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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191222458
Report Date: 07/15/2024
Date Signed: 07/15/2024 03:36:05 PM

Document Has Been Signed on 07/15/2024 03:36 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:LA CRESCENTA PRESBYTERIAN CTR. FOR CHILDREN/INFANTFACILITY NUMBER:
191222458
ADMINISTRATOR/
DIRECTOR:		PATRICIA CHAMBERSFACILITY TYPE:
830
ADDRESS:2902 MONTROSE AVE.TELEPHONE:
(818) 249-8124
CITY:LA CRESCENTASTATE: CAZIP CODE:
91214
CAPACITY: 20TOTAL ENROLLED CHILDREN: 20CENSUS: 7DATE:
07/15/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:41 AM
MET WITH:Patricia Chambers TIME VISIT/
INSPECTION COMPLETED:
09:42 AM
NARRATIVE
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On 07/15/2024, at 08:30 am , Licensing Program Analyst (LPA ) Shushanik Safaryan conducted Case Management visit .During the visit , LPA met with Facility Representative, Patricia Chambers , to whom the purpose of the visit was explained. Facility Representative guided LPA on the tour of the facility. This is the infant program that consists of two classrooms . LPA toured room # 207 , where observed 3 infants with 2 staff members. Next LPA toured room # 106 . At 08:46 am , LPA observed 7 infants with staff #1 and staff #2 . Per records and information provided by the facility ,staff #2 is under 18 and still in school . Per director, staff # 4 is absent today . Per Director , staff #2 was assigned to wash the dishes and staff # 3 was assigned to be in the class . During the tour , Staff # 3 was in the kitchen and staff #2 was in the class. Per Director , she understands there shall be a ratio of one teacher for every four infants in attendance and admits that room # 106 was out of the ratio.

Based on the observations , interviews and records reviews the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.


Licensing staff informed Facility Representative a copy of this licensing report dated 07/15/2024 that documents any Type A citation(s) need to provide to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

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

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE: DATE: 07/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/15/2024
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: LA CRESCENTA PRESBYTERIAN CTR. FOR CHILDREN/INFANT
FACILITY NUMBER: 191222458
VISIT DATE: 07/15/2024
NARRATIVE
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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.

An exit Interview was conducted, a copy of this report along with Notice of Site visit , Deficiency pages and Appeal Rights were explained and provided to the Facility Representative , Patricia Chambers on 07/15/2024.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/15/2024 03:36 PM - It Cannot Be Edited


Created By: Shushanik Safaryan On 07/15/2024 at 10:01 AM
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: 07/15/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/16/2024
Section Cited
CCR
101416.5(b)

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101416.5Staff-Infant Ratio (b) There shall be a ratio of one teacher for every four infants in attendance. This requiremen ts is not met evidenced by :
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Per Director , she will talk to the satff members and will make sure everyone understands their duties and will send LPA metting agenda by POC date .
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LPA observed in room #106 , seven infants with 1 staff member and another staff member who was under 18.
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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:Brandi VanOosten
LICENSING EVALUATOR NAME:Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:
DATE: 07/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/15/2024


LIC809 (FAS) - (06/04)
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