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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198001459
Report Date: 10/17/2022
Date Signed: 10/17/2022 03:23:17 PM


Document Has Been Signed on 10/17/2022 03:23 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:
10/17/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Sonia RoderiguezTIME COMPLETED:
03:30 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.

The following was observed during this visit. Licensing staff was provided a tour of the facility. This is a preschool program which consists of 5 classrooms (Room 201, 202, 203, 204, 207, and 208). Licensing staff observed a total of 33 children with 8 staff. Teacher-child ratios were observed. All children were observed by licensing staff to be under visual supervision of a teacher at all times.

Licensing staff observed the facility to be clean, safe, sanitary and in good repair. Furniture and equipment were inspected for good repair, free of sharp, loose, or pointed parts. All indoor classrooms were inspected to ensure that the floors have a surface that is safe and clean. All toilets and hand washing facilities are in safe and sanitary operating conditions. The children's restrooms are located in each classroom. There is drinking water accessible to the children in care via personal sippy cups. At this time, the school nurse’s office is used as an isolation area. Parents are contacted immediately when children are determined to be ill and staff are ensuring that children with obvious symptoms of illness are not being accepted. Children are signed in electronically by parents upon entry to their designated classroom.

The facility has snacks and lunch provided by an outside vendor (1 Potato). Per Director, facility does not used the water faucets to prepare food or provide drinking water. Licensing observed bottle water being provided to the children in care. All storage containers for solid waste, including moveable bins, have tight fitting covers on and are in good repair.
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
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: PILGRIM SCHOOL
FACILITY NUMBER: 198001459
VISIT DATE: 10/17/2022
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Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are stored in an area inaccessible to children. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. The facility takes measures to keep the facility free of flies, other insects and rodents.
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. Areas around and/or under climbing equipment, swings and slides have cushioning material to absorb a fall.
Staff Records were reviewed to ensure that a health screening report is on file. Children’s Records were reviewed to ensure that Identification and Emergency form and a medical assessment are on file. Criminal Records Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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
At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.
A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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.

Exit interview was conducted with Director, Sonia Roderiguez.
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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