198012164-2-2-2022-33-CC-NTCG-CB9ULX-20220202144128

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198012164
Report Date: 02/02/2022
Date Signed: 02/02/2022 02:41:39 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:	TINY WORLD PRE-SCHOOL		FACILITY NUMBER:	198012164
ADMINISTRATOR:	RAHINI SABANAYAGAM		FACILITY TYPE:	850
ADDRESS:	1977 E. VILLA STREET		TELEPHONE:	(626) 568-8469
CITY:	PASADENA	STATE: CA	ZIP CODE:	91107
CAPACITY:	30	CENSUS: 11	DATE:	02/02/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:57 PM
MET WITH:	Rahini Sabanayagam - Director		TIME COMPLETED:	02:55 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 Analyst (LPA) Nolan Tcheng conducted an unannounced random annual inspection. Upon arrival at 12:57pm, LPA met with Director Rahini Sabanayagam. At 1:25pm, LPA was led on a tour of the facility. This is a preschool program which consists of 3 classrooms. This facility also has an infant licence, facility #198016078. Per licensee, there are currently 13 enrolled in the program. Hours of operation for this facility are 7am-6pm, Monday-Friday.

Licensing staff observed all required forms/publications to be posted in the office. Snack menus were reviewed to ensure that they are being posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request.

Upon arrival, due to staff lunch breaks and facility nap time, Director could not step away from the groups in order to provide LPA with an immediate tour of the facility. LPA conducted Facility File review first.

FACILITY RECORDS: Sign in and out sheets were reviewed by facility entrance, to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. At 1:10pm, Staff files were reviewed for a health screening report and immunizations that meet regulatory requirements. Criminal Record Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed. The name of the child care center director or fully qualified teacher(s) designated to act in the director's absence is on file. Educational background, training, and/or experience for each staff present are on file and were reviewed. A random sample of Children’s Records were reviewed to ensure that they are complete.

PHYSICAL PLANT: At 1:25pm, LPA entered and inspected Classroom 1 (4-5s): 11 children with 1 staff member were present, and Classroom 4 (2-3s): 0 children and 0 staff. The tour took place during the scheduled nap time. Children all come to Classroom 1 for nap time. LPA observed the use of cots for nap time and the storage of the cots along the wall of Classroom 1. REPORT CONTINUES PAGE 1 of 3

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Nolan Tcheng	TELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2022

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 3

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: TINY WORLD PRE-SCHOOL	FACILITY NUMBER: 198012164
	VISIT DATE: 02/02/2022

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
26
27
28
29
30
31
32

Classroom 2 is used in the morning during drop off. Children will gather there and be moved to their assigned classrooms with their teachers. LPA observed the restroom for children that is shared between Classroom 1 and 4. All toilets, hand washing, and bathing facilities are safe, sanitary and are operating properly. At 1:30pm, a fire extinguisher was observed. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 09/03/2021 as indicated on service tag. Per State Fire Marshall standards, fire extinguishers shall be serviced annually. Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children by being placed on shelves out of reach out children. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. All floors are clean and safe. 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. The facility was observed to be free of flies, other insects and rodents. Sufficient individual storage space for children was observed and each child has a cubby. Drinking water was readily available indoors in the form of a gallon water bottle with cups next to it. At this time, the office is used as an isolation area. A cot is available for an ill child to rest on. First Aid supplies are available and complete. Facility has a functioning carbon monoxide detector that meets statutory requirements. Director states there are no weapons, firearms, or bodies of water on the premises. This facility provides am snack and pm snack. Families provide their own lunch from home for children.

Teacher-child ratios were observed to be in accordance with Title 22 regulations. Staff names were recorded. All children were observed to be under visual supervision of a teacher during tour. The Licensee is within the conditions, limitations, and capacity specified on the license. All areas were identified on the Facility Sketch were inspected.

OUTDOORS: At 1:36pm, LPA reviewed the outdoor play area. Outdoor playground equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with material that absorbs a fall. The entire play space was observed to have woodchips on the floor as cushion. There is one outside play space that has a slide, jungle gym, Swings, and playhouses for children to use. Drinking water is readily available outdoors by bringing out the gallon water and cups.

REPORT CONTINUES PAGE 2 of 3

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Nolan Tcheng	TELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2022

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: TINY WORLD PRE-SCHOOL	FACILITY NUMBER: 198012164
	VISIT DATE: 02/02/2022

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
26
27
28
29
30
31
32

INCIDENTAL MEDICAL SERVICES:
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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

During this inspection LPA discussed PIN 20-06 CCP, Social And Physical Distancing Guidance And Healthy Practices For Child Care Facilities In Response To The Global Coronavirus (COVID-19) Pandemic Written In Collaboration With The California Department Of Education and reviewed Child Care Covid-19 Self Assessment.

LPA advised the licensee how to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov. AB1207 Mandated Child Abuse Reporting – Implementation was discussed with Licensee. Website provided: http://mandatedreporterca.com/

At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.

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.

Exit interview was conducted with Director Rahini Sabanayagam, at 2:35pm, including a copy of report.

END OF REPORT PAGE 3 of 3

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Nolan Tcheng	TELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2022

LIC809 (FAS) - (06/04)

Page: 3 of 3