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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198011061
Report Date: 10/29/2024
Date Signed: 10/29/2024 02:33:31 PM

Document Has Been Signed on 10/29/2024 02:33 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:CELEBRATION KIDS, INC.FACILITY NUMBER:
198011061
ADMINISTRATOR/
DIRECTOR:		SARA GURLEYFACILITY TYPE:
850
ADDRESS:1101 ARROYO VERDE ROADTELEPHONE:
(323) 258-9890
CITY:SOUTH PASADENASTATE: CAZIP CODE:
91030
CAPACITY: 86TOTAL ENROLLED CHILDREN: 86CENSUS: 79DATE:
10/29/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:27 AM
MET WITH:Sara Curley TIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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On 10/29/24 ,at 10:30 am, Licensing Program Analyst (LPA) Shushanik Safaryan conducted an unannounced annual random inspection to the above facility . Upon arrival , LPA met with the Facility Representative , Sara Curley , to whom the reason of the visit was explained and who guided LPA on a tour of the facility . This is a preschool age program which consists of seven classrooms and Art room and operates Monday through Friday from 7:30AM to 6:00 PM. Per Facility Representative there are 85 children enrolled.

Upon arrival ,LPA observed 12 children with 2 staff members in Room #1, 9 children with 2 staff members in Room #2, 17 children with 2 staff members in Room #6, 7 children with 1 staff member in Room #8 . LPA did not observe any children in Room # 3, 4, 5. All other children were observed playing in outdoor play area . Teacher child ratios were observed to be in accordance with Title 22 Regulations. Staff names were recorded. All children were observed to be under supervision, including visual supervision. Licensed facility is within the conditions, limitations, and capacity specified on the license.

The classroom furniture and equipment were inspected for good repair, free of sharp, loose, or pointed parts. At 11:00 am , during the tour , LPA observed carpet in Room #6 with multiple black stains.(Pictures were taken). Next LPA inspected all toilets and washing facilities and observed bathroom floor in Room #8 was ripped which can be tripping hazard for children in care. (Pictures were taken).

First Aid supplies are available and complete in each classroom .Napping equipment and bedding were inspected for good condition, appropriate storage, and cleanliness. Storage for children's belongings was inspected. Parents take linens home on Friday and returned on Monday. Some classrooms have space to store mats , only Room #1 cots were observed to be stored in the tent in the front of the school.

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NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Shushanik Safaryan
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/29/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: CELEBRATION KIDS, INC.
FACILITY NUMBER: 198011061
VISIT DATE: 10/29/2024
NARRATIVE
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Per Facility Representative , facility provides AM and PM snack , children bring their own lunch . Snack menus were posted one week in advance in the classrooms along with weekly lesson plan where it is visible by the child's authorized representative. Per facility representative cabinets and refrigerators are used for storing snacks. Per Facility Representative , snacks are kept in each classroom and some stored in outside refrigerator too. LPA checked storage for snacks. During the tour , LPA inspected refrigerator in outdoor play area and observed spilled food on the bottom of the shelf, two gallons of milk with an expiration date 10/23/24. Facility representative removed the milk from the refrigerator to discard .

LPA observed that there are functioning smoke and carbon detectors in the facility. LPA observed a fully charged and serviced fire extinguisher with the service date 06/11/24. Emergency disaster drill was last conducted on 10/17/24. Facility representative states there are no weapons, firearms, or bodies of water on the premises.

All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids. Drinking water is readily available both indoors and outdoors, children bring their own water bottles too. The facility was observed to be free of flies, other insects, and rodents.

The Director`s office and staff restroom used for the ill children. Cot will be available upon request.

At 11:30 am , LPA toured the outdoor play area and observed the wooden step to the wooden house was broken, which poses potential risk to the safety of children in care . All areas around or under high climbing equipment, slides, and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard.



Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. For Rooms #1 and 2 parents sign in in the classrooms , for the other rooms sign in sheets were observed next to the gate on the side .

Children’s Records were reviewed to ensure that Identification and Emergency form and a medical assessment are on file. Inspection of required forms was made and documented on the LIC 857.

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NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Shushanik Safaryan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2024
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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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: CELEBRATION KIDS, INC.
FACILITY NUMBER: 198011061
VISIT DATE: 10/29/2024
NARRATIVE
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 At 12:30 PM, LPA reviewed ten staff records and observed five out of ten records were missing immunization's records , 4 out of 10 staff members have incomplete Health Screening Reports (LIC 503 ) and 2 out of 10 staff members were missing Mandated Reporter Certificates .

There is at least one person trained in CPR and Pediatric First Aid present during this inspection. The review of Staff records was documented on the LIC 859.

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 PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.
LPA advised the licensee to access forms, regulations, and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

Facility Representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Based on the LPA’s observations and records reviews, the following deficiencies listed on the attached LIC 809D (Deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health and safety.


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.
An exit Interview was conducted, a copy of this report along with Notice of Site visit , Deficiency pages and Appeal Rights were explained and provided to the Facility Representative , Sara Gurley on 10/29/24.

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NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Shushanik Safaryan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/29/2024 02:33 PM - It Cannot Be Edited


Created By: Shushanik Safaryan On 10/29/2024 at 01:13 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: CELEBRATION KIDS, INC.
FACILITY NUMBER: 198011061

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/29/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238.3(b)
Indoor Activity Space
(b) The floors of all rooms shall have a surface that is safe and clean.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations , the licensee did not comply with the section cited above. During the tour , LPA observed carpet in Room #6 have multiple black stains , bathroom floor in Room #8 was ripped ,which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/12/2024
Plan of Correction
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Licensee satted bathroom floor will be fixed and carpet in room will be cleaned by POC date and LPA will be notified for follow up inspections .
Type B
Section Cited
CCR
101238.2(d)(2)
Outdoor Activity Space
(d) The surface of the outdoor activity space shall be maintained: (2) Free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation , the licensee did not comply with the section cited above . LPA observed wooden step that leads to the wooden house in thr outdoor play area was broken ,which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/12/2024
Plan of Correction
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Licensee stated , step will be fixed by POC date and LPA will be notified for follow up inspection .
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Brandi VanOosten
LICENSING EVALUATOR NAME:Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:
DATE: 10/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/29/2024


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/29/2024 02:33 PM - It Cannot Be Edited


Created By: Shushanik Safaryan On 10/29/2024 at 01:13 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: CELEBRATION KIDS, INC.
FACILITY NUMBER: 198011061

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/29/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on the records review and interview , the licensee did not comply with the section cited above . LPA reviewed 10 records , 2 out of 10 records were missing Mandated Reporter Certificates , which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/12/2024
Plan of Correction
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Liensee stated , staff missing training will take the training and will obtain certificates by POC date .
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview , records review ,the licensee did not comply with the section cited above, 5 out 10 employee records were missing immunization records ,which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/19/2024
Plan of Correction
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Licensee stated , she will obtain immunization records and will notify LPA by POC date for follow up visit .
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Brandi VanOosten
LICENSING EVALUATOR NAME:Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:
DATE: 10/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/29/2024


LIC809 (FAS) - (06/04)
Page: 5 of 6
Document Has Been Signed on 10/29/2024 02:33 PM - It Cannot Be Edited


Created By: Shushanik Safaryan On 10/29/2024 at 01:13 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: CELEBRATION KIDS, INC.
FACILITY NUMBER: 198011061

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/29/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(g)(2)
Personnel Requirements
(2) Each person specified in (g) above shall have a health-screening report signed by the person performing the screening. This report shall indicate the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on records review , interview , the licensee did not comply with the section cited above . 4 out of 10 records were missing health screening reports, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/19/2024
Plan of Correction
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Licensee stated , staff will obtain forms and will notify LPA by POC date .
Type B
Section Cited
CCR
101227(a)(18)
Food Service
(18) All kitchen, food-preparation and storage areas shall be kept clean and free of litter and rubbish; and measures shall be taken to keep all such areas free of rodents and other vermin.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview , the licensee did not comply with the section cited above. LPA observed in the refregirator were children`s snack kept spilled food on the bottom of the shelf and expired gallons of milk , which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/12/2024
Plan of Correction
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Licensee satted , refregirator will be cleaned and snack will be checked . LPA will be notified and follow up visit will be conducted .
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Brandi VanOosten
LICENSING EVALUATOR NAME:Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:
DATE: 10/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/29/2024


LIC809 (FAS) - (06/04)
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