198020513-4-10-2025-33-CC-SLII-DFLU95-20250410152233

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020513
Report Date: 04/10/2025
Date Signed: 04/10/2025 03:22:40 PM

Document Has Been Signed on 04/10/2025 03:22 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:	KIDDIE ACADEMY OF PASADENA		FACILITY NUMBER:	198020513
ADMINISTRATOR/ DIRECTOR:	CHRISTINE JENNINGS		FACILITY TYPE:	850
ADDRESS:	169 N. HALSTEAD ST		TELEPHONE:	(626) 606-2800
CITY:	PASADENA	STATE: CA	ZIP CODE:	91107
CAPACITY: 30	TOTAL ENROLLED CHILDREN: 30	CENSUS: 7	DATE:	04/10/2025
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:15 PM
MET WITH:	Director Christina Jennings		TIME VISIT/ INSPECTION COMPLETED:	03:50 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	Licensing Program Analyst (LPA) Stephanie Li conducted an unannounced Case Management inspection- licensee initiated for the purpose of following up on a playground waiver request. A risk assessment was conducted. LPA met with Director Christine Jennings to whom the reason for the visit was explained. Director guided LPA on a tour of the facility. There were 7 children present and 2 staff on the 198020513 license. The facility was observed to be operating within the license capacity limitations. On 3/17/2025, a waiver request was emailed to LPA asking for children (2's) from this license to use the playground associated to 198021260 (preschool yard). The letter was submitted along with a master playground schedule. Letter was not clear and did not include details of supervision and transitions. Schedule was not clear and did not identify staggered play times. LPA responded to email requesting updates to the letter request and to include a statement about how supervision will be insured. LPA requested an updated play ground schedule to identify which age groups would be using the yards at which times and a facility sketch identifying the play spaces. Owner Jen Moore sent back a letter and schedule without the requested details. During todays visit, LPA interviewed Director Christina Jennings and obtained details. Per director, this license has only one class of younger 2 year olds and 2 teachers. They are requesting a waiver to allow younger 2's to combine with other 2 year old class in their play yard from the other license for one hour in the morning (9:30am-10:30am) and combine with all age groups in the preschool yard for the last hour of the day (5:30pm-6:30pm, due to low numbers and end of staff shifts). Each 2 year old group will have one of their own teachers supervising them during their combined play time. Page 1 of 2

NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Stephanie Li
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2025

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 3

California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

Page: 2 of 3

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: KIDDIE ACADEMY OF PASADENA	FACILITY NUMBER: 198020513
	VISIT DATE: 04/10/2025

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
26
27
28
29
30
31
32

LPA advised that teachers from younger 2's license will need to be associated to the facility 198021260 and teachers from the older 2's will need to be associated to this license, 198020513.

LPA obtained updated play yard schedules identifying which age groups and classrooms will be using the yards during specific times. LPA also obtained a print out of the yard and Director labeled the yard names to match the schedule. LPA obtained current staff schedule and identified that there are 4 closing staff till 6pm and 2 closing staff from 6:00-6:30pm.

Based on information obtained during this visit, follow up is necessary to move forward with the waiver request. LPA requested an updated waiver letter to include the following details:

1. Detailed statement identifying times younger 2's are requesting usage of the preschool yard (9:30am-10:30am and 5:30pm-6:30pm)

2. Detailed statement ensuring that facility will ensure teacher-child ratios will be kept.

3. Detailed statement stating who will maintain supervision of the younger 2's when combining with the older 2's.

4. Statement ensuring age-appropriate materials will be provided for younger 2 year old children.

Per director, Owner Jen Moore will follow up emailing the updated letter. No deficiencies are being cited at this time.

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

Exit interview conducted and report was reviewed with Director Christine Jennings.

Page 2 of 2

NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Stephanie Li
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2025

LIC809 (FAS) - (06/04)

Page: 3 of 3