191290460-3-19-2025-33-CC-POCA-DEWUFL-20250319153254

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191290460
Report Date: 03/19/2025
Date Signed: 03/19/2025 03:33:06 PM

Document Has Been Signed on 03/19/2025 03:33 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:	LONGFELLOW CHILDREN'S CENTER		FACILITY NUMBER:	191290460
ADMINISTRATOR/ DIRECTOR:	REE HUDSON		FACILITY TYPE:	850
ADDRESS:	1065 E. WASHINGTON BLVD.		TELEPHONE:	(626) 797-6927
CITY:	PASADENA	STATE: CA	ZIP CODE:	91109
CAPACITY: 66	TOTAL ENROLLED CHILDREN: 44	CENSUS: 36	DATE:	03/19/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:00 PM
MET WITH:	Site Supervisor, Monica Duran		TIME VISIT/ INSPECTION COMPLETED:	04:00 PM

NARRATIVE

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On March 19, 2025 at 1:00 pm Licensing Program Analysts (LPA) Priscilla Ochoa conducted an unannounced random annual inspection. LPA was greeted by Site Supervisor, Monica Duran, who guided LPA on a tour of the facility. This is a Pasadena Unified School District (PUSD) preschool program and is located on Longfellow Elementary School campus. The preschool program operates Monday – Friday from 7:30 am – 5:45 pm. Per Site Supervisor, there are currently 44 children enrolled in the program. LPA observed 36 children in care with 7 staff members. All adults observed obtain criminal record clearance as employees through Pasadena Unified School District.

At 1:15 pm, Site Supervisor guided LPA on a tour of facility. Parents enter through the main gate, sign in their child on the tablet in the from office and drop off their child to their designated classroom. This Preschool program consists of 2 classrooms which are adjacent and separated by a sliding wall; Classroom 1: 17 children and 3 staff and Classroom 2: 19 children and 4 staff. Teacher-child ratios were observed to be in accordance with Title 22 Regulations. Staff names were recorded. All children were observed to be under supervision, including visual supervision. Napping equipment was observed in the form of cots in each classroom. Bedding was inspected for good condition, appropriate storage, and cleanliness. Per Site Supervisor, children take home their blankets every Friday for washing purposes and brought back on Monday. The facility does wash the cot sheets at the facility for children in care. There are age-appropriate toys and supplies for children in each classroom and are in good repair. Each child was observed to have their cubby to store personal belongings. Children's restrooms are located in the middle of the room. All toilets and hand washing facilities are in safe and sanitary operating condition. Drinking water is available in form of personal water bottles that are also taken outside when needed. The facility provides additional filtered water which is dispensed in each classroom for children in care.

The classroom furniture and equipment were inspected for good repair, free of sharp, loose, or pointed parts. All indoor classrooms were inspected to ensure that the floors have a surface that is safe and clean. All materials and surfaces accessible to children are toxic free.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Priscilla Ochoa
LICENSING EVALUATOR SIGNATURE:	DATE: 03/19/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2025

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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Document Has Been Signed on 03/19/2025 03:33 PM - It Cannot Be Edited

Created By: Priscilla Ochoa On 03/19/2025 at 03:09 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: LONGFELLOW CHILDREN'S CENTER	FACILITY NUMBER: 191290460
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/19/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101221(a)

Child's Records

(a) The licensee shall ensure that a separate, complete and current record for each child is maintained in the child care center. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, record review, the licensee did not comply with the section cited above in 2 out of 5 children did not have missing Emergency Information (LIC 700), Physician’s Report (LIC 701), Consent for Emergency Medical Treatment(LIC 627), and Immunization Record for LPA to observe, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/18/2025
	Plan of Correction
1 2 3 4	Site Director will ensure Emergency Information (LIC 700), Physician’s Report (LIC 701), Consent for Emergency Medical Treatment(LIC 627), and Immunization ecords are in the child's file and send proof to LPA by POC date.

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:

Ana Chico

LICENSING EVALUATOR NAME:

Priscilla Ochoa

LICENSING EVALUATOR SIGNATURE:

DATE: 03/19/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2025

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: LONGFELLOW CHILDREN'S CENTER	FACILITY NUMBER: 191290460
	VISIT DATE: 03/19/2025

NARRATIVE

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The 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. All areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard.

When a child becomes ill, they are isolated in the front office. There is also a cot available if needed.

The facility provides AM, lunch and PM snacks for children in care. Meals are provided by Longfellow Elementary School. LPA reminded the Site Supervisor, food that is brought from home must be labeled with the child’s name, stored properly and or refrigerated. There is a kitchen on site and was observed to be clean, and the cleaning compounds/solutions were found to be away from the food. Storage areas are clean, free of litter, rubbish, and rodents/vermin. All storage containers for solid waste, including moveable bins, have tight fitting covers on and are in good repair. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are stored in an area inaccessible to children. The facility takes measures to keep the facility free of flies, other insects, and rodents. Per Site Supervisor there are no weapons, firearms, or bodies of water on the premises.

The facility is within the conditions, limitations, and capacity specified on the license. All areas were identified on the Facility Sketch were inspected. The following documents were posted: Facility License, Notification of Parents' Rights (PUB 393), Personal Rights (LIC 613A), PUB 269 Child Passenger System Poster, Daily Schedule, and snack menus.

LPA did observe a smoke/carbon monoxide detector. LPA did not test as children were napping. LPA observed a fully charged 2A-10BC fire extinguisher. The valve on the fire extinguisher was pointing to the fully charged green section. Fire extinguisher was serviced on 06/06/2024. Site Supervisor could not find documentation where LPA can observe when the last Emergency disaster drill was conducted. Although, Site Supervisor did recall that the Emergency disaster drill was conducted on 2/24/2025. LPA explained that Emergency disaster drill must be documented for licensing to observe. The facility will receive a technical violation.

The facility uses an app called Care Connect, where parents sign in and out through a tablet in the front office. LPA reviewed Sign in and out sheets to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Priscilla Ochoa
LICENSING EVALUATOR SIGNATURE:	DATE: 03/19/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2025

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: LONGFELLOW CHILDREN'S CENTER	FACILITY NUMBER: 191290460
	VISIT DATE: 03/19/2025

NARRATIVE

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Children’s Records were reviewed to ensure that Identification and Emergency form and a medical assessment are on file. Child records were deemed not complete. 2 out of 5 staff were missing Emergency Information (LIC 700), Physician’s Report (LIC 701), Consent for Emergency Medical Treatment (LIC 627), and Immunization Records in their file.

Staff records were not reviewed as staff records are housed at PUSD. LPA advised that the facility apply for a waiver with the department to store confidential records at PUSD and the facility have access to licensing forms.

AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018 any person who works in a child care facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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

CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES: Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP

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

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Priscilla Ochoa
LICENSING EVALUATOR SIGNATURE:	DATE: 03/19/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2025

LIC809 (FAS) - (06/04)

Page: 5 of 6

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: LONGFELLOW CHILDREN'S CENTER	FACILITY NUMBER: 191290460
	VISIT DATE: 03/19/2025

NARRATIVE

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Site Supervisor was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Site Supervisor was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Based on the LPA’s observations and record review, 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 and safety.

A notice of site visit was given and must remain posted for 30 days during facility’s hours of operation. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted, and a copy of the report was provided to Site Supervisor, Monica Duran.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Priscilla Ochoa
LICENSING EVALUATOR SIGNATURE:	DATE: 03/19/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2025

LIC809 (FAS) - (06/04)

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