191500117-12-22-2022-33-CC-BBAT-CMCSTW-20221222131014

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191500117
Report Date: 12/22/2022
Date Signed: 12/22/2022 01:10:20 PM

Document Has Been Signed on 12/22/2022 01:10 PM - It Cannot Be Edited

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:	CALVARY PRESCHOOL		FACILITY NUMBER:	191500117
ADMINISTRATOR:	MOLLY SPRAGG		FACILITY TYPE:	850
ADDRESS:	1050 FREMONT AVE.		TELEPHONE:	(626) 799-0385
CITY:	SOUTH PASADENA	STATE: CA	ZIP CODE:	91030
CAPACITY:	134	CENSUS: 15	DATE:	12/22/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:24 AM
MET WITH:	Director, Molly Spragg		TIME COMPLETED:	01:30 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) Bardo Baluyot conducted an unannounced Required Annual inspection. Upon arrival, LPA conducted a COVID risk self-assessment and met with Director Molly Spragg who guided analyst on a tour of facility. This is a preschool program which consists of 8 classrooms. The classrooms are numbered as RM 1, RM 2, RM3, RM 6, RM 5, RM 7, RM 9, and RM 10. Per Director, due to low enrollment RM2 is currently not in use. This facility does not have a classroom 4 or 8. Room 5 and Room 10 are half day programs which operate from 8:45am to 11:45pm. This facility is located on the grounds of Calvary Presbyterian Church. Facility hours are Monday to Friday from 7:00 AM to 6:00 PM. All areas identified on the Facility Sketch were inspected. Disinfectants, cleaning solutions, medication and other items that may pose a danger to children, were observed in each classroom and were to be inaccessible. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. All toilets and hand washing sinks are safe, sanitary and are operating properly. All floors are clean and safe. All kitchen areas/food preparation areas and food storage areas are kept clean. 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. Drinking water is readily available both indoors and outdoors. The facility was observed to be free of flies and insects. Napping equipment and bedding was inspected for good condition, appropriate storage and cleanliness. Storage for children's belongings was inspected. Parents take bedding home on Thursday or Fridays and returned items on Monday. The school washes the linens every Friday. There is laundry equipment in the office hallway. This area is inaccessible to children. 1 of 3

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Bardo Baluyot	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 12/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2022

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: CALVARY PRESCHOOL	FACILITY NUMBER: 191500117
	VISIT DATE: 12/22/2022

NARRATIVE

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Teacher child ratios were observed and staff names recorded. Sign in and out sheets were reviewed. The school uses an electronic sign in and out system. The company is called OneCore. The facility also has a manual system that is use and there is a back up plan incase of an emergency or system does not work.

There are 4 yards in this facility: Bike Yard, Thing Yard, Sand Yard, and Court Yard. The Thing Yard is connected to The Bike Yard and is open so children can go between the two yards as they wish. 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 adequate shade in the play yard.

All individuals present have obtained a criminal record clearance or criminal record exemption. All staff are trained in CPR and Pediatric First Aid and certification were observed to be current and on file. Educational background, training, and/or experience for each staff present were also on file and were reviewed.

In review of children’s records, files contain information including, but not limited to the following: Name, address and telephone number of the child's authorized representative and of relatives or others who can assume responsibility for the child if the authorized representative cannot be reached when necessary.

Children's roster was reviewed and is current. Disaster drill log was available and shows last drills were conducted on 12/2022.

Snack menus are posted one month in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request. Snacks were reviewed for availability, quantity and appropriateness to children in care. Children enrolled bring their own lunch but facility will do on site hot lunch (pizza) once a month. The facility provides AM and PM snack.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Bardo Baluyot	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 12/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2022

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: CALVARY PRESCHOOL	FACILITY NUMBER: 191500117
	VISIT DATE: 12/22/2022

NARRATIVE

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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

Staff and Children’s Records were reviewed for completeness. LPA issued the Children's Record Review (LIC 857) and Staff Records Review (LIC 859) to the Director during this inspection. These forms document the staff and children’s files that were reviewed during this inspection.

No deficiencies were cited during today's visit.

Exit interview conducted and report was reviewed with the Director, Molly Spragg.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

LPA advised the licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

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END OF REPORT

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Bardo Baluyot	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 12/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2022

LIC809 (FAS) - (06/04)

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