198002592-1-8-2020-33-CC-CGRN-BKN2X4-20200108164631

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198002592
Report Date: 01/08/2020
Date Signed: 01/08/2020 04:46:43 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:	PASADENA CITY COLLEGE CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	198002592
ADMINISTRATOR:	NICKI A. HARMON		FACILITY TYPE:	830
ADDRESS:	1324 E. GREEN ST.		TELEPHONE:	(626) 585-3180
CITY:	PASADENA	STATE: CA	ZIP CODE:	91106
CAPACITY:	25	CENSUS: 15	DATE:	01/08/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:05 PM
MET WITH:	Brenda Trejo		TIME COMPLETED:	04:00 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	Licensing Program Analysts (LPAs) Crystal Green and Nolan Tcheng conducted an unannounced annual inspection. Upon arrival, LPAs met with Marisol Jar-Garza, Program Specialist until Brenda Trejo, Director, arrived shortly after. LPAs was guided on a tour of the facility both indoors and outdoors. This is an infant program licensed for (25) infants ages 0 – 2 years of age. During the tour, LPAs observed that there was a preschool program (198002397) located on the premises that is physically separate from the infant center both indoors and outdoors. This infant program consists of 2 classrooms. All children were observed by LPAs to be under visual supervision of a teacher at all times. Cribs and napping equipment were observed in the classrooms. Per Director, linen and bedding are provided by the facility and washed daily on site. Food menus were also observed posted in the classrooms. Sign in and out sheets were reviewed. At this time, the office is used as an isolation area. Furniture and equipment were inspected for age appropriateness. All changing tables and feeding chairs are in operational condition. There is a sink with hot water within arm’s reach of each of the changing table located in each classroom. Indoor classroom was inspected to ensure that the floors have a surface that is safe and clean. Infants used personal drinking bottles for water. This facility does have a food program, which provides food for all children enrolled. Food is prepared in the kitchen. There are bottle warmers and refrigerator available for infants. LPAs observed all bottles and cups to be labeled. Counter tops were clean and free of clutter or standing food. Cleaning compounds are inaccessible. All storage containers for solid waste, including moveable bins, have tight fitting covers. Outdoor playground equipment was observed to be in a safe condition. There is adequate shade in the play yard.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Crystal Green	TELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:	DATE: 01/08/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2020

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: PASADENA CITY COLLEGE CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 198002592
	VISIT DATE: 01/08/2020

NARRATIVE

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This facility provides Incidental Medical Services – IMS. There are no children enrolled at this time that require these services. Due to no children being enrolled, LPA did not review 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.

Staff Records was reviewed to ensure that Infant Teacher present are qualified with Criminal Records Clearance and verification of CPR/First Aid. Children’s Records were reviewed to ensure that Identification and Emergency form and a Needs and Services Plan are on file.

No deficiencies are being cited in accordance with California Code of Regulations Title 22.

Exit interview was conducted with Director, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.

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: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Crystal Green	TELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:	DATE: 01/08/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2020

LIC809 (FAS) - (06/04)

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