191290357-1-11-2021-33-CC-TRAO-BX6NNQ-20210111093709

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191290357
Report Date: 01/11/2021
Date Signed: 01/11/2021 09:37:24 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:	GRANDVIEW PRESBYTERIAN CHURCH COMM CHILDRENS CTR.		FACILITY NUMBER:	191290357
ADMINISTRATOR:	RICKSECKER, E.		FACILITY TYPE:	850
ADDRESS:	1130 RUBERTA AVE		TELEPHONE:	(818) 243-1088
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91201
CAPACITY:	68	CENSUS: 20	DATE:	01/11/2021
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Roxanne Mullich, Interim Director		TIME COMPLETED:	09:30 AM

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	A subsequent Case Management - Incident call was made by Licensing Program Analyst (LPA) Thelma Razo due to COVID-19 and precautionary measures. LPA spoke with Interim Director Roxanne Mullich. LPA stated the purpose of the call was due to Unusual Incident that happened on 10/2/2020. According to the reported incident, Parent #1 (P1) informed Staff #1 (S1) that Child #1 (C1) was left in the sand yard. On 10/5/2020, LPA conducted an initial tele-inspection with Ms. Mullich and together, toured the facility to include the parking lot, playground/sand yard and 3 classrooms. Interviews were conducted with Ms. Mullich, S1 and Staff #2. Per Ms. Mullich, she was assisting S2 around noon during transition from the playground/sand yard to Butterfly Bungalow classroom which is 100 feet apart. Within 3 to 5 minutes, S1 who was in another classroom came by with C1. Per S1, P1 rung the bell at which point S1 saw C1 alone in the sand yard/playground. S2 admitted that a head count was not done during the transition. Per Ms. Mullich, the playground fence is 5 feet tall and C1 would not be able to open the playground gate since C1 is a little under 3 feet. LPA observed that the fence' gate has a manual latch with a carabiner hook on the latch but would only work properly if it was closed by staff. Since staff was not aware that C1 was left outside, LPA interviewed P1 who witnessed if the gate was closed property as well as the conditions in which the child was left unattended. The playground entrance is located next to an open parking lot. Per Ms. Mullich, S2 was not terminated due to the parents' request to keep S2. However, a written warning was given to S2 and facility had instituted a stricter protocol during transition. On 10/14/2020, LPA interviewed P1 and Parent #2 over the phone. There were conflicting statements as to whether the sand yard gate was left open or closed. Day care representatives stated the gate was closed behind them but the witness stated that the gate was left open and informed the day care staff. There were also a conflicting statement in regards to the length of time C1 was left alone in the sand yard (approximate time was between 3 to 10 minutes) and according to interviews with P1, temperature was between 95 ºF to 100 ºF. LPA searched the web and found that temperature at Glendale on 10/2/2020 was 104 ºF.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 513-3793
LICENSING EVALUATOR NAME: Thelma Razo	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2021

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: GRANDVIEW PRESBYTERIAN CHURCH COMM CHILDRENS CTR.	FACILITY NUMBER: 191290357
	VISIT DATE: 01/11/2021

NARRATIVE

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Based on various interviews, information gathered and observation, facility was cited under California Code of Regulations, Title 22, Division 12 Chapter 1 Article 6 and is on the next page. An immediate civil penalty of $500 is being assessed due to C1 being unsupervised in the sand yard that leads to an open parking garage and to the street. Staff also failed to follow their own protocol to ensure that all children were accounted for and were unaware that C1 was left alone until a parent who found the child alone brought it to their attention.

Exit interview was conducted with Interim Director Roxanne Mullich via phone. This report along with a copy of the Appeal Rights will be sent to Ms. Mullich via email with a read receipt or confirmation of receipt of email, which will act as the facility representative’s signature. A copy of the signed report will also be sent to the Department.

A Notice of Site Visit was not provided since a physical inspection was not conducted.

A copy of this report shall be posted where the parent/guardian of children enter and exit the facility and shall remain posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty. A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon their return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled child for the next 12 months. A signed Acknowledgement of Receipt (LIC9224) shall be in each child’s file, acknowledging receipt.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 513-3793
LICENSING EVALUATOR NAME: Thelma Razo	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2021

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: GRANDVIEW PRESBYTERIAN CHURCH COMM CHILDRENS CTR.	FACILITY NUMBER: 191290357
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/11/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 01/12/2021 Section Cited	1 2 3 4 5 6 7	Responsibility for Providing Care and Supervision. No children shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. Based on interviews and information gathered, Child #1 was left unsupervised and
	8 9 10 11 12 13 14	was alone in the sand yard on 10/2/2020. This poses an immediate health and safety risk to the children in care.	8 9 10 11 12 13 14
	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: Ana Chico	TELEPHONE: (323) 513-3793
LICENSING EVALUATOR NAME: Thelma Razo	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2021

LIC809 (FAS) - (06/04)

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