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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191291022
Report Date: 09/08/2023
Date Signed: 09/08/2023 11:20:17 AM


Document Has Been Signed on 09/08/2023 11:20 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:COTTAGE NURSERY SCHOOLFACILITY NUMBER:
191291022
ADMINISTRATOR:JOCELYN ROBERTSONFACILITY TYPE:
850
ADDRESS:169 WEST ARLINGTON DRIVETELEPHONE:
(626) 799-0387
CITY:PASADENASTATE: CAZIP CODE:
91105
CAPACITY:40CENSUS: 30DATE:
09/08/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:39 AM
MET WITH:Jocelyn Robertson - DirectorTIME COMPLETED:
11:35 AM
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Licensing Program Analyst (LPA) Nolan Tcheng conducted a Case Management inspection for the purpose of following up on a Notice received from City of Pasadena Public Health Department (PPHD). Upon arrival at 10:39am, LPA met with Director Jocelyn Robertson, to whom the purpose of the inspection was explained. There were children present during the time of inspection.

Census was taken. There are 30 children with 9 staff members

Notice from PPHD indicates that the facility has not published results of the drinking water test for lead contamination. Per Director, when the State first announced the requirement in 2018, facility had their water tested on 08/30/2018. Testing was not through the State Water Lead sampling Program. Results from the test were 3.38ppb for their kitchen sink.

During today's inspection, LPA was provided proof of appointment for water sampling through the State Lead Sampling Program, via email. Appointment is set for 09/14/2023. Director disclosed that they have had to reschedule multiple times do to leaks in some pipes. She was instructed testing could not be done till all leaks are fixed. Per Director, the leaks have now been fixed.

LPA advised Director to contact PPHD in order to notify and update their department of the upcoming appointment for water sampling.

At this time, there no deficiencies are being cited per California Title 22 regulations.

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 Director Jocelyn Robertson, at 11:17am. Copy of report provided.

END OF REPORT

SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) -98-3391
LICENSING EVALUATOR NAME: Nolan TchengTELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:
DATE: 09/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/08/2023
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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