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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019653
Report Date: 10/29/2024
Date Signed: 10/29/2024 03:59:03 PM

Document Has Been Signed on 10/29/2024 03:59 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:SIERRA MADRE UNITED METHODIST CHURCH-BRIDGEFACILITY NUMBER:
198019653
ADMINISTRATOR/
DIRECTOR:		AARTHI RAMALINGHAMFACILITY TYPE:
850
ADDRESS:695 W. SIERRA MADRE BLVDTELEPHONE:
(626) 355-0629
CITY:SIERRA MADRESTATE: CAZIP CODE:
91024
CAPACITY: 107TOTAL ENROLLED CHILDREN: 107CENSUS: 51DATE:
10/29/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:05 PM
MET WITH:Aarthi Ramalingham TIME VISIT/
INSPECTION COMPLETED:
04:30 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
On 10/29/24, Licensing Program Analyst(LPA) Shushanik Safaryan conducted an unannounced Case Management inspection to the above facility to ensure Type B deficiencies cited on 09/26/24 have been corrected.

Upon arrival LPA met with Facility Representative, Aarthi Ramalingham, who guided analyst on a tour of the facility. During this inspection, 51 children with 10 staff members were present in the facility .


During the visit LPA toured the outdoor play area and observed stairs that had a cracks on the play were replaced .
Reviewed two staff files and observed required Mandated Reporter Certificates in staff files .
LPA cleared deficiencies cited on 09/26/24 and provided a copy of the Licensing Report to Facility Representative , Aarthi Ramalingham and issued POC clearance letter.



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.

End of the Report .
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE: DATE: 10/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/29/2024
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 1