Poisons are locked in a cabinet. Cleaning compounds and sharp items are inaccessible.

SUPERVISOR'S NAME: Adriana Hernandez	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Justin Dorsey	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 05/28/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2019

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: ABILITY FIRST	FACILITY NUMBER: 191223376
	VISIT DATE: 05/28/2019

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The outdoor area includes a grassy area with a bench with an umbrella for shade. The play area is fully fenced. There is a pool on the premises which meets Title 22 Regulations and is off limits currently. A certificate is required, and water activities staff and ratios must comply when in use. A review of records was conducted for staff and participants. LPA observed that staff have current First Aid and CPR (Expires 8/2020). 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.

Licensee submitted an Incidental Medical Services (IMS) plan and 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

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.

No deficiencies were cited in accordance with California Code of Regulations Title 22. . 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 Michael Barkyoumb Appeal Rights were given.

SUPERVISOR'S NAME: Adriana Hernandez	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Justin Dorsey	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 05/28/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2019

LIC809 (FAS) - (06/04)

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