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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017598
Report Date: 06/09/2021
Date Signed: 06/09/2021 04:00:51 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:PACIFIC CLINICS NESBITT EARLY HEAD STARTFACILITY NUMBER:
198017598
ADMINISTRATOR:LA SHON TILLIE-JONESFACILITY TYPE:
830
ADDRESS:349 W. ALTADENA DR.TELEPHONE:
(626) 794-7192
CITY:ALTADENASTATE: CAZIP CODE:
91001
CAPACITY:32CENSUS: 7DATE:
06/09/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:13 PM
MET WITH:LaShon Tillie-Jones, Service Area Supervisor TIME COMPLETED:
04:15 PM
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At 1:12p.m. on June 9, 2021, Licensing Program Analyst (LPA) Lissete Gonzalez conducted an unannounced Required 1 Year inspection on this date. LPA met with Service Area Supervisor, LaShon Tillie-Jones and Early Childhood Education Manager, Judy Cashell, who provided LPA with a tour of the facility. LPA conducted an inspection of the facility as well as addressed the application for the addition of a toddler option to the license. Pacific Clinics Nesbitt Early Head Start is requesting to add 24 toddlers to the existing infant license and to decrease the infant capacity to 8 for an overall capacity of 32. Currently, the facility is licensed for 32 Infants from birth until 3 years old per section 101362; up to 8 infants may be non-ambulatory.

There were (07) seven children present during today’s visit. Staff-child ratios were met. LPA toured the areas according to the facility sketch. LPA observed licensee to be following the social distancing among the children in the classrooms. The proposed Toddler classrooms are Room #2 and Room #3. Room #1 will remain as an infant classroom. LPA observed age appropriate equipment, toys, and supplies for children. The Toddlers designated isolation is located in the Director’s office. A cot is available for ill children waiting to be picked up.

Central air and heating are available in the classrooms. Sign-in and out sheets were reviewed and in compliance. There are napping cots available for the children. Per Service Area Supervisor, linens and bedding are laundered daily by a staff member. There are laundry services available at the facility. LPA observed a landline in each classroom. LPA observed the smoke and carbon monoxide combination detectors in the classrooms to be operational. There are emergency supplies and a first aid kit located in each classroom. There is drinking water available in form of a water dispenser with disposable cups. Cleaning supplies are inaccessible to children in care. There are trash cans with tight fitting lids available in the classrooms.

REPORT CONTINUES ON NEXT PAGE: 1 OF 3
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3383
LICENSING EVALUATOR NAME: Lissete GonzalezTELEPHONE: (323) 981-3383
LICENSING EVALUATOR SIGNATURE:

DATE: 06/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2021
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: PACIFIC CLINICS NESBITT EARLY HEAD START
FACILITY NUMBER: 198017598
VISIT DATE: 06/09/2021
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The restroom is located in the hallway of the facility which was observed to have two sinks and two toilets. There is a diaper room available for toddlers in care. There are two diaper changing stations in the diapering room within arm’s reach of a sink. There is a parent board with the required postings at the entrance to the facility.

LPA observed snack and meal menus in the classrooms. Facility provides Breakfast, Lunch, and PM snacks. Meals are individually packaged. The facility kitchen is used for washing dishes (dishwasher on site). There are two refrigerators and one food warmer. Food is brought in daily by a caterer and meals are maintained warm through the food warmer. The kitchen was observed to be clean and orderly.

The Toddler and infant outdoor playgrounds were inspected and measured. There is age appropriate play equipment in the playground. The outdoor space is fenced. Drinking water is available to children via a water jugs and disposable cups. There is adequate shade in the yard.

LPAs also reviewed criminal record clearances, children and staff records. Children's records were reviewed and found to be in compliance.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual -
Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is
provided, a Plan for Providing 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

Based on the measurements, the facility can accommodate 24 Toddlers and 8 infants. There is a current and valid fire clearance on file with the Department with an inspection date of 5/12/2021.

LPA observed the infants will need to walk through the toddler outdoor playground to access the infant playground. In addition, approval is needed to allow for a staggered outdoor play schedule for toddlers. The matter will be addressed with the management team prior to approval of granting the toddler option and infant capacity decrease.
REPORT CONTINUES ON NEXT PAGE: 2 OF 3
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3383
LICENSING EVALUATOR NAME: Lissete GonzalezTELEPHONE: (323) 981-3383
LICENSING EVALUATOR SIGNATURE:

DATE: 06/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2021
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: PACIFIC CLINICS NESBITT EARLY HEAD START
FACILITY NUMBER: 198017598
VISIT DATE: 06/09/2021
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No deficiencies cited during this visit. Exit interview conducted with Service Area Supervisor, LaShon Tillie-Jones. A copy of this report and appeal rights were provided and explained.

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.

END OF REPORT: PAGE 3 OF 3
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3383
LICENSING EVALUATOR NAME: Lissete GonzalezTELEPHONE: (323) 981-3383
LICENSING EVALUATOR SIGNATURE:

DATE: 06/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3