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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191225946
Report Date: 01/22/2020
Date Signed: 01/22/2020 04:00:02 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:SUNRISE PRE-SCHOOLFACILITY NUMBER:
191225946
ADMINISTRATOR:HEIDI MORGANFACILITY TYPE:
850
ADDRESS:3700 E SIERRA MADRE BLVDTELEPHONE:
(626) 351-9899
CITY:PASADENASTATE: CAZIP CODE:
91107
CAPACITY:165CENSUS: 76DATE:
01/22/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:01 PM
MET WITH:Jihan (Jiji) MassoudTIME COMPLETED:
04:15 PM
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An unannounced case management inspection was made on this day by Licensing Program Analysts (LPAs) Ariel Cazares and Thelma Razo. LPA met with Director Jihan (Jiji) Massoud to discuss the purpose of the inspection. Director guided LPAs on tour of the facility. LPAs observed a total of 72 napping children with a total of 12 staff.

The purpose for the inspection was to conduct follow up on incidents reported to the Department on 11/15/19 regarding personal rights. LPA Cazares conducted interviews with staff, obtained copies of pertinent documentation, and reviewed files. At this time additional information is needed prior to determining whether or not a violation occurred.

Exit interview conduct with Director Jihan (Jiji) Massoud. A copy of this report and appeals rights were provided. A "Notice of Site Visit" and copy of the report was issued. Notice of Site Visit must remain posted for 30 days. Failure to do so will result in a $100.00 civil penalty.
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Ariel CazaresTELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:

DATE: 01/22/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2020
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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