191231022-12-12-2019-33-CC-ACAS-BJSUBT-20191212142652

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191231022
Report Date: 12/12/2019
Date Signed: 12/12/2019 02:26:57 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:	HAMILTON PRESCHOOL		FACILITY NUMBER:	191231022
ADMINISTRATOR:	PATRICIA GUZMAN		FACILITY TYPE:	850
ADDRESS:	2089 ROSA VILLA ST. RM. 102		TELEPHONE:	(626) 793-0678
CITY:	PASADENA	STATE: CA	ZIP CODE:	91107
CAPACITY:	20	CENSUS: 18	DATE:	12/12/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Antonieta Murillo-Smith		TIME COMPLETED:	02:35 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 Analysts (LPAs) Ariel Cazares and Bardo Baluyot conducted an unannounced annual random inspection on this date. LPA met with Teacher Antonieta (Tonie) Murillo-Smith. There is both an AM session from 8:15-11:15 and PM session from 12:15-3:15. LPA observed 18 children and 3 staff total present for the PM session. LPA inspected the classroom. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Children have their own hooks outside of the classroom to store their belongings. Age appropriate sinks and toilets were inspected for availability and good repair in all restrooms. LPA did observe availability of indoor drinking water was observed in classroom in form of a water fountain with 2 spouts. Children's also have their own personal water bottles in the classroom. First Aid supplies were observed in the classroom in a cabinet near the teacher's desk. LPAs observed the carbon monoxide detector in the classroom, tested it, and found it to be operational. Teacher Tonie was unable to verify if the classroom had one installed. LPA inquired with the elementary school office staff, who was unable to verify if the school had a detector in place. Lunch is provided by the school and brought to the classroom where children are served. Food menu was reviewed for availability and appropriateness to children in care. Children are provided one meal each session; breakfast in the AM session and lunch for the PM session. The outdoor equipment was inspected for safety, cushioning material, good repair and age appropriateness. Required shade and fencing were inspected. Outdoor play yard has water via water fountains. LPA found that fountains are functional.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Ariel Cazares	TELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2019

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: HAMILTON PRESCHOOL	FACILITY NUMBER: 191231022
	VISIT DATE: 12/12/2019

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Children's files were reviewed on this date. Sign in and out sheets were observed outside of the classroom and were reviewed and found to be accurate. Staff records are kept off-site at the main office.

Teacher child ratios were observed to be in compliance. Care and supervision was evaluated to determine if the basic needs of children are met. All children are adequately supervised.

Incidental Medical Services (IMS) 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

No deficiencies were cited on this date.

Exit interview conducted with Teacher Tonie Murillo Smith. A copy of this report and appeal rights were provided.

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. Failure to maintain posting as required will result in a civil penalty of $100.00.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Ariel Cazares	TELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2019

LIC809 (FAS) - (06/04)

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