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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191599532
Report Date: 02/24/2020
Date Signed: 02/24/2020 02:52:46 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:ARCADIA PRESBYTERIAN CHURCH CHILD DEVELOPMENT CTRFACILITY NUMBER:
191599532
ADMINISTRATOR:TURNER, BILLIEFACILITY TYPE:
830
ADDRESS:121 ALICE STREETTELEPHONE:
(626) 445-9764
CITY:ARCADIASTATE: CAZIP CODE:
91006
CAPACITY:30CENSUS: 21DATE:
02/24/2020
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:43 PM
MET WITH:Billie Turner, DierctorTIME COMPLETED:
03:10 PM
NARRATIVE
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Licensing Program Analysts (LPA) Anomeh Eivazian and Nolan Tcheng, conducted an unannounced case management inspection. LPAs met with Billie Turner, director who guided Analysts on a tour of the facility.

During this inspection LPAs were informed from 04/11/2019 to 5/13/2019, 3 infants, from 06/19/2019 to 08/19/2019,15 infants, and from 01/03/2020 to 01/27/2020 6 infants were exposed to hand, foot, and mouth disease. Also, from 01/12/2020 to 02/12/2020, 3 infants were exposed to pink eye. Per LPAs file review facility did not report all the above incidents to the Licensing Department. There was only one unusual incident report on file, reported 08/26/2019 for two cases of hand, foot, and mouth disease.

The following are being cited in accordance to Title 22 of the California Code of Regulations. Please refer to 809D for cited deficiencies.

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. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

Exit interview was conducted with Billie Turner, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role. A copy of this report and all other Licensing reports must be made available to the public for 3 years.
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Anomeh EivazianTELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2020
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: ARCADIA PRESBYTERIAN CHURCH CHILD DEVELOPMENT CTR
FACILITY NUMBER: 191599532
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/24/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/28/2020
Section Cited

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Reporting Requirements: 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. 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.
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This requirement has not been meet as evidenced by LPAs staff interviews. Facility had 3 outbreaks of hand, foot, and mouth disease and one pink eye out outbreak from April 2019 till current and facility did not report any of the incidents to the department.
This poses 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: Christina GabelmanTELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Anomeh EivazianTELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:
DATE: 02/24/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/24/2020
LIC809 (FAS) - (06/04)
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