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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019653
Report Date: 09/26/2024
Date Signed: 09/26/2024 11:17:37 AM


Document Has Been Signed on 09/26/2024 11:17 AM - 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:STEPHANIE MCREYNOLDSFACILITY TYPE:
850
ADDRESS:695 W. SIERRA MADRE BLVDTELEPHONE:
(626) 355-0629
CITY:SIERRA MADRESTATE: CAZIP CODE:
91024
CAPACITY:107CENSUS: 74DATE:
09/26/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Aarti Ramalingam TIME COMPLETED:
12:00 PM
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On 09/26/24, at 8:15 am ,Licensing Program Analyst (LPA) Shushanik Safaryan conducted an unannounced annual random inspection. At 08:30 am , LPA met with Facility Representative, Aarthi Ramalingam , Director .Licensee, Rajeev Nandakumaran arrived a short time later and resumed the inspection. This is a preschool age program currently licensed for 107 children which operates Monday – Friday from 7:30 AM – 5:00 PM. There is a toddler component attached to the preschool license that allows for 39 toddlers ages 18 months to 36 months. Facility has an approved outdoor waiver on file for staggered use of the preschool play yards that does not include the use of the toddler play area. Facility consist of 6 classrooms: two toddler rooms and four preschool classrooms . Per Facility Representative 12 toddlers and 62 preschoolers are enrolled.

LPA observed all required forms/publications posted in the classrooms visible to the parents .
All the classrooms were inspected .During the visit LPA observed 12 toddlers with 2 staff members and 36 preschoolers with 6 staff members .Teacher child ratios were observed to be in accordance with Title 22 Regulations. Staff names were recorded. Licensed facility is within the conditions, limitations, and capacity specified on the license.

The classroom furniture and equipment were inspected for good repair, free of sharp, loose, or pointed parts. All 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. All toilets and washing facilities are in safe and sanitary operating conditions.

First Aid supplies are available and complete in each classroom .

Napping equipment and bedding were inspected for good condition, appropriate storage, and cleanliness. Storage for children's belongings was inspected. Parents take linens home on Friday and returned on Monday.


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SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Shushanik SafaryanTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 09/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/26/2024
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: SIERRA MADRE UNITED METHODIST CHURCH-BRIDGE
FACILITY NUMBER: 198019653
VISIT DATE: 09/26/2024
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LPA observed that there are functioning smoke and carbon detectors in the facility. LPA observed a fully charged and serviced fire extinguisher with the service date 08/04/24. Emergency disaster drill was last conducted on 09/12/24. Facility representative states there are no weapons, firearms, or bodies of water on the premises.

Facility does not provide snacks , children bring their own snacks and lunch . Per facilities representative each classroom have an emergency snacks in case children forget to bring their snacks . Trash cans used to discard food have tight fitting lids. Drinking water is readily available both indoors and outdoors, children bring their own water bottles too. The facility was observed to be free of flies, other insects, and rodents.

The Directors office is an isolation area for the ill children .Cot will be available upon request .

LPA observed 3 outdoor play areas: two preschool yards and one toddler yard . During the tour at 09:00 am, LPA observed crack on the stairs of the play structure in the preschool yard . (Pictures Taken). All areas around or under high climbing equipment, slides, and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard.



Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. Facility uses a program called Bright Wheel to sign children in and out. Facility has hard copies of sign in and sign out sheets as needed.

Children’s Records were reviewed to ensure that Identification and Emergency form and a medical assessment are on file. Inspection of required forms was made and documented on the LIC 857.

LPA reviewed staff records; Criminal Records Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed. There is at least one person trained in CPR and Pediatric First Aid present during this inspection. The review of Staff records was documented on the LIC 859.

At 10:15 am , LPA observed 2 out 6 staff records had an expired Mandated Reporter Certificates . AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018, any person who works in a childcare facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers.

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SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Shushanik SafaryanTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024
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: SIERRA MADRE UNITED METHODIST CHURCH-BRIDGE
FACILITY NUMBER: 198019653
VISIT DATE: 09/26/2024
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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

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

Facility Representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

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

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 childcare 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).
Per Facility Representative , facility does not use indoor and outdoor water outlets for drinking. Facility utilizes filtered water from local TA water service . Water get delivered one every two weeks or as needed.

Per Representative, Facility applied for an exemption.

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SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Shushanik SafaryanTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: SIERRA MADRE UNITED METHODIST CHURCH-BRIDGE
FACILITY NUMBER: 198019653
VISIT DATE: 09/26/2024
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To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Based on the LPA’s observations 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 and safety.

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 , Rajeev Nandakumaran on 09/26/24.

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SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Shushanik SafaryanTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024
LIC809 (FAS) - (06/04)
Page: 4 of 5
Document Has Been Signed on 09/26/2024 11:17 AM - It Cannot Be Edited

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: SIERRA MADRE UNITED METHODIST CHURCH-BRIDGE
FACILITY NUMBER: 198019653

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/26/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238.2(d)(1)
Outdoor Activity Space
(d) The surface of the outdoor activity space shall be maintained: (1) In a safe condition for the activities planned.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations and interviewes , the licensee did not comply with the section cited above . During the tour LPA observed cracks on the play structure stairs ,which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/17/2024
Plan of Correction
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Licensee will get contact with the curch either replace the piece or the structure .
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations, records review, interview , the licensee did not comply with the section cited above, 2 out of 6 staff members missing Mandated Rpeorter Certificates ,which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/17/2024
Plan of Correction
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Licensee will email certificates to LPA by POC date .
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 VanOostenTELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Shushanik SafaryanTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 09/26/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/26/2024
LIC809 (FAS) - (06/04)
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