198021078-3-22-2023-33-CC-CGRN-CQ6QZG-20230322123644

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198021078
Report Date: 03/22/2023
Date Signed: 03/22/2023 12:36:54 PM

Document Has Been Signed on 03/22/2023 12:36 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:	GAN, THE		FACILITY NUMBER:	198021078
ADMINISTRATOR:	GITTEL RIVKIN		FACILITY TYPE:	850
ADDRESS:	1090 E. WALNUT STREET		TELEPHONE:	(626) 372-3221
CITY:	PASADENA	STATE: CA	ZIP CODE:	91106
CAPACITY: 28	TOTAL ENROLLED CHILDREN: 28	CENSUS: 0	DATE:	03/22/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Gittel Rivkin		TIME COMPLETED:	12:45 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	An announced pre-licensing site inspection was conducted today by Licensing Program Analyst (LPA) Crystal Green to inspect and measure facility for capacity determination. The applicant is requesting is requesting to operate a Preschool Program with Toddler Option. Licensing staff met with Applicant, Gittel Rivkin. The proposed hours of operation will be Monday to Friday from 9:00 am 3:00 pm. The facility is located on the premises of Chabad of Pasadena. The entrance to the facility will be accessible from Wilson Ave., parents will enter the parking lot. Per Applicant, staff will be located in the parking lot to supervise drop offs and pickups. The facility will utilize the Playground app. to communicate with parents and for sign in and sign outs. At approximately 10:40 am, LPA was provided a tour of the facility. This facility has 2 classrooms. Per Applicant, one classroom will be for the preschoolers and the second classroom with be for the toddlers. Each classroom has direct access from the playground area. LPA observed the toddler classroom to be physically separate from the preschool classroom. Licensing staff observed age-appropriate equipment, toys, and supplies for children. Individual storage space was observed located within the classrooms. Central air and heating are available in the classrooms. There are napping cots available for the children. There will be drinking water available via filter water system attached to the sink located in the classrooms. There are trash cans with tight fitting lids available in the classrooms. There are emergency supplies and a first aid kit located in each classroom. LPA observed there to be a restroom located between the classrooms which contain 3 toilets, 3 sinks, and a changing table within arm's reach of a sink. All toilets and sinks are in safe and sanitary operating conditions. Per applicant, the toddlers do not have access to a separate restroom. There are doors leading to both the preschool and the toddler’s classroom to prevent access.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023

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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GAN, THE	FACILITY NUMBER: 198021078
	VISIT DATE: 03/22/2023

NARRATIVE

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There are smoke detectors and fire extinguishers located throughout the premises. The isolation area for an ill child will be located in the office. There is a parent board with the required postings at the entrance to the facility near the office.

Licensing staff was guided through the proposed outdoor activity space. There is only one play area available for the children in care. There is age-appropriate play equipment in the playground. The outdoor space is fenced. Drinking water will be available to children via a water pitcher and disposable cups. There is adequate shade in the yard.

Facility will provide snacks and parents will provide lunch for their child. No transportation will be conducted by the facility.

Facility representative was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023

LIC809 (FAS) - (06/04)

Page: 3 of 3

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: GAN, THE	FACILITY NUMBER: 198021078
	VISIT DATE: 03/22/2023

NARRATIVE

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An approved Fire Clearance has been received by the Department. Based on measurements obtained today, the overall capacity will be 28 children (14 preschoolers and 14 toddlers).

LPA consulted with the applicant regarding information needed to submit an outdoor waiver request and a waiver request for toddlers to share the restroom usage with the preschoolers. LPA informed applicant that waivers are not automatically granted and will need to be review by the Regional Office for final approval. LPA obtained pictures of the outdoor play areas and the restroom areas during this inspection.

At approximately 12:30 pm, an exit interview was conducted with Applicant and a signed copy of this report was provided.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023

LIC809 (FAS) - (06/04)

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