191231022-1-25-2022-33-CC-NTCG-CAZQ7J-20220125105513

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191231022
Report Date: 01/25/2022
Date Signed: 01/25/2022 10:55:23 AM

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: 0	DATE:	01/25/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Antonieta Murillo - Lead Teacher		TIME COMPLETED:	11:15 AM

NARRATIVE

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Licensing Program Analyst (LPA) Nolan Tcheng conducted an unannounced random annual inspection. Upon arrival at 9:10am, LPA met with Lead Teacher Antonieta Murillo. At 9:15am, Lead Teacher led LPA on a tour of the facility. This is a preschool program which consists of 1 classroom. This facility is on Hamilton Elementary School campus, Room 102. Per Lead Teacher, there are currently 32 enrolled in the program. This is a half day program with Morning session 8:15-11:15am, and afternoon session 12:15pm-3:15pm, Monday to Friday.

Licensing staff observed all required forms/publications to be posted in the classroom. Snack menus were reviewed to ensure that they are being posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request.

PHYSICAL PLANT: At 9:15am LPA inspected Room 102, where there were 0 children and 1 staff member. Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children, out of reach above the sinks. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. All floors are clean and safe. Due to half day sessions, this facility does not have nap or rest time for the children. At 9:18am, a fire extinguisher was observed. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 12/07/2021, as indicated on service tag. Per State Fire Marshall standards, fire extinguishers shall be serviced annually. All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids. The facility was observed to be free of flies, other insects and rodents. Sufficient individual storage space for children was observed and each child has a cubby and a hook on the wall outside the classroom for any backpacks. Drinking water was readily available indoors. At this time, the school nurse's office is used as an isolation area. First Aid supplies are available and complete. Facility has a functioning carbon monoxide detector that meets statutory requirements. Director states there are no weapons, firearms, or bodies of water on the premises.

REPORT CONTINUES PAGE 1 of 3

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Nolan Tcheng	TELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2022

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: 01/25/2022

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The classroom has its own attached restroom for the children in care. All toilets, hand washing, and bathing facilities are safe, sanitary and are operating properly. Supplies were observed to be in good amount. This facility provides breakfast to the morning session and lunch to the afternoon session. Food is provided through the elementary school cafeteria. Per Lead Teacher, communication is held between the program and the cafeteria regarding any children with food allergies. Teacher-child ratios were observed to be in accordance with Title 22 regulations. Staff names were recorded. No children were present during the time of the inspection. The Licensee is within the conditions, limitations, and capacity specified on the license. All areas were identified on the Facility Sketch were inspected.

At 9:25am, LPA reviewed the outdoor play area. Outdoor playground equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with material that absorbs a fall. There is one outside play space that has an age appropriate play structure with sand below and around it. There are locked sheds that hold the outdoor play equipment. Drinking water is readily available outdoors.

FACILITY RECORDS: Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. Staff files were unable to be reviewed at the time of inspection. Staff files are held at Cleveland Elementary School, where all licensed schools/facilities in the Pasadena Unified School District store their staff files. An inspection to review staff files at the Cleveland location will be conducted at a later date. A random sample of Children’s Records were reviewed to ensure that they are complete.

INCIDENTAL MEDICAL SERVICES:
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

REPORT CONTINUES PAGE 2 of 3

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Nolan Tcheng	TELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2022

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: 01/25/2022

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LPA observed that a COVID-19 Technical Assistance call had been made on 04/05/2021.

LPA advised the licensee how to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov. AB1207 Mandated Child Abuse Reporting – Implementation was discussed with Licensee. Website provided: http://mandatedreporterca.com/

At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.

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 was conducted with Lead Teacher Antonieta Murillo, at 10:50am. A copy of the report was provided.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Nolan Tcheng	TELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2022

LIC809 (FAS) - (06/04)

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