197416633-10-18-2022-30-CC-LJCS-CKBNFQ-20221018102551

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197416633
Report Date: 10/10/2022
Date Signed: 10/18/2022 10:26:30 AM

Document Has Been Signed on 10/18/2022 10:26 AM - 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	CATHOLIC CHARITIES L.A.INC.S.M.ADESTE PROG.		FACILITY NUMBER:	197416633
ADMINISTRATOR:	JOURDAN STOLLEY		FACILITY TYPE:	840
ADDRESS:	1039 7TH STREET		TELEPHONE:	(310) 393-9287
CITY:	SANTA MONICA	STATE: CA	ZIP CODE:	90403
CAPACITY:	75	CENSUS: 0	DATE:	10/10/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Correne Tallarico		TIME COMPLETED:	02:00 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

On 10/10/2022, Licensing Program Analyst (LPA) Lillian Casillas conducted an unannounced annual inspection. LPA met with Assistant Principal, Correne Tallarico, who guided LPA on a tour of the facility. Days and hours of operation are Monday through Friday, 2:00PM to 6:00PM. The facility is part of the Adeste after-school program and operates out of 1 classroom in Duvall Hall, which is part of a large campus that includes a high school and elementary school. Child Development DIrector, Rocio Bach, was not present during the inspection.

A walk-through of the classroom was conducted, and classroom was found to be clean and free from any potential hazards. LPA observed 1 sink and 10 tables with chairs and furniture was found to be in good repair. There is adequate heating, lighting and ventilation. Arts/crafts and learning materials are stored in cabinets. LPA observed a 2A10:BC fire extinguisher, smoke detector, and carbon monoxide detector.

Facility provides snacks and children eat in the classroom or on picnic tables outside. Facility provides a monthly snack menu. Children bring their own water bottles and facility provides water as well.

Children use the bathrooms inside the elementary school. The boys bathroom 5 stalls and 3 sinks. The grils bathroom includes 8 stalls and 4 sinks. There are sufficient toilets and sinks to accommodate the facility’s capacity. Bathrooms were found to be clean.

The outdoor play area is large and equipped with age-appropriate play equipment that is in safe condition. Facility uses the play structure closest to the high school. The surface of the outdoor activity space is maintained in safe condition and is free of hazards

[CONTINUE ON PAGE 2]

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Lillian J Casillas	TELEPHONE: (424) 301-3097
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2022

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: CATHOLIC CHARITIES L.A.INC.S.M.ADESTE PROG.	FACILITY NUMBER: 197416633
	VISIT DATE: 10/10/2022

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
26
27
28
29
30
31
32

PAGE 2

Facility was observed to be operating within the conditions, limitations, and capacity specified on the license.
Child Development Director provided scans of the children's files and staff files via email. LPA reviewed 2 staff files, which are complete. Staff are trained in CPR and Pediatric First Aid (expires 11/2023). All staff completed Mandated Reporter training on 4/2024. LPA reviewed a sample of 5 children’s files and observed files were complete.

Child Development Director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated. Upon notification from the Department, the licensee will comply and act immediately to terminate the employment of, remove from the facility or bar from entering the facility for any person it is deemed necessary while the Department considers granting or denying an exemption.

Incidental Medical Services (IMS) are not currently being provided. Director is aware that an IMS plan is

required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

Exit interview conducted and report was provided to Child Development Director, Rocio Bach, via email. Rocio Bach replied to the email in lieu of signature.

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Lillian J Casillas	TELEPHONE: (424) 301-3097
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2022

LIC809 (FAS) - (06/04)

Page: 2 of 2