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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191502478
Report Date: 02/05/2020
Date Signed: 02/05/2020 01:29:17 PM

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:ST JAMES PARISH SCHOOLFACILITY NUMBER:
191502478
ADMINISTRATOR:KIM GOODRICHFACILITY TYPE:
850
ADDRESS:1325 MONTEREY ROADTELEPHONE:
(626) 799-6906
CITY:SOUTH PASADENASTATE: CAZIP CODE:
91030
CAPACITY:90CENSUS: 76DATE:
02/05/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Kim GoodrichTIME COMPLETED:
01:45 PM
NARRATIVE
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Licensing Program Analyst's (LPA's) Judy Mora and Nolan Tcheng conducted an unannounced Required 1 Year inspection. Licensing staff met with designated facility Director, Kim Goodrich, who guided licensing staff on a tour of the facility. This is a preschool age program licensed for 90 children which operates Monday – Friday from 8:00 AM - 3:00 PM, extended is care from 12:00 PM to 3:00 PM. Per the Director there are 118 children enrolled.

All areas identified on the facility sketch were inspected. This facility is located in a 2 story building which consists of 7 classrooms. Licensing staff toured 4 classrooms located on the first floor and 3 classrooms on the second floor. There is a Kindergarten program located on the second floor that operates with a private school affidavit which is on file (verified). During tour licensing staff observed 09 children with 02 staff in The Owls Room, 09 children with 02 staff in the Bluebirds Room, 10 children with 02 staff in the Kangaroos Room, 11 children with 02 staff in the Bunnies Room, 13 children with 02 staff in the Teddies Room, 12 children with 02 staff in the Pandas Room and 12 children with 02 staff in the Koalas Room. Teacher-child ratios were observed to be in accordance with Title 22 regulations. Staff names were recorded. All children were observed to be under visual supervision of a teacher during tour. Licensing staff observed all required forms/publications to be posted in the office. The Licensee is within the conditions, limitations, and capacity specified on the license.

Furniture and equipment was inspected for good repair, free of sharp, loose, or pointed parts. All indoor classrooms were inspected to ensure that the floors have a surface that is safe and clean. All toilets and hand washing facilities are in safe and sanitary operating conditions. All materials and surfaces accessible to children are toxic free. At this time, the office is used as an isolation area. A mat is available for an ill child to rest on. Sufficient individual storage space for children was observed. Each child has a cubby. First Aid supplies are available and complete.

*REPORT CONTINUES ON NEXT PAGE
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Judy MoraTELEPHONE: (323) 981-3371
LICENSING EVALUATOR SIGNATURE:

DATE: 02/05/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2020
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 6
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: ST JAMES PARISH SCHOOL
FACILITY NUMBER: 191502478
VISIT DATE: 02/05/2020
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. Licensing staff observed several medications including Epi pens and over the counter medications to be expired. Licensing staff asked that the medication be removed from the medication box. 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

During this inspection, licensing staff also addressed an Unusual Incident Report which was received by the Department on 01/24/2020. The incident occurred on 01/23/2020. During documentation review, licensing staff observed another Unusual Incident Report that documented an incident which occurred on 01/18/20 that was not reported to the Department. There is documentation showing that the facility was notified of the incident on 01/18/20. The facility is being cited for not reporting the first incident to the Department. Licensing staff conducted interviews and obtained documentation during this visit.



Based on the information provided during this visit and interviews conducted no staff observed either incident. A follow up inspection will be conducted to conduct additional interviews.

REMINDER: Failure to obtain a criminal record background check clearances prior to initial presence in the facility will result in an immediate $100.00 dollar or more per day Civil Penalty.
LPA advised the licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

The deficiencies listed on the following pages were observed by the LPA and are being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809D for deficiencies that are being cited and need to be cleared to protect the children’s health & safety.

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 Director, Kim Goodrich. Appeal Rights and Procedures explained and provided.

*END OF REPORT
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Judy MoraTELEPHONE: (323) 981-3371
LICENSING EVALUATOR SIGNATURE:

DATE: 02/05/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2020
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: ST JAMES PARISH SCHOOL
FACILITY NUMBER: 191502478
VISIT DATE: 02/05/2020
NARRATIVE
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Snack menus were reviewed to ensure that they are being posted at least one week in advance and visible to an authorized representative. The facility provides AM snack, some children bring their own lunches. All food preparation and storage areas are clean, free of litter, rubbish. Licensing staff observed 6 bags of string cheese in the freezer that expired on 01/18/2020, licensing staff asked that the bags be removed and thrown away immediately. There is drinking water available in all indoor classrooms and a drinking fountain is available outdoors. All storage containers for solid waste, including moveable bins, have tight fitting covers on and are in good repair. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are stored in an area inaccessible to children.

Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. Outdoor play equipment was observed to be in good condition, free of sharp, loose or pointed parts. Outdoor activity space surface is maintained in a safe condition as is free of hazards. The Director states that there are no bodies of water on the premises and licensing staff did not observe any bodies of water during this visit. Areas around and/or under climbing equipment, swings and slides have sand as a cushioning material to absorb a fall. Director states there are no weapons or firearms on the premises.

Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. Staff files were reviewed for a health screening report. A random sample of Children’s Records were reviewed to ensure that they are complete. Criminal Record Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed.



SB792 Immunization Requirements for Staff and Employees was discussed. Licensing staff observed that several staff are missing immunization documentation.

AB1207 Mandated Child Abuse Reporting – was discussed with Licensee. Website provided: http://mandatedreporterca.com/. Licensing staff observed that several staff have not renewed the mandated training as required and have expired certificates on file.

*REPORT CONTINUES ON NEXT PAGE

SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Judy MoraTELEPHONE: (323) 981-3371
LICENSING EVALUATOR SIGNATURE:

DATE: 02/05/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2020
LIC809 (FAS) - (06/04)
Page: 2 of 6
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: ST JAMES PARISH SCHOOL
FACILITY NUMBER: 191502478
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/05/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/15/2020
Section Cited

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Food Service
Commercial foods shall be approved by appropriate federal, state and local authorities. All foods shall be selected, transported, stored, prepared and served so as to be free from contamination and spoilage and shall be fit for human consumption.
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This requirement was not met as evidenced by Licensing staff observeing 6 bags of string cheese in the freezer that expired on 01/18/2020, licensing staff asked that the bags be removed and thrown away immediately. This is a potential risk to the health and safety of children in care.
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Type B
02/15/2020
Section Cited

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Health Related Services
All prescription and nonprescription medications shall be maintained with the child's name and shall be dated.
This requirement was not met as evidenced by licensing staff observing several medications including Epi pens and over the counter medications to be
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expired. Licensing staff asked that the medication be removed from the medication box. This is a potential risk to the health and safety of children in care.
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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: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Judy MoraTELEPHONE: (323) 981-3371
LICENSING EVALUATOR SIGNATURE:
DATE: 02/05/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/05/2020
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: ST JAMES PARISH SCHOOL
FACILITY NUMBER: 191502478
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/05/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/05/2020
Section Cited

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Employees or volunteers at day care center; immunization requirements; records; exemptions
Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee
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and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
This requirement was not met as evidenced by staff file review. Licensing staff observed that several staff are missing immunization's. This is a potential risk to the health and safety of children in care.
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Type B
03/20/2020
Section Cited

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Availability of information regarding detecting and reporting child abuse and neglect; training for mandated reporter who is licensed day care provider, administrator, or employee of a licensed child day care facility; proof of completion
On or before March 30, 2018, a person who, on January 1, 2018, is a licensed
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child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.
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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: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Judy MoraTELEPHONE: (323) 981-3371
LICENSING EVALUATOR SIGNATURE:
DATE: 02/05/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/05/2020
LIC809 (FAS) - (06/04)
Page: 6 of 6
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: ST JAMES PARISH SCHOOL
FACILITY NUMBER: 191502478
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/05/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/15/2020
Section Cited

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Reporting Requirements
Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours.
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 In addition, a written report containing the information specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event.
This requirement was not met as evidenced by facility file review and documentation obtained. The faciity did not report the incident that was reported to the Director on 01/18/20. This is a potential risk to the health and safety of children in care.
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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: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Judy MoraTELEPHONE: (323) 981-3371
LICENSING EVALUATOR SIGNATURE:
DATE: 02/05/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/05/2020
LIC809 (FAS) - (06/04)
Page: 5 of 6