191230960-8-12-2019-33-CC-JDOY-BEYUPD-20190812154523

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191230960
Report Date: 08/12/2019
Date Signed: 08/12/2019 03:45:37 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 CANADA FLINTRIDGE YOUTH HOUSE COMM. CTR. PRESCH		FACILITY NUMBER:	191230960
ADMINISTRATOR:	DANIELLE M. CAPUTO		FACILITY TYPE:	850
ADDRESS:	4469 CHEVY CHASE DRIVE		TELEPHONE:	(818) 790-8687
CITY:	LA CANADA	STATE: CA	ZIP CODE:	91011
CAPACITY:	75	CENSUS: 0	DATE:	08/12/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Danielle Caputo		TIME COMPLETED:	04:00 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 conducted an unannounced Annual Random Inspection. LPA met with Danielle Caputo, Director, who guided LPA on a tour of the facility. During the inspection there were no children present because of summer break. Per Director children will return 08/21/19. The facility offers a half day program which runs from 9:00 am - 12:00pm and an extended day program that runs from 12:00 pm - 3:30 pm. LPA inspected all areas identified on the Facility Sketch. The following classrooms were observed: Green Door Classroom, Blue Door Classroom, Red Door Classroom, and the Yellow Door Classroom. Students have access to both multi-purpose rooms, outdoor art areas (depending on classroom location), classrooms, restrooms (located in each classroom) and outdoor play area. Students of the program are signed in by their parents in their designated classroom. The facility does not provide transportation. Furniture and equipment are safe and in good repair. There is telephone service, heating, lighting and ventilation available at the facility. The facility uses the Directors office as an isolation area. The teachers restroom has been designated for the use of ill children. Per Director 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 located near the Green Door Classroom. The facility provides snack, lunch is provided by parents. No snack menus were posted in the kitchen because the students are currently not present. 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: 08/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2019

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: LA CANADA FLINTRIDGE YOUTH HOUSE COMM. CTR. PRESCH	FACILITY NUMBER: 191230960
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/12/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 09/04/2019 Section Cited CCR 101174(d)(2)	1 2 3 4 5 6 7	101174 Disaster and Mass Casualty Plan (d)(2) Disaster drills shall be conducted at least every six months. The drills shall be documented. This documentation shall be kept in the child care center for at least one year. This is not met as evidenced by:	1 2 3 4 5 6 7	Per Director the facility will conduct a fire and earthquake drill and email LPA a log with the drills documented on it.
	8 9 10 11 12 13 14	Based on observation and interview the facility does not documentation of the last completed disaster drills. Per director the facility conducted these drills on 07/05/19, which poses a potential Health, Safety or Personal Rights risk to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	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: Adriana Hernandez	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Justin Dorsey	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 08/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2019

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: LA CANADA FLINTRIDGE YOUTH HOUSE COMM. CTR. PRESCH	FACILITY NUMBER: 191230960
	VISIT DATE: 08/12/2019

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The outdoor area includes sand and wood chips for the children to play. LPA observed canopies and umbrellas for shade. There is also a shaded area with benches for the children to sit. The play area is fully fenced. A review of records was conducted for staff and participants. LPA observed that staff have current First Aid and CPR (Expires 11/2020). Staff has met all immunization requirements. First Aid supplies are available.

On 08/12/19 at 2:00 LPA found the facility does not currently have record of their last fire/earthquake drill. Per Director the last time these drills were conducted was 07/05/19.

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.

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 Danielle Caputo, 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: 08/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2019

LIC809 (FAS) - (06/04)

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