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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191290221
Report Date: 10/08/2024
Date Signed: 10/08/2024 09:43:36 AM

Document Has Been Signed on 10/08/2024 09:43 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:LA CANADA PRESBYTERIAN CHURCH INFANT CARE CENTERFACILITY NUMBER:
191290221
ADMINISTRATOR/
DIRECTOR:		DIANA URTEAGAFACILITY TYPE:
830
ADDRESS:626 FOOTHILL BOULEVARDTELEPHONE:
(818) 790-6708
CITY:LA CANADASTATE: CAZIP CODE:
91011
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 8DATE:
10/08/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:20 AM
MET WITH:Diana UrteagaTIME VISIT/
INSPECTION COMPLETED:
10:00 AM
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On 10/08/24 , at 08:30 am , Licensing Program Analyst(LPA) Shushanik Safaryan conducted an unannounced Case Management inspection to the above facility to ensure Type B deficiencies cited on 09/17/24 has been cleared.
Upon arrival, LPA met with Facility Representative , Dianne Urteaga , to whom the reason of the visit was explained . Tour was provided . During the tour ,LPA observed 8 children with 4 staff members .
During the visit, LPA reviewed staff files and observed valid Mandated Reporter Certificates . Toured the outdoor play area and observed cracks on the outdoor play area were fixed. (Pictures taken ).
During the visit, LPA cleared deficiency cited on 09/17/2024 and provided a copy of the Licensing Report to Licensee and issued POC clearance letter.

The Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE: DATE: 10/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/08/2024
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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