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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019097
Report Date: 10/23/2023
Date Signed: 10/23/2023 12:42:51 PM

Document Has Been Signed on 10/23/2023 12:42 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:ST. ANDREW CATHOLIC PRESCHOOLFACILITY NUMBER:
198019097
ADMINISTRATOR:SERENA LEEFACILITY TYPE:
850
ADDRESS:42 CHESTNUT STTELEPHONE:
(626) 796-7697
CITY:PASADENASTATE: CAZIP CODE:
91103
CAPACITY: 30TOTAL ENROLLED CHILDREN: 16CENSUS: 14DATE:
10/23/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:Ariana JacoboTIME COMPLETED:
12:50 PM
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Licensing Program Analyst (LPA) Crystal Green conducted an unannounced case management licensee- initiated inspection to inspect facility for capacity increase determination. Licensing staff met with Facility Representative, Ariana Jacobo, Director. The preschool operating hours are Monday to Friday from 8:00am to 6:00pm.

This facility is located on the premises of St. Andrews Catholic School. The facility is currently licensed to serve a total of 30 preschool children. The existing licensed areas are for 2 classrooms (classroom 112 and 116). Licensee has requested to increase the overall capacity by adding an additional classroom to the existing license. LPA was provided a tour of the existing licensed area and the proposed classroom. The facility was observed to be clean, safe, and in good repair. LPA observed there to be 14 children with 2 staff members in the classroom 112. LPA observed did not observed children in classroom 116. Per Facility representative, classroom 116 is currently not in use. Teacher- child ratios were observed. All children were observed by licensing staff to be under visual supervision of a teacher at all times.

Per Facility Representative, the licensee has changed their request to add classroom 117 to the license and instead classroom 118. Classroom 118 is currently being used by the kindergarten children. Licensing staff inspected classroom 117 and observed age-appropriate furniture and equipment. There were storage cubbies located within the classroom. LPA did not observe the children to have access to a restroom located within the classroom. The existing restroom for the preschoolers is located within classroom 112, which contains 2 toilets and 2 sinks. All toilets and hand washing facilities are in safe and sanitary operating conditions.

Licensing staff inspected the outdoor play area and equipment which was observed to be age appropriate and in good condition, free of sharp, lose or pointed parts. Outdoor activity space surface was observed to be maintained in a safe condition as is free of hazards.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE: DATE: 10/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/12/2023
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: ST. ANDREW CATHOLIC PRESCHOOL
FACILITY NUMBER: 198019097
VISIT DATE: 10/23/2023
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There is adequate shade in the outdoor play area. There is an approved waiver on file allowing the preschoolers to share usage of the outdoor space with TK and Kindergarten students using a staggered play schedule.

Measurements were obtained during this inspection:
Preschool classroom 117 measured for 737.14 sq. ft. divide by 35 sq. ft. which calculated for 21 children.
Preschool classroom 118 measured for 854.36 sq. ft. divided by 35 sq. ft. which calculated for 24 children.

Measurements for the outdoor play area were not obtained during this inspection. Total toilets and sinks available to the children will be 2 toilets and 2 sinks which calculates for 30 children.

The licensee is requesting to increase the overall capacity to 50 however due to the number of toilets and sinks currently designated for the preschool program the licensee can only accommodate a capacity of 30 children. LPA discussed with the facility representative that the licensee will need to designate an additional 2 toilets and 2 sinks in order to accommodate the requested capacity of 50.

During this inspection, LPA also obtained measurements of classroom 118 since it contains 1 toilet and 2 sinks within the classroom. LPA discussed the option of moving forward with adding classroom 118 instead which will be able to accommodate the capacity of 45 children. The Department has received an approved Fire Clearance from the Pasadena Fire Department for classroom 118. The Licensee will need to obtain the Fire Clearance approval for classroom 117 and designate an additional 2 toilets and 2 sinks in order to use classroom 117. The Facility Representative informed that she will discuss the options with the principal regarding proceeding with the application request to increase the licensed capacity.

Exit interview conducted and report was reviewed with the Facility Representative. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2023
LIC809 (FAS) - (06/04)
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