191501069-5-3-2019-33-CC-SLEE-BBTTSL-20190503145919

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191501069
Report Date: 05/03/2019
Date Signed: 05/03/2019 02:59:25 PM

COMPREHENSIVE INSPECTION

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:	SAN MARINO COMMUNITY CHURCH		FACILITY NUMBER:	191501069
ADMINISTRATOR:	JANE WALKER		FACILITY TYPE:	850
ADDRESS:	1750 VIRGINIA RD		TELEPHONE:	(626) 282-4186
CITY:	SAN MARINO	STATE: CA	ZIP CODE:	91108
CAPACITY:	75	CENSUS: 27	DATE:	05/03/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Jane Walker		TIME COMPLETED:	03:15 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) Seung Lee conducted an unannounced random inspection. LPA met with Jane Walker, Director, who guided analyst on tour of the facility. This is a half day preschool program which consists of 5 classrooms (RM#2-RM#6); During the inspection LPA Lee observed 1 classroom part of the after school enrichment program that ends at 2pm which is provided on Fridays. The facility is open from 9AM-12PM M-F. A picnic program is offered M-TH from 12pm-3pm. The following was observed during the inspection. Room#2: Staff#2 and #3 with 15 children. Room#3: Staff#1 with 12 children for the after school supplementary program. PHYSICAL PLANT- Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Licensee states that there are no poisons on the premises. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. All toilets, hand washing, and bathing facilities are safe, sanitary and are operating properly. All floors are clean and safe. Telephone service, heating, lighting and ventilation were also evaluated. There is drinking water available both indoors and outdoors. All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish and rodents and/or any other vermin. 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, other insects and rodents. 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.

SUPERVISOR'S NAME: Guangorena Claudia	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Seung Lee	TELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2019

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: SAN MARINO COMMUNITY CHURCH	FACILITY NUMBER: 191501069
	VISIT DATE: 05/03/2019

NARRATIVE

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FACILITY RECORDS-All individuals present have obtained a criminal record clearance or criminal record exemption. There is at least one person trained in CPR and Pediatric First Aid was present during this visit. The name of the child care center director or fully qualified teacher(s) designated to act in the director's absence is on file. Educational background, training, and/or experience for each staff present are on file and were reviewed. Required immunization records for staff were available for review.

Snack menus were reviewed. Snacks are provided by the families enrolled at the facility. There is a list posted of families signed up daily. The facility has extra snacks available if needed. The facility provides AM snack for the half day program and a PM snack for the picnic program. Children participating in the picnic program bring their own lunch.

Incidental Medical Services (IMS).-This facility provides Incidental Medical Services – IMS. 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.

Although this is a part-time program, the facility does have some napping equipment available for children to nap, if needed. Bedding is brought by individual families if children are staying for picnic time. At this time, the office is used as an isolation area. A mat is brought to the office for ill children to rest until parents arrive. Any ill children will use the church nursery restroom.

LPA advised the licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov. There were no deficiencies cited on this inspection.

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. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Jane Walker, Director, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.

SUPERVISOR'S NAME: Guangorena Claudia	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Seung Lee	TELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2019

LIC809 (FAS) - (06/04)

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