198020008-9-13-2019-33-CC-AALN-BFYUSE-20190913155014

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020008
Report Date: 09/13/2019
Date Signed: 09/13/2019 03:50:19 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:	ABILITYFIRST GLENDALE CENTER		FACILITY NUMBER:	198020008
ADMINISTRATOR:	MONICA ALCANTAR		FACILITY TYPE:	840
ADDRESS:	440 WEST LOMITA AVE		TELEPHONE:	(626) 639-1749
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91205
CAPACITY:	30	CENSUS: 8	DATE:	09/13/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:45 PM
MET WITH:	Phillip West		TIME COMPLETED:	04:00 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	Licensing Program Analysts (LPAs) Ariel Cazares and Dayna Chambers conducted an unannounced annual/random inspection on this date. LPAs met with Phillip West and observed a total of 8 participants and 4 staff. The facility operates on the campus of the Pacific Education Center, currently in rooms #6 and the Multipurpose Room. The program hours are from 2:00 P.M. to 6:00 P.M, but during school breaks hours are from 8:30 AM to 6:00 PM. Participants enter the facility through the side of the building coming from Pacific Ave. Participants are signed in and out using logs and an electronic system. LPA inspected the rooms currently used by the program. LPA inspected the restrooms and the outdoor space designated for the participants. LPA did not observe any hazards or violations. There is accessible drinking water available in form of water pitchers and cups. Snacks are provided and prepared on site. Lunch is brought by the parents during full days. Furniture and equipment are age appropriate and in good repair. The carbon monoxide detector in the Room #8 was tested and found to be in operable condition and there are detectors in Rooms #6 and the MPR. A current fire clearance is on file with the Department for the facility. The outdoor area is located in between the building that houses Room #6 & 8 and MPR. There is adequate shading and tables for rest. There are water fountains available for drinking water. LPA observed that doors on gates are maintained locked and participants are supervised at all times when outdoors. No pools, spas, or other bodies of water were observed. LPA reviewed participant and staff files. LPA observed them to be complete and in order. Mr. West had his CPR/First Aid certificate valid until 4/25/2021. Staff files reviewed had mandated reporter training certificates on file. Sign in and out sheets were observed in the MPR and complete.

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Ariel Almazan	TELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2019

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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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: ABILITYFIRST GLENDALE CENTER	FACILITY NUMBER: 198020008
	VISIT DATE: 09/13/2019

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A request was made to change rooms from Room #6 to Room #8, but maintain the MPR and restrooms. LPA inspected Room #8 and observed there to be no corrections needed or violation observed. Items currently used by the participants in Room #6 will be transitioned over to Room #8 once approval is granted. Currently pending is an updated contract with the school for use of Room #8 by the program. Upon approval, the facility will be using Room #8 and continue use of the MPR, restrooms, and outdoor space.

Incidental Medical Services (IMS) plan and policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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

No deficiencies were cited in accordance with California Code of Regulations Title 22.

Exit interview conducted with Phillip West. A copy of this report was provided and 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 reprehensive. Failure to maintain posting as required will result in a civil penalty of $100.00.

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Ariel Almazan	TELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2019

LIC809 (FAS) - (06/04)

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