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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018862
Report Date: 03/05/2024
Date Signed: 03/05/2024 11:23:03 AM


Document Has Been Signed on 03/05/2024 11:23 AM - It Cannot Be Edited

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:PASADENA WALDORF SCHOOLFACILITY NUMBER:
198018862
ADMINISTRATOR:LAURA CABRALFACILITY TYPE:
850
ADDRESS:536 E. MENDOCINO ST.TELEPHONE:
(626) 765-9978
CITY:ALTADENASTATE: CAZIP CODE:
91001
CAPACITY:48CENSUS: 31DATE:
03/05/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
08:05 AM
MET WITH:Laura Cabral, DirectorTIME COMPLETED:
09:16 AM
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On March 5, 2024, Licensing Program Analyst (LPA) Monique Ayala conducted an unannounced Case Management Inspection – Plan of Correction at the above facility. A COVID-19 risk assessment was conducted prior to entering the facility. LPA met with director, Laura Cabral who guided LPA on a tour of the facility. LPA observed 31 children in care. The purpose of this inspection is to ensure that the facility is in compliance with Title 22 Regulations and the deficiencies cited on 02/08/2024 were corrected.

Licensing staff observed and reviewed the following:

  • Mandated Reporter for 2 staff
  • Health Screening for the director
  • Proof of completion of water lead testing

Letters of Deficiencies Citations Cleared were provided for deficiencies corrected.

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

An exit interview was conducted, and a copy of this report was provided to director, Laura Cabral.

SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Monique Jessica AyalaTELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 03/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/05/2024
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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