198019903-10-1-2020-33-CC-CGRN-BTYQVK-20201001123028

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019903
Report Date: 10/01/2020
Date Signed: 10/01/2020 12:30:34 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:	PASADENA WALDORF SCHOOL		FACILITY NUMBER:	198019903
ADMINISTRATOR:	LAURA MARINA CABRAL		FACILITY TYPE:	850
ADDRESS:	209 E MARIPOSA ST		TELEPHONE:	(626) 794-9564
CITY:	ALTADENA	STATE: CA	ZIP CODE:	91001
CAPACITY:	30	CENSUS: 13	DATE:	10/01/2020
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Laura Cabrel		TIME COMPLETED:	12:35 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	An announced case management inspection was conducted today by Licensing Program Analyst (LPA) Crystal Green to inspect and measure facility for capacity increase determination. Due to COVID- 19 precautionary measures were taken, individuals present during inspection wore appropriate personal protective equipment. Facility was observed to be adhering to local public health guidelines. Licensing staff met with Director, Laura Cabral, who guided analyst on a tour of the facility. The preschool program operates from Monday through Friday 8:00 AM - 4:00 PM. NOTE: Pasadena Waldorf (K-8th) operates on the same campus. The school is a private school which operates through a private school affidavit. Per Director, at this time the school-age program is not operating. At 11:15 AM, Licensing staff was guided through a tour of the proposed preschool classroom. The Preschool facility is currently operating and a total of 13 children with 3 staff members were observed. Existing classrooms are the Lily room and Buttercup room. Licensee is requesting to add an additional classroom which will be called the Rose room. LPA observed 2 toilets and 2 sinks available for children in care located inside the classroom. All toilets and sinks are in safe and sanitary operating conditions. Individual storage space is available for each child which is located outside the classroom in the front patio area. Toys were observed to be clean and safe. Furniture and equipment were inspected for age appropriateness and good repair. There are cots available for napping. Per Director, cots are sanitized before and after each use. Linen are token home and washed by parents on a weekly basis or as needed. LPA observed each classroom to have its own entrance accessible from the front and back walkway of the building. The director’s office will be used as the ill isolation room. There is a cot and restroom for ill children to use. Due to COVID- 19 precautionary measures, Director states that each classroom will have their own drop off times to limit contact with other preschool children and temperature checks will be conducted prior to entry. Report Continues Page 1 of 2

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Crystal Green	TELEPHONE: (323) 854-5730
LICENSING EVALUATOR SIGNATURE:	DATE: 10/01/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2020

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 2

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: PASADENA WALDORF SCHOOL	FACILITY NUMBER: 198019903
	VISIT DATE: 10/01/2020

NARRATIVE

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Children attending will be signed in upon entry to the main office area. Children will remain in that area with their assign classroom until all children are accounted for. Parents will provide snacks and lunches for their child. Children will bring their own drinking cup for water due to COVID-19 precautionary measure.

Based on measurements obtained today, capacity for the preschool program will be increased to fifty (50) preschoolers. A fire clearance was received and approved by LA County Fire Department. No correction is needed at this time. Facility will be submitted for final approval upon return Monterey Park Regional Office.
Exit interview was conducted with Director Laura Cabral and a copy of the report and appeals rights were provided.

Report Ends Page 2 of 2.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Crystal Green	TELEPHONE: (323) 854-5730
LICENSING EVALUATOR SIGNATURE:	DATE: 10/01/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2020

LIC809 (FAS) - (06/04)

Page: 2 of 2