198020505-10-28-2021-33-CC-CGRN-C88V6A-20211028160914

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020505
Report Date: 10/28/2021
Date Signed: 10/28/2021 04:09:21 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 PASADENA		FACILITY NUMBER:	198020505
ADMINISTRATOR:	LYNNE FISHER		FACILITY TYPE:	830
ADDRESS:	169 HALSTEAD ST		TELEPHONE:	(626) 606-2800
CITY:	PASADENA	STATE: CA	ZIP CODE:	91107
CAPACITY:	25	CENSUS: 16	DATE:	10/28/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Christine Jennings		TIME COMPLETED:	04:15 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 Analyst (LPA) Crystal Green conducted an unannounced case management licensee initiated inspection to inspect and measure facility for capacity increase determination. Licensee is requesting to increase capacity to their existing license. Due to COVID- 19 precautionary measures were taken, individuals present during inspection wore appropriate personal protective equipment. Licensing staff met with Director, Christine Jennings. There is also a preschool program (198020513) that operates on the same premises as the infant program. Hours of operation will be from Monday through Friday, 7 am - 6:30pm. LPA was provided a tour of the facility’s existing licensed infants areas and the proposed additional classroom space. The existing classrooms licensed for use under the infant program are Room 1 called The Ocean and Room 2 called The Farm. Per Director, licensee is requesting to add Room 4 to the infant license. During this inspection, LPA observed 10 infants napping in Room 1 with 1 staff member and 6 infants napping in Room 2 with 2 staff members. The facility was observed to be operating within its licensed capacity. LPA inspected Room 4 and observed a changing table available along with age appropriate furniture. Toys were observed to be clean and safe. LPA observed the Infant designated areas to be physically separate from the Preschool designated areas. Report Continues Page 1 of 2

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Crystal Green	TELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:	DATE: 10/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021

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: KIDDIE ACADEMY OF PASADENA	FACILITY NUMBER: 198020505
	VISIT DATE: 10/28/2021

NARRATIVE

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There is adequate shade in the outdoor play area. The outdoor play equipment was observed to be in good condition, free of sharp, loose, or pointed parts. Outdoor activity space surface is maintained in a safe condition as is free of hazards.

At this time, the facility was observed to be operating in compliance with California Title 22 Regulations. Measurements used during this inspection were obtained from the inspection conducted on 02/20/2020. The classrooms that will be licensed for use by Infants will be Room 1, Room 2, and Room 4. Based on the measurements obtained on 02/20/2020, the new capacity for the infant program forty- four (44) infants. An approved Fire Clearance has been received by the department.

An exit interview was conducted with the Director, Christine Jennings. A copy of this report along with the Notice of Site Visit were provided to the Director.

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.

Report Ends Page 2 of 2.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Crystal Green	TELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:	DATE: 10/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021

LIC809 (FAS) - (06/04)

Page: 2 of 2