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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020505
Report Date: 05/07/2020
Date Signed: 05/07/2020 01:24:00 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:KIDDIE ACADEMY OF PASADENAFACILITY NUMBER:
198020505
ADMINISTRATOR:LYNNE FISHERFACILITY TYPE:
830
ADDRESS:169 HALSTEAD STTELEPHONE:
(626) 606-2800
CITY:PASADENASTATE: CAZIP CODE:
91107
CAPACITY:24CENSUS: 2DATE:
05/07/2020
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Christine JenningsTIME COMPLETED:
01:15 PM
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This was an announced case management inspection conducted by Licensing Program Analyst (LPA) Ariel Cazares due to COVID-19 and precautionary measures. This inspection was conducted with Director Christine Jennings, via a tele-inspection by use of Zoom.

The purpose of the inspection is to address the request for an increase in capacity for the infant program. An additional space was added to the infant room in order to accommodate the requested increase. LPA received a facility sketch showing the addition.

At 1:00 pm, LPA was guided on a tour of the facility. LPA observed 0 children in the inafnt room and 2 children with 1 staff in the toddler room. LPA was shown the outdoor playground, no children were observed. The added space is located in the infant room and was shown to LPA. LPA did not observe any hazards or need for repair. Director will also submit photos of the measurements/dimensions of the added space prior to increase to license being approved.

Exit interview was conducted with Director Christine Jennings. A copy of this report and appeal rights will be emailed, and a read receipt will be acknowledgment of receipt of report. A copy of the report will also be signed and mailed to the department.
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Ariel CazaresTELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:

DATE: 05/07/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2020
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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