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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191502477
Report Date: 05/08/2019
Date Signed: 05/08/2019 12:13:45 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 CONGREGATIONAL CHURCH PRE SCHOOLFACILITY NUMBER:
191502477
ADMINISTRATOR:JANE BEAULIEUFACILITY TYPE:
850
ADDRESS:2560 HUNTINGTON DRTELEPHONE:
(626) 292-2082
CITY:SAN MARINOSTATE: CAZIP CODE:
91108
CAPACITY:45CENSUS: 33DATE:
05/08/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Janet Beaulieu TIME COMPLETED:
11:45 AM
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Licensing Program Analyst (LPA) Seung Lee conducted an unannounced random visit. LPA met with Janet Beaulieu, Director who guided analysts on tour of facility. This is a preschool program which is consists of 3 classrooms; 2yr (Green) class, 3yr (Yellow) class and 4yr (Blue) class. The operating hours are M-F 8:30AM-3:00PM with a optional extended program that ends at 4:30PM depending on the need of the parents. Some children do leave for the day with parents during lunch period of 12:00PM.

All areas identified on the Facility Sketch were inspected. Blue Room: Staff#1 & #2 with 12 children; Yellow Room: Staff#3 & #4 with 11 children; Green Room: Staff#5 & #6 with 10 children.

PHYSICAL PLANT- Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. 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. 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. Trash cans observed to 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 was observed. All areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with material that absorbs a fall. There is outside shade for resting and required fencing was also observed. There are no bodies of water on the premises.

Children have their own cubbies to use for personal storage space. Napping sheets are provided by the facility and are washed weekly. Per Director, the children who stay for lunch partake in napping.
SUPERVISOR'S NAME: Guangorena ClaudiaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Seung LeeTELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
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 CONGREGATIONAL CHURCH PRE SCHOOL
FACILITY NUMBER: 191502477
VISIT DATE: 05/08/2019
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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.

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.

Snack menus are posted one week 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. The facility provides AM and PM snack. Parent sometimes provide AM snack.

Incidental Medial Services (IMS). This facility will only administer medication if needed in case of an emergency. This does include prescription inhalers and Epi-Pens. Therefore, the facility does offer Incidental Medial Services (IMS). The facility has submitted an updated plan of operation.

There were no deficiencies cited during this inspection.

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

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 Janet Beaulieu, Director, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.
SUPERVISOR'S NAME: Guangorena ClaudiaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Seung LeeTELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2