198000608-10-16-2019-33-CC-AALN-BGZUTU-20191016155230

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198000608
Report Date: 10/16/2019
Date Signed: 10/16/2019 03:52:35 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:	PACIFIC FRIENDS SCHOOL		FACILITY NUMBER:	198000608
ADMINISTRATOR:	MCKINLEY,KELLIE		FACILITY TYPE:	840
ADDRESS:	6210 TEMPLE CITY BLVD.		TELEPHONE:	(818) 287-6880
CITY:	TEMPLE CITY	STATE: CA	ZIP CODE:	91780
CAPACITY:	30	CENSUS: 9	DATE:	10/16/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:39 PM
MET WITH:	Kellie McKinley		TIME COMPLETED:	04:05 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	Licensing Program Analysts (LPAs) Ariel Cazares and Bardo Baluyot conducted an unannounced annual/random inspection on this date. LPA met with Director Kellie McKinley and was guided on a tour of the facility. There were 9 children present and 1 teachers in total during the inspection. The facility’s hours of operation are Monday-Friday, before and after school hours. During the summer, the program operates full day. There is a preschool component on site, license # 191591710. LPA toured the areas according to the facility sketch on file. Per Director, no alterations have been made since the last inspection. The facility consists of 1 classrooms and an outdoor playground. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Children have their own cubby to store their belongings. There is available drinking water in form of a water fountain in the classroom. There are first aid and emergency supplies located in the classroom. LPAs observed a carbon monoxide detector in the classroom, which was tested and found to be operational. LPA inspected the children’s outdoor space. The playground was inspected for safety, cushioning material, good repair and age appropriateness. LPA observed there to be shade and adequate fencing. Drinking water is available in form of a water fountain that was functional. LPA also reviewed criminal record clearances, children and staff records. LPA found the records to be complete and in order. Sign in and out sheets were reviewed and found to be accurate.

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Ariel Almazan	TELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2019

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: PACIFIC FRIENDS SCHOOL	FACILITY NUMBER: 198000608
	VISIT DATE: 10/16/2019

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (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

No deficiencies were observed or cited on this inspection.

Exit interview conducted with Director Kellie McKinley. A copy of this report and appeal rights were provided and explained.

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.

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Ariel Almazan	TELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2019

LIC809 (FAS) - (06/04)

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