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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198015779
Report Date: 10/15/2019
Date Signed: 10/15/2019 11:37:46 AM

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:SAINT MARK'S SCHOOL, ALTADENA, INC.FACILITY NUMBER:
198015779
ADMINISTRATOR:KELLY MANCUSOFACILITY TYPE:
850
ADDRESS:1050 E. ALTADENA DRIVETELEPHONE:
(626) 798-8858
CITY:ALTADENASTATE: CAZIP CODE:
91001
CAPACITY:64CENSUS: 47DATE:
10/15/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Bailey TrippTIME COMPLETED:
11:55 AM
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Licensing Program Analysts (LPAs) Crystal Green and Bardo Baluyot conducted an unannounced case management inspection to follow up on an incident that was reported to the Department on 09/19/2019. Upon arrival, LPAs met with Director, Bailey Tripp, who provided LPAs a tour of the facility inside and outside. Census was taken.

On 09/19/2019, an incident was reported to the department where a child fell down a few steps while transitioning to the outside play yard which resulted in a scraped to child's face. The facility reported this incident to the Department within the required 24 hours period. Upon arrival, LPAs observed a preschool classroom transitioning from the lower level play yard using the stairwell. LPAs observed their to be adequate supervision during the transitioning process. Per Director, child returned to school the next day. Based on LPAs observation of the transition process to the play area. LPA determined there was adequate supervision provided the day of the incident. Per California Code of Regulations Title 22, Division 12, no deficiency cited during today's visit.

Exit interview conducted with the Director, Bailey Tripp.

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 GabelmanTELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Crystal GreenTELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2019
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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