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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198001459
Report Date: 10/13/2022
Date Signed: 10/17/2022 03:24:01 PM


Document Has Been Signed on 10/17/2022 03:24 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:PILGRIM SCHOOLFACILITY NUMBER:
198001459
ADMINISTRATOR:SHERYL COHENFACILITY TYPE:
850
ADDRESS:540 SO. COMMONWEALTH AVE.TELEPHONE:
(213) 385-7351
CITY:LOS ANGELESSTATE: CAZIP CODE:
90020
CAPACITY:72CENSUS: 33DATE:
10/13/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Sonia Roderiguez TIME COMPLETED:
02:40 PM
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Licensing Program Analysts (LPAs) Crystal Green and Enjoli Maeweather conducted an unannounced Case Management- Licensee Initiated inspection to evaluate the facility's request to reduce preschool program capacity and add a new toddler option program. Licensing staff met with Director, Sonia Roderiguez. Facility is located on the same site as First Congregational Church of Los Angeles. There is also a private school grades K- 12 located on the same premises there are no shared areas between the program.

This is a preschool program which consists of 5 classrooms (Room 201, 202, 203, 204, 207, and 208). At 1:40 PM, Licensing staff was guided through a tour of the proposed toddler option classroom and outdoor area. No alterations have been made to the exterior or interior of the facility. LPAs observed children during this inspection and obtained census.The proposed toddler option classroom will be located in Classroom 203 and 204. LPAs observed the toddler classroom area to be physically separate from the preschool classrooms. There are age-appropriate toys available for children in care. Furniture and equipment were inspected for good repair, free of sharp, loose, or pointed parts. All materials and surfaces accessible to children are toxic-free. LPA observed drinking water availble via water cooler with disposable cups available in the classroom. LPA observed the toddler to have a designated restroom space. There are two toilets available. There is also a changing table located within arms reach of a sink. All toilets and handwashing facilities are in safe and sanitary operating conditions.

Licensing staff was guided through outdoor space. At this time, the outdoor space is designated for preschoolers use only. Per Director, The facility currently does not have a separate designated outdoor space for the toddler option program and would like to request a waiver to shared outdoor space on a staggered schedule. The 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. There is adequate shade in the outdoor play area.
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Crystal GreenTELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:
DATE: 10/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/13/2022
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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: PILGRIM SCHOOL
FACILITY NUMBER: 198001459
VISIT DATE: 10/13/2022
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LPA did not obtained measurements during this inspection. At this time, the licensee is in compliance with California Title 22 Regulations. However, in order for the licensee to obtain the toddler option program a waiver must be requested and approved. LPA consulted with the Director regarding obtaining a waiver for shared use of the outdoor space. Licensing staff informed the Director that waivers are not automatically granted and will need to be review by the department for final approval. LPA obtained pictures of the outdoor play areas during this inspection.

Exit interview conducted and report was reviewed with the Director,

A notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Crystal GreenTELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2022
LIC809 (FAS) - (06/04)
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