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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191593920
Report Date: 09/20/2023
Date Signed: 09/20/2023 04:39:29 PM


Document Has Been Signed on 09/20/2023 04:39 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:CLAREMONT PRESBYTERIAN CHURCH CHILDREN'S CENTERFACILITY NUMBER:
191593920
ADMINISTRATOR:SASKIA (SACHA) LORDFACILITY TYPE:
830
ADDRESS:1111 NO. MOUNTAINTELEPHONE:
(909) 626-6261
CITY:CLAREMONTSTATE: CAZIP CODE:
91711
CAPACITY:38CENSUS: DATE:
09/20/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Alexandria Adamson-ChungTIME COMPLETED:
04:45 PM
NARRATIVE
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On 9/20/2023, Licensing Program Analyst (LPA) Carolyn Tuba conducted an unannounced Annual inspection. LPA met with Assistant Director, Alexandria Adamson-Chung. LPA was guided on a tour of the facility indoors and outdoors. This is an infant program licensed for 38 infant children with a toddler component, which operates Monday through Friday from 7:00 AM to 6:00 PM. The Assistant Director stated there are 31 children currently enrolled. The facility is located on the same campus as the Claremont Presbyterian Church. The infant center is right next door to the preschool that is also licensed.

The following classrooms were inspected: Infant room #1 had 4 infants in care ages 0-12 months with 2 staff members who are fingerprint cleared. Ladybug room #3 had 10 children in care ages 18-30 months with 1 staff during naptime who was fingerprint cleared. Butterfly room #2 had 7 children in care ages 12-24 months with 1 staff member during naptime who is fingerprint cleared. Teacher-child ratios were observed to be in accordance with Title 22 Regulations. Staff names were recorded. All children were observed to be under supervision, including visual supervision. Licensed facility is within the conditions, limitations, and capacity specified on the license.

The classroom furniture and equipment were inspected for good repair, free of sharp, loose, or pointed parts. Indoor classrooms were inspected to ensure that the floors have a surface that is safe and clean. Telephone service, heating, lighting, and ventilation were evaluated. Storage for infants’ belongings and napping equipment/cribs was inspected and meet all regulatory requirements. Availability of drinking water was reviewed and per Assistant Director the parents provide water from home and refills are available with a filter waterspout attached to the faucet. There are currently 3 changing tables that have soft matting and raised sides at least three inches high and is within an arm’s reach of a hand washing sink. Facility has a small child’s toilet for toilet training. Toys and surfaces are observed to be safe and clean. During the inspection LPA observed 5 cribs in Infant room 1 were in the infant activity space and were found outside of the nap room. LPA took photos. Staff restroom is available.

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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn TubaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 09/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/20/2023
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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Document Has Been Signed on 09/20/2023 04:39 PM - It Cannot Be Edited

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: CLAREMONT PRESBYTERIAN CHURCH CHILDREN'S CENTER
FACILITY NUMBER: 191593920

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/20/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101438.3(c)(1)
Indoor Activity Space For Infants
(1) The sleeping area for infants shall be physically separate from the indoor activity space. This separation shall be accomplished as specified in (b) above.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above as 5 cribs were in the infant activity space and were found outside of the nap room which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/27/2023
Plan of Correction
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Per Assistant Director cribs will be moved out of the space and LPA will conduct a follow-up visit.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn TubaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 09/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/20/2023
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: CLAREMONT PRESBYTERIAN CHURCH CHILDREN'S CENTER
FACILITY NUMBER: 191593920
VISIT DATE: 09/20/2023
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Kiddie combo Carbon monoxide and smoke detectors were present in the facility. Fire extinguishers are serviced annually and were last serviced 9/22/2022. Per Assistant Director the fire department come annually to service but will be calling to inquire when they will be visiting and conducting their fire extinguisher service. Storage cabinets in classrooms were locked and hazardous items including poisonous cleaning compounds were stored inaccessible to children in the kitchen area. Emergency disaster drill was last conducted on 08/2023. There is a First Aid kit available inside each classroom; the supplies were inventoried and found to be in good condition.

Children bring their own bedding, which are sent home at the end of each week to be laundered. Storage for children's belongings was observed. Food preparation areas were toured for safety, cleanliness, and proper equipment. Bottles, dishes, and containers were labeled with infants’ names; names and dates were visible on all children's bottles and other refrigerated items. AM and PM snacks are served by the facility and lunch is provided by parents. Menu is posted in the main lobby of the facility and provided on the monthly newsletter. Formula, diapers, wipes are provided by the parents. LPA observed parent board with all required documentation.

LPA will be sending via email to the Assistant Director a Safe Sleep Handout and LPA reviewed that the 15-minute log for children 0-24 months, is being conducted. LPA was told there are no children on medications but that IMS procedures will be adhered, and that medication will be stored in the kitchen area out of reach of children. LPA discussed Safe Sleep Plan to be filled out by parents, which is currently being implemented for children who begin the program under the age of 12 months.

The following was discussed with the Assistant Director:
Rooms that are off-limits need to be made inaccessible during operating hours. Smoking is prohibited. No infant walkers, no Johnny Jumpers, no baby saucers, or any other item that falls into that category are allowed in the facility.

The Assistant Director was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Sudden Infant Death Syndrome (SIDS) and Never-Shake-a-Baby were discussed.

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 climbing equipment, slides, and similar equipment are cushioned with sand and is swept each day and staff cover sandbox with tarp. There is adequate shade in the play yard with trees. There is enough equipment for


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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn TubaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2023
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: CLAREMONT PRESBYTERIAN CHURCH CHILDREN'S CENTER
FACILITY NUMBER: 191593920
VISIT DATE: 09/20/2023
NARRATIVE
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the children to use in the play yard. Area is gated with chain link fence at least 6 feet tall and staff check the area for any harmful objects prior to children playing in the play area.

Sign in and out is done electronically using ProCare and per Assistant Director is able to print a report for review. Parents use a QR code record the time of the day signing in/out their child. It also has information on adults authorized to pick up children.

Licensing staff reviewed staff records and found that they were complete. Clearance for adults and verification of CPR/First Aid, current mandated reporting certificates, educational requirements and health preventative practices documentation was reviewed. Children’s records were reviewed to ensure that Identification and Emergency form and a medical assessment are on file. The Assistant Director and staff currently have immunization documentation.

Assistant Director was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.



AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018, any person who works in a childcare facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers. 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 may 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 CARE tools, please send email inquiries 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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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn TubaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2023
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: CLAREMONT PRESBYTERIAN CHURCH CHILDREN'S CENTER
FACILITY NUMBER: 191593920
VISIT DATE: 09/20/2023
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Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for
drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Assistant Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

The deficiency listed on the following page were observed by the LPA and is being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809-D. The deficiency that is being cited needs to be cleared to protect the children’s health & safety.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Assistant Director, Alexandria Adamson-Chung.
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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn TubaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2023
LIC809 (FAS) - (06/04)
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