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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191224480
Report Date: 02/06/2025
Date Signed: 02/06/2025 12:28:28 PM

Document Has Been Signed on 02/06/2025 12:28 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:LA CANADA UNITED METHODIST CHILDREN'S CENTERFACILITY NUMBER:
191224480
ADMINISTRATOR/
DIRECTOR:		BLANCA ELIASSENFACILITY TYPE:
850
ADDRESS:104 BERKSHIRE PLACETELEPHONE:
(818) 790-2871
CITY:LA CANADASTATE: CAZIP CODE:
91011
CAPACITY: 35TOTAL ENROLLED CHILDREN: 34CENSUS: 21DATE:
02/06/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:Director, Blanca EliassenTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
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On February 6, 2025 at 8:45 am Licensing Program Analysts (LPA) Priscilla Ochoa conducted an unannounced random annual inspection. LPA was greeted by Director Blanca Eliassen, who led LPA on a tour of the facility. This is a Preschool program which consists of two buildings: Building 1 and Building 2 and a total of 5 classrooms. Per Director, there are currently 34 children enrolled in the program. LPA observed 21 children in care. Hours of operation for this facility are Monday – Friday form 7 am – 6 pm.

Upon entrance LPA observed all required forms/publications to be posted by front entrance of building 2 in the Directors office, which is accessible to parents. Snack menus were reviewed to ensure that they are being posted in each building one week in advance where it is visible by the child's authorized representative.

At 9:00 am, LPA entered and inspected building 2 and which consist of 2 classrooms: Tigers (4 – 5 years olds): 7 children with 1 teacher, Tiger Cubs (3 and half year olds): 3 children and 1 teacher. LPA inspected the children bathroom which is directly next to Tiger and Tiger Cubs classroom. The bathroom was clean and orderly.

Building 1 consist of 3 classrooms: Bears (3 year olds): 4 children with 1 teacher, Turtles (2 year olds:) 3 children with 1 teacher, Ducklings (2 and half year olds): 4 children with 1 teacher assistant. LPA observed a pet fish in a small fish tank in the Turtles classroom and Black bearded dragon named Andy in the front entrance of building. Andy is in a enclosed terrarium. Per Director, children do not touch nor play with Andy. LPA inspected the children bathroom which is next Bears classroom. LPA observed a changing table that is in arms reach of a sink. The changing mat was also at least 3 inches thick. LPA also observed extra clothes, diapers, and wipes for children in care. The bathroom was clean and orderly.

Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children in care. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts in each classroom. All floors are clean and safe. LPA observed mats stored in each building as napping equipment. Bedding was also inspected for good condition, appropriate storage, and cleanliness.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Priscilla Ochoa
LICENSING EVALUATOR SIGNATURE: DATE: 02/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/06/2025
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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Document Has Been Signed on 02/06/2025 12:28 PM - It Cannot Be Edited


Created By: Priscilla Ochoa On 02/06/2025 at 10:59 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: LA CANADA UNITED METHODIST CHILDREN'S CENTER
FACILITY NUMBER: 191224480

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/06/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview and record review, the licensee did not comply with the section cited above in 1 out of 6 staff did not have proof of immunizations on file for LPA to review, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/07/2025
Plan of Correction
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Director will make sure S2 provides proof of immunizations against influenza, pertussis, and measles. Director will provide proof to LPA P. Ochoa by POC date 3/07/2025
Type B
Section Cited
CCR
101216.2(e)
Teacher Aide Qualifications and Duties
(e) An aide shall work only under the direct supervision of a teacher.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in 1 out of 6 staff members do not have the teacher qualifications to supervise children on their own, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/06/2025
Plan of Correction
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Director will provide LPA a written and signed statement explaining that a fully qualified teacher will be in the classroom with S2 meanwhile S2 gains teacher qualifications.
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:Ana Chico
LICENSING EVALUATOR NAME:Priscilla Ochoa
LICENSING EVALUATOR SIGNATURE:
DATE: 02/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/06/2025


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: LA CANADA UNITED METHODIST CHILDREN'S CENTER
FACILITY NUMBER: 191224480
VISIT DATE: 02/06/2025
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Per Director, children take their sheets and blankets home every Friday to be washed. All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids. The facility was observed to be free of flies, other insects, and rodents. Sufficient individual storage space for children was observed and each child has a cubby. Drinking water was readily available indoors.

At this time, the Directors office is used as an isolation area for when a child becomes ill. A mat is available for an ill child to rest on. First Aid supplies are available and complete.

Facility has a functioning carbon monoxide detector that meets statutory requirements. LPA did observe a smoke detector but did not test. Per director, the smoke detector is hardwired to the fire department. Director states there are no weapons, firearms, or bodies of water on the premises.

A fire extinguisher was observed. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 05/22/2024, as indicated on service tag. Per State Fire Marshall standards, fire extinguishers shall be serviced annually.

All toilets, hand washing, and bathing facilities are safe, sanitary and are operating properly. All food preparation areas and food storage areas are kept clean and are free of litter, rubbish and rodents and/or any other vermin. Snacks were reviewed for availability, quantity, and appropriateness to children in care. This facility only provides snacks for children in care. Children bring their own lunch from home. LPA reminder Director, that lunch that is brought from home must be labeled with the child’s name and stored properly or refrigerated.

At 9:45 am, LPA inspected the outdoor play area, which is located at the front entrance of the center. LPA observed plastic play structures, playhouses, and sand area. Outdoor playground equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with material that absorbs a fall. LPA consulted with director to have teachers observe the sand area before children have access to ensure there is no hazardous materials. Drinking water is readily available outdoors.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Priscilla Ochoa
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2025
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: LA CANADA UNITED METHODIST CHILDREN'S CENTER
FACILITY NUMBER: 191224480
VISIT DATE: 02/06/2025
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Teacher-child ratios were not observed to be in accordance with Title 22 regulations. S2 who is in the Duckling classroom was observed to be supervising children in care. Upon staff file review, LPA discussed with director S2 is not a qualified teacher. S2 has only completed 3 units, which is an assistant teacher. Per Title 22 Regulations, Assistant Teacher cannot be left alone with children, they must be supervised by a fully qualified teacher. LPA communicated with the Director, once an assistant teacher completes 6 approved units, assistant teachers can supervise children in care with a fully qualified teacher in the vicinity. Staff names were recorded. All children were observed to be under visual supervision of a teacher during tour. The Licensee is within the conditions, limitations, and capacity specified on the license. All areas were identified on the Facility Sketch were inspected.

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. Disaster drills have been conducted at least every six months. Last emergency drill was conducted 10/17/2024.

Children’s Records were reviewed to ensure that Identification and Emergency form and a medical assessment are on file and deemed complete.

Staff files were reviewed for a health screening report and immunizations that meet regulatory requirements, criminal Record Clearance for adults and verification of CPR/First Aid and health preventative practices documentation, and educational background, training, and/or experience for each staff present. During file review, LPA observed 1 of 6 staff did not have teacher qualifications to be supervising children. 1 out of 6 staff did not have proof of immunization records for LPA to review.

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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated 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

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Priscilla Ochoa
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2025
LIC809 (FAS) - (06/04)
Page: 4 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: LA CANADA UNITED METHODIST CHILDREN'S CENTER
FACILITY NUMBER: 191224480
VISIT DATE: 02/06/2025
NARRATIVE
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CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES: 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 child care 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). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP

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

Director was reminded that all adults 18 and over, 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.

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

Based on the LPA’s observations and record review, 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.

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

An exit interview was conducted, and a copy of the report was provided to Director, Blanca Eliassen.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Priscilla Ochoa
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2025
LIC809 (FAS) - (06/04)
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