191290261-8-28-2019-33-CC-JDOY-BFGPY4-20190828114320

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191290261
Report Date: 08/28/2019
Date Signed: 08/28/2019 11:43:27 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:	CLOUD PRE-SCHOOL		FACILITY NUMBER:	191290261
ADMINISTRATOR:	MENA, ANA		FACILITY TYPE:	850
ADDRESS:	4444 CLOUD AVE.		TELEPHONE:	(818) 249-1414
CITY:	LA CRESCENTA	STATE: CA	ZIP CODE:	91214
CAPACITY:	60	CENSUS: 30	DATE:	08/28/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:55 AM
MET WITH:	Christa Castillo		TIME COMPLETED:	12:00 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 conducted an unannounced Annual Random Inspection. LPA met with Teachers Aide Liana Babajanyan, who guided LPA on a tour of the facility. Director Christa Castillo arrived to the facility shortly after. The preschool shares a play yard for outdoor play activities with a special education program located in the back of the property. There is a waiver on file for staggered use of outdoor playground with the special education program. The following staff were observed in each classroom during this visit: Class #1: Staff #1, Staff #2, Staff #3 and Staff #4 with 20 children; Class #2: Staff #5, Staff #6, Staff #7 and Staff #8 with 10 children. LPA inspected all areas identified on the Facility Sketch. Students have access to the classrooms, restrooms (located in each classroom), cafeteria and outdoor play area. Students of the program are signed in by their parents at their assigned classrooms. 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. Per Site Supervisor Alyson Beecher when children are sick they use the directors office as an isolation areas, the staff restroom has been designated for the use of ill children. 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 in the cafeteria and blocked off by door. The facility provides breakfast, A.M./P.M. snack and lunch. Containers used to discard food have tight fitting lids at this time. Snack menus were posted in the kitchen and are available online. 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: 08/28/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2019

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 2

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: CLOUD PRE-SCHOOL	FACILITY NUMBER: 191290261
	VISIT DATE: 08/28/2019

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
26
27
28
29
30
31
32

The outdoor area includes a grassy area and play equipment for the children that is properly padded to absorb a child's fall. The facility uses a metal shade structure that provides shade to the children's benches. 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 01/2021). 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.

***The files for Staff #4 and Staff #8 are currently located at the Glendale School Districts HR office, LPA will review those files at a later date.

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.

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 Site Supervisor Alyson Beecher, Notice of Site Visit and 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: 08/28/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2019

LIC809 (FAS) - (06/04)

Page: 2 of 2