191290357-5-22-2023-33-CC-CGAN-CSUPYA-20230616114336

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191290357
Report Date: 05/22/2023
Date Signed: 05/22/2023 12:14:29 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/12/2023 and conducted by Evaluator Anomeh Eivazian

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20230512102316

FACILITY NAME:	GRANDVIEW PRESBYTERIAN CHURCH COMM CHILDRENS CTR.		FACILITY NUMBER:	191290357
ADMINISTRATOR:	MULLICH, ROXANNE		FACILITY TYPE:	850
ADDRESS:	1130 RUBERTA AVE		TELEPHONE:	(818) 243-1088
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91201
CAPACITY:	68	CENSUS: 26	DATE:	05/22/2023
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Roxanne Mullich, Director		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Facility has cockroaches.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced complaint inspection to the above facility in regards to the above allegation. LPA arrived at the facility at 9:00 AM and met with Roxanne Mullich, director who guided analyst on a tour of the facility. During this inspection there were total of 26 children present in the facility with 6 staff.

During this investigation, LPA Eivazian conducted an interview with director. LPA toured the entire facility indoor and outdoor areas including gym and courtyard. LPA obtained a copy of Dewey Pest Control Co. receipt dated 04/20/23.

Based on an interview that was conducted with director, facility has contract with Dewey Pest Control Co. that they are coming out monthly to spay facility entire outdoor areas. Per director, Pest Control Company will visit facility today, 05/22/23 to spray the facility outdoor areas. Per director, she never observed any
REPORT CONTINUES ON NEXT PAGE 1 of 2

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023

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

LIC9099 (FAS) - (06/04)

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Control Number 33-CC-20230512102316

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: GRANDVIEW PRESBYTERIAN CHURCH COMM CHILDRENS CTR.	FACILITY NUMBER: 191290357
	VISIT DATE: 05/22/2023

NARRATIVE

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cockroaches inside the classrooms. However, she observed in the gym and stairways between gym and court yard.

Based on LPA's observation during 05/22/23 inspection, LPA observed four dead cockroaches in the gym area. (Pictures were taken). LPA did not observe any cockroaches or rodent inside the classrooms or outdoor playarea.

Based on LPA observations and interviews which were conducted and record reviews, the preponderance of evidence standard has been meet, therefore the above allegation is found to be Substantiated at this time. California Code of Regulations, 101238(a)(1)--Buildings and Grounds:(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. (1) The licensee shall take measures to keep the center free of flies, other insects, and rodents is being cited on the attached LIC9099D.

LPA Anomeh Eivazian informed director, Roxanne Mullich that this report dated 05/22/2023 document(s) 1 of Type A citation. Type A citation which shall be posted for 30 consecutive days as there is immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Anomeh Eivazian informed the director, Roxanne Mullich to provide a copy of this licensing report dated 05/22/2023 that documents 1 Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

The notice of site visit was posted where the parent/guardian of children enter and exit the facility. This notice shall remain posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.

Exit interview was conducted with Director, Roxanne Mullich at 12:30 p.m..

REPORT END 2 of 2

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023

LIC9099 (FAS) - (06/04)

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Control Number 33-CC-20230512102316

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: GRANDVIEW PRESBYTERIAN CHURCH COMM CHILDRENS CTR.	FACILITY NUMBER: 191290357
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/22/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 05/23/2023 Section Cited CCR 101238(a)(1)	1 2 3 4 5 6 7	Buildings and Grounds (a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. etc... This requirement was not met as evidence by...	1 2 3 4 5 6 7	Per director, pest control company will spray facility monthly. Effective today, daily one staff will check the gym, courtyard, and outdoor play areas to ensure it is clean and free of rodent, insects and cockroaches.
	8 9 10 11 12 13 14	During this inspection LPA Eivazian observed four dead cockroaches in the gym. This poses an immediate health, safety and personal right to the children in care.	8 9 10 11 12 13 14	A written plan will be submitted to LPA by 05/23/23 via email.
	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.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023

LIC9099 (FAS) - (06/04)

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