198019653-10-29-2020-33-CC-ACAS-BUUR39-20201029123933

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019653
Report Date: 10/29/2020
Date Signed: 10/29/2020 12:39:59 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:	SIERRA MADRE UNITED METHODIST CHURCH-BRIDGE		FACILITY NUMBER:	198019653
ADMINISTRATOR:	STEPHANIE MCREYNOLDS		FACILITY TYPE:	850
ADDRESS:	695 W. SIERRA MADRE BLVD		TELEPHONE:	(626) 355-0629
CITY:	SIERRA MADRE	STATE: CA	ZIP CODE:	91024
CAPACITY:	78	CENSUS: 49	DATE:	10/29/2020
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Lydia Nandakumaran		TIME COMPLETED:	11:30 AM

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	On 10/29/2020, Licensing Program Analyst (LPA) Ariel Cazares met with Licensee Lydia Nandakumara of the licensed facility via FaceTime. The purpose of the visit was to provide technical assistance to the facility that has been granted a waiver to temporarily operate a toddler and school-age component under the preschool license. This waiver will be used to due to the spread of COVID-19 in Southern/Northern California. The child care will be operated Monday through Friday, 7am to 6pm and under the waiver will serve children starting at 18 months and K to 8^th grade, with a combined total capacity of 24 under the waiver. Should the facility need to increase capacity beyond what has been approved in the waiver or any changes to the conditions of the waiver occur, Sierra Madre United Methodist Church shall notify the Monterey Park Child Care Regional Office. At 10:45am, Licensee Lydia Nandakumaran guided LPA tour of the facility. The temporary school-age component consists of two rooms and a separate, private restroom. The toddler component will have a separate classroom. Check-in will take place at the entrance of the facility, outside. If child/ren become ill during the course of the day, they will be placed in the isolation area known as the staff lounge (Sierra House) where a restroom is also located. The toddler component has their own playground. School-age children will share the preschool yard on a staggered schedule.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Ariel Cazares	TELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:	DATE: 10/29/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2020

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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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: SIERRA MADRE UNITED METHODIST CHURCH-BRIDGE	FACILITY NUMBER: 198019653
	VISIT DATE: 10/29/2020

NARRATIVE

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There were 0 school-age children present during the inspection as they have not been enrolled yet. This facility consists of the following: 4 preschool rooms, 3 toddler rooms, 2 of the toddler rooms may be used as the temporary school-age rooms under the waiver. There were a total 46 preschool and 3 toddler children present during this inspection.

Outside Group 1: 12 children with 2 staff.
Outside Group 2: 12 children and 2 staff.
Outside Group 3: 10 children and 2 staff.
Outside Group 4: 12 children and 2 staff.
Toddler Room: 3 toddler and 1 staff

The ratio kept for the school-age component will be 1:12. The equipment used by school-age children is age appropriate. School-age children do have the option to rest and a mat is available. Drinking water is available via water gallons and personal bottles.

LPA was guided through the outdoor space designated for school-age children. Drinking water is available in form of personal water bottles and water jug is available for outdoors. Children practice social distancing outdoors and per licensee the play structures are used and cleaned after each group of children.

To further ensure health and safety of the children in care, Community Care Licensing will provide on-going Technical Assistance (TA) to Glendora Unified School District Preschool. LPA advised director to stay updated with the Provider Information Notices (PINs) on the department website www.ccld.ca.gov as well as www.covid19.ca.gov for COVID-19 related information.

An exit interview was conducted with Licensee Lydia Nandakumaran. A copy of this report will be sent via email with an attached read receipt as proof of receipt. LPA request report be signed and a copy returned to the Regional Office.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Ariel Cazares	TELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:	DATE: 10/29/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2020

LIC809 (FAS) - (06/04)

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