<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191222458
Report Date: 09/09/2022
Date Signed: 09/09/2022 03:56:45 PM

Document Has Been Signed on 09/09/2022 03:56 PM - It Cannot Be Edited

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:LA CRESCENTA PRESBYTERIAN CTR. FOR CHILDREN/INFANTFACILITY NUMBER:
191222458
ADMINISTRATOR:PATRICIA CHAMBERSFACILITY TYPE:
830
ADDRESS:2902 MONTROSE AVE.TELEPHONE:
(818) 249-8124
CITY:LA CRESCENTASTATE: CAZIP CODE:
91214
CAPACITY: 20TOTAL ENROLLED CHILDREN: 15CENSUS: 10DATE:
09/09/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Patricia Chambers, DirectorTIME 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 Analyst (LPA) Anomeh Eivazian conducted an unannounced Annual Required- 1 year inspection. LPA met with Patricia Chambers, Director who guided analyst on tour of the facility. This is an infant program which consists of two classrooms; RM 207 (0 -12 months) and RM 106 (12-24 months). This facility is located on La Crescenta Presbyterian Church property. Facility operation hours are Monday to Friday from 7:00 AM to 6:00 PM. There are preschool program on the premises with facility number 191201896 and school age program with facility number 191223032.

All areas identified on the Facility Sketch were inspected. The following staff were present during this inspection: RM 207: Staff #1, and #2 with six infants (0-12 months); RM 106: Staff #4, and #5 with four infants (12-24 months). The following was observed during the tour of facility:

PHYSICAL PLANT


Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Director states that poisons are locked in the laundry room. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. All toilets and hand washing facilities are safe, sanitary and are operating properly. All floors are clean and safe. Per director, cleaning crew clean the facility daily after hours.

All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish and rodents and/or any other vermin. All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids. Drinking water is readily available both indoors and outdoors. Per director, infants drink water by their own sippy cups. The facility was observed to be free of flies, other insects and rodents.
REPORT CONTINUES ON THE NEXT PAGE 1 OF 4
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE: DATE: 09/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/09/2022
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 5
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: LA CRESCENTA PRESBYTERIAN CTR. FOR CHILDREN/INFANT
FACILITY NUMBER: 191222458
VISIT DATE: 09/09/2022
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
26
27
28
29
30
31
32
Both classrooms currently are using the outdoor playarea located in from of the classroom 207 (facing the street). Outdoor playground equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. LPA observed two playhouses on the outdoor playarea. There is adequate shade in the play yard.

The Director states that there are no bodies of water on the premises and LPA did not observe any bodies of water during this inspection. Director states there are no weapons or firearms on the premises.

INFANT PROGRAM (in addition to general compliance)


LPA observed changing table in each classroom. Infant changing tables have a padded surface no less than one inch thick and are covered with washable vinyl or plastic and have raised sides at least three inches high. Toys were observed to be clean and safe. Infant napping equipment meets the requirements of 101439.1 (a) - (f). Per director, infants napping sheets are laundered at the facility daily or as much is needed. Laundry room is adjacent to the director's office. Indoor activity space for this infant program is physically separate from the other components at this facility, and meets the requirements of 101438.3 (a) - (e).

The facility is in compliance with the staff-infant ratios required in 101416.5 (a) - (e). A fully qualified teacher is directly supervising no more than 12 infants. Each aide is responsible for the direct care and supervision of a group of no more than four infants. Individual Feeding Plans are on file for each infant that meets the requirements of 101427 (b)(1) - (5). Infant Needs and Services Plan are on file for each infant that meets the requirements of 101419.2 (a)-(b) and 101419.3 (a). Teachers present have proof of the required infant units on file and meet the qualification requirements of 101416.2 (a), (b), (c) and (g).

FACILITY RECORDS
There is at least one person trained in CPR and Pediatric First Aid present during this inspection. LPA also reviewed staff records. The review of Staff records was documented on the LIC 859. Staff present had proof of the AB 1207 Mandated Reporter Training certificate on file. Staff present had proof against TB, measles, pertussis, and influenza. All staff have been given on the-job training sanitation principles, housekeeping, including universal health precautions. Four staff files were reviewed and staff#2 and staff#4 did not have health screening LIC 503 on file during this inspection.
REPORT CONTINUES ON THE NEXT PAGE 2 OF 4
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2022
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: LA CRESCENTA PRESBYTERIAN CTR. FOR CHILDREN/INFANT
FACILITY NUMBER: 191222458
VISIT DATE: 09/09/2022
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
26
27
28
29
30
31
32
Children's roster was reviewed and is current. Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. LPA observed sign in/out sheet was placed outside by the entrance door of each classroom. During this inspection 10 infants were present and all 10 children were singed in. Disaster drill log was available, last drill was conducted on 08/01/22.

LPA observed operable carbon monoxide detector in each classroom. LPA observed 2A 10 BC fire extinguisher in each classroom. It was serviced on 05/16/22 as read by LPA from service tag.

Menus are posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request. Snacks were reviewed for availability, quantity and appropriateness to children in care. Infants 0-12 months bring their own food. Infants 12-24 months have an option to participate in lunch program or bring their own lunch. Facility provide breakfast, lunch and PM snack to older infants.

The facility shall ensure that each infant is never left unattended, and is under the direct visual supervision of a staff person at all times. Facility does not provide transportation for infant program.

First Aid supplies were observed in the classroom in a cabinet. According to director, medication is only administered to a child when accompanied with a doctor's note and is stored in the laundry room which is adjacent to the director's office. The facility was observed to be equipped with an isolation area for any child who becomes ill and it is located in the staff office. The ill child will use the staff restroom during isolation which is disinfected immediately after use per Site Supervisor.

LPA discussed the safe sleep regulations with director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
REPORT CONTINUES ON THE NEXT PAGE 3 OF 4
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2022
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: LA CRESCENTA PRESBYTERIAN CTR. FOR CHILDREN/INFANT
FACILITY NUMBER: 191222458
VISIT DATE: 09/09/2022
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
26
27
28
29
30
31
32
Medication: This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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. Plan of Operation for IMS was submitted on 07/20/2016.

LPA advised the licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

The deficiencies listed on the following pages were observed by the LPA and are being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809D for deficiencies that are being cited and need to be cleared to protect the children’s health & safety.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experienced. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding inspection tools and methods, please visit the Program website at www.cdss.gov/inforesouces/community-care-liceinsing/inspection-process

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with director, Patricia Chambers at 4:00 p.m..
REPORT END 4 OF 4
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2022
LIC809 (FAS) - (06/04)
Page: 4 of 5
Document Has Been Signed on 09/09/2022 03:56 PM - It Cannot Be Edited


Created By: Anomeh Eivazian On 09/09/2022 at 02:40 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: LA CRESCENTA PRESBYTERIAN CTR. FOR CHILDREN/INFANT
FACILITY NUMBER: 191222458

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/09/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(g)
Personnel Requirmetns
All personnel, including the licensee, administrator and volunteers, shall be in good health and shall be physically and mentally capable of performing assigned tasks.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on four staff file reviews, the licensee did not comply with the section cited above and staff#2 and staff #4 did not have Health Screening form LIC 503 on file which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/30/2022
Plan of Correction
1
2
3
4
Per director, staff #2 and staff#4 will have required Health Screening by plan of correction due date, 09/30/22 and copies will be submitted to LPA Eivazian via email.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Christina Gabelman
LICENSING EVALUATOR NAME:Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:
DATE: 09/09/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/09/2022


LIC809 (FAS) - (06/04)
Page: 5 of 5