191290357-8-5-2025-33-CC-AEIN-DK9SS4-20250805140720

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191290357
Report Date: 08/05/2025
Date Signed: 08/05/2025 02:07:31 PM

Document Has Been Signed on 08/05/2025 02:07 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:	GRANDVIEW PRESBYTERIAN CHURCH COMM CHILDRENS CTR.		FACILITY NUMBER:	191290357
ADMINISTRATOR/ DIRECTOR:	MULLICH, ROXANNE		FACILITY TYPE:	850
ADDRESS:	1130 RUBERTA AVE		TELEPHONE:	(818) 243-1088
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91201
CAPACITY: 68	TOTAL ENROLLED CHILDREN: 25	CENSUS: 17	DATE:	08/05/2025
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:30 AM
MET WITH:	Roxanne Mullich, Director		TIME VISIT/ INSPECTION COMPLETED:	02:30 PM

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Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced case management- incident inspection on 08/05/25 at 11:30 AM, due to an incident that occurred on Friday, 08/01/25. LPA met with Roxanne Mullich, Director who guided analyst on a tour of the facility. During this inspection 17 children were present in the facility with four staff.

Alleged Incident took place on Friday 08/01/25. The incident was reported via telephone next working day, on Monday 08/04/25. The written incident report was received by email on Monday 08/04/25. The facility reported the incident within the required 24 hour time frame.

LPA observed the area where the alleged incident took place. LPA conducted interviews with two staff. LPA obtained a copy of text communication that staff#1 had with parent#1 on 08/01/25, sign in/out sheet for 08/01/25, and an email that was sent out to involved parents on 08/01/25.

Based on staff#1 and staff#2 interviews, parent#1 came to the school on Friday 08/01/25 approximately at 3:50 p.m. to pick up child #1, checked Lady Bug classroom, child#1' classroom, and it was dark and quiet and thought there were no kids in Lady Bug classroom, sent a text message to staff#1 at 3:54 p.m., that parent#1 can not find child#1, they are not outside and not in the classroom or gym. Per staff#1, she called staff#2 at 3:55 p.m., to ask her to assist parent#1. Per staff#1, parent#2 texted staff#1 at 4:00 p.m. that she found child#1, all kids were asleep. The Lady bug classroom was dark and quiet, and staff#3 had fallen asleep with children.

Per staff#2, she received a call from staff#1, on 08/01/25 at 3:55 p.m., to assist parent#1 who was at the school to pick up child#1, at that time, staff#2 who was going outside with her classroom 9 children, entered Lady Bug classroom, the classroom was dark and quiet, called staff#3 name twice, no answer, observed staff#3 eyes closed, laid side way to the wall napping with rest of 8 children. Classroom naptime is from 1PM to 3:15 PM.

REPORT CONTINUES ON NEXT PAGE 1 of 2

NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Anomeh Eivazian
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/05/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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: GRANDVIEW PRESBYTERIAN CHURCH COMM CHILDRENS CTR.	FACILITY NUMBER: 191290357
	VISIT DATE: 08/05/2025

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Based on two staff interviews and unusual incident report, on 08/01/25 approximately at 4:00 p.m., staff#3 had fallen asleep in Lady Bug classroom with present 8 children.

Per Roxanne Mullich, director, staff#3 was fired on 08/01/25 right after the incident. An email was sent out to all of the parents involved on 08/01/25 at 6:37 p.m., and informed them what happened.

Ratio and staffing were in accordance of Title 22 Code of Regulations at the time of the incident. There were 8 children present in Lady Bug classroom with staff#3 and 9 children were present in Busy Bees with staff#2.

LPA issued the Confidential Names List (LIC 811) to the licensee during this inspection. The Confidential Names List documents the staff and children involved with the incident documented in this report.

Based on this information, the following deficiency listed on the attached LIC 809D are being cited in accordance with California Code of Regulations Title 22.

LPA Eivazian informed Director, Roxanne Mullich that this report dated 08/05/25 document(s) 1 Type A citation. Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Eivazian informed the Director, Roxanne Mullich to provide a copy of this licensing report dated 08/05/25 that documents 1 Type A citation 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.

The Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Director, Roxanne Mullich.

REPORT END 2 of 2

NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Anomeh Eivazian
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/05/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 08/05/2025 02:07 PM - It Cannot Be Edited

Created By: Anomeh Eivazian On 08/05/2025 at 12:01 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: GRANDVIEW PRESBYTERIAN CHURCH COMM CHILDRENS CTR.	FACILITY NUMBER: 191290357
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/05/2025

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 08/06/2025 Section Cited CCR 101229(a)	1 2 3 4 5 6 7	Responsibility for Providing Care and Supervision No child(ren) shall be left without the supervision of a teacher at any time, etc... This requirement was not met as evidenced by...	1 2 3 4 5 6 7	Per director, Roxanne Mullich staff#3 was fired immediately after this incident on 08/01/25, an email was sent out to all involved parents on 08/01/25. A written plan will be submitted to LPA by 08/06/25.
	8 9 10 11 12 13 14	Based on Unusual Incident report, received on 08/04/25, and two staff interviews, on 08/01/25 at 4:00 p.m. staff#3 had fallen asleep with children in LadyBug classroom and was observed by staff#2. This poses an immediate health, safety and personal right risk to the children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Christina Gabelman
NAME OF LICENSING PROGRAM MANAGER:

	Anomeh Eivazian
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/05/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2025

LIC809 (FAS) - (06/04)

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