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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198007301
Report Date: 05/09/2019
Date Signed: 05/09/2019 02:20:48 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:ALTADENA CHILDREN'S CENTERFACILITY NUMBER:
198007301
ADMINISTRATOR:BOUCHER, TONIFACILITY TYPE:
830
ADDRESS:791 CALAVERASTELEPHONE:
(626) 797-6142
CITY:ALTADENASTATE: CAZIP CODE:
91001
CAPACITY:18CENSUS: 13DATE:
05/09/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:10 PM
MET WITH:Toni BoucherTIME COMPLETED:
01:46 PM
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Licensing Program Analyst (LPA) Ariel Cazares conducted an unannounced case management inspection on this date. LPA met with Director Toni Boucher, who guided analyst on the tour of the facility. LPA observed a total of 13 children (8 toddlers napping, and 5 infants awake) along with 4 staff (1 in toddler classroom and 3 in infant classroom).

LPA conducted the inspection in order to inspect the infant/toddler yard after repair was completed. LPA walked through the yard and captured photos. LPA observed proper flooring, shaded area, and age-appropriate toys and play equipment. LPA did not observe any hazards or violations.

As the infant/toddler playground is ready for use, the waiver to share the preschool program's yard with the infant program will no longer be in use or valid. Program will revert to its own designated spaces.

No deficiencies were observed or cited on this date.

Exit interview conducted with Director Toni Boucher. A copy of this report was provided.

A "Notice of Site Visit" and copy of the report was issued. Notice of Site Visit must remain posted for 30 days. Failure to do so will result in a $100.00 civil penalty.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Ariel AlmazanTELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:

DATE: 05/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2019
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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