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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020513
Report Date: 10/28/2021
Date Signed: 10/28/2021 04:10:24 PM

Document Has Been Signed on 10/28/2021 04:10 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:KIDDIE ACADEMY OF PASADENAFACILITY NUMBER:
198020513
ADMINISTRATOR:LYNNE FISHERFACILITY TYPE:
850
ADDRESS:169 N. HALSTEAD STTELEPHONE:
(626) 606-2800
CITY:PASADENASTATE: CAZIP CODE:
91107
CAPACITY: 43TOTAL ENROLLED CHILDREN: 43CENSUS: 21DATE:
10/28/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:18 PM
MET WITH:Christine JenningsTIME COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA) Crystal Green conducted an unannounced case management licensee initiated inspection to inspect and measure facility for capacity increase determination. Licensee is requesting to increase capacity to their existing license. Due to COVID- 19 precautionary measures were taken, individuals present during inspection wore appropriate personal protective equipment. Licensing staff met with Director, Christine Jennings. There is also an infant program (198020505) that operates on the same premises as the preschool program. Hours of operation will be from Monday through Friday, 7 am -6:30pm.

At 1:34 PM, LPA was provided a tour of the facility’s existing licensed areas and the proposed additional classroom space. The existing classroom licensed for use under the preschool program are Room 3 called The Jungle and Room 4 called The Forest. Per Director, facility is requesting to remove Room 4 and add Room 5 to the preschool license. During this inspection, LPA observed 9 children napping in Room 4 with 1 staff member and 12 children napping in Room 3 with 1 staff member. The facility was observed to be operating within its licensed capacity. LPA inspected Room 5 and observed cots available along with age appropriate furniture. Individual storage space was available for each child located inside each classroom. Toys were observed to be clean and safe. There are smoke detectors and fire extinguishers located throughout the facility.

Report Continues Page 1 of 2

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE: DATE: 10/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/28/2021
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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: KIDDIE ACADEMY OF PASADENA
FACILITY NUMBER: 198020513
VISIT DATE: 10/28/2021
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The outdoor activity area designated for preschool use is surrounded by a fence (4 feet in height) to separate from the infant program. Children can access the outdoor area without accessing other program's classrooms and spaces. Outdoor play equipment was observed to be in good condition. The outdoor activity space surface was observed to be maintained in a safe condition as is free of hazards.

At this time, the facility was observed to be operating in compliance with California Title 22 Regulations. Measurements used during this inspection were obtained from the inspection conducted on 02/20/2020. The classrooms that will be licensed for use by preschoolers will be Room 3 and Room 5. Based on the measurements obtained on 02/20/2020, the new capacity for the preschool program forty- eight (48) preschoolers. An approved Fire Clearance has been received by the department.

An exit interview was conducted with the Director, Christine Jennings. A copy of this report along with the Notice of Site Visit were provided to the Director.

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. Failure to maintain posting as required will result in a civil penalty of $100.00.

Report Ends Page 2 of 2.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021
LIC809 (FAS) - (06/04)
Page: 2 of 2