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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191290221
Report Date: 10/20/2025
Date Signed: 10/20/2025 12:05:41 PM

Document Has Been Signed on 10/20/2025 12:05 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 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: 11DATE:
10/20/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Heather HenryTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On 10/20/2025, at 9:00 am, Licensing Program Analyst (LPA) Shushanik Safaryan conducted an unannounced annual random inspection. Upon arrival , LPA met with Facility Representative Jennifer Lira , who guided LPA on a tour of the facility. Per Facility Representative, Director was out due to medical leave. Facility Representative, Heather Henry came in later.
This is an infant program which operates Monday through Friday from 07:00am to 6:00PM. Infant Program consists of 2 classrooms. Per Facility Representative there are 11 children enrolled.

LPA observed all required forms/publications posted in the classrooms. Facility was having pumpkin patch, LPA observed parents present with the children. During this visit , LPA observed 11 infants with 6 staff members.

Teacher child ratios were observed to be in accordance with Title 22 Regulations. Staff names were recorded. All children were observed to be under supervision, including visual supervision. Licensed facility is within the conditions, limitations, and capacity specified on the license.

The classrooms furniture and equipment were inspected for good repair, free of sharp, loose, or pointed parts. Furniture and equipment are age appropriate for height and size of infants. All classrooms were inspected to ensure that the floors have a surface that is safe and clean. All materials and surfaces accessible to children are toxic free.

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NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Shushanik Safaryan
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/20/2025
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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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)
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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 PRESBYTERIAN CHURCH INFANT CARE CENTER
FACILITY NUMBER: 191290221
VISIT DATE: 10/20/2025
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 Each infant has labeled storage for its belongings. Infants have sufficient changes of clothing and diapers to be always clean and dry. Diaper changing area is clean and within arm's length of a sink with running water and dispensable soap. Diaper changing table has a padded surface of no less than one inch thick and is covered with washable vinyl. Sides are raised at least 3 inches to prevent the infant from rolling off the mat. Soiled diapers are sealed in plastic bags and dispose of in a trash can that is inaccessible to infants.

Napping equipment and bedding were inspected for good condition, appropriate storage, and cleanliness. Cribs and cots are used for napping and are placed in a room separate from the activity area. Infants able to pull themselves up, sleep on cots.


Cribs are used by younger infants . Mattress is at its lowest position and side rail cannot be lowered. Mattress is covered with vinyl or similar moisture resistant material. Bedding is replaced when wet or soiled or when being occupied by another infant. Facility washes linens , LPA observed washing machine and dryer in the facility.

LPA observed that there are functioning smoke and carbon detectors in the facility. LPA observed a fully charged and serviced fire extinguisher with the service tag 07/10/25.

At 10:30 am, per facility representative and form posted in the director`s office emergency disaster drill was last conducted in September 2024. Facility Representative was reminded it needs to be conducted at least every six months. Facility Representative states there are no weapons, firearms, or bodies of water on the premises.

Per facility representatives , am and pm snacks provided to older infants by the facility and lunch provided by the parents. Parents provide snacks and lunches for younger infants . LPA observed kitchen area between the classrooms were observed snacks stored for children .Bottles and food brought from home labeled with the infant’s name. Cabinet space and refrigerator are used for storing food items and perishables. Microwave oven is used for warming up foods while bottles are warmed up in bottle warmers. First aid bags are kept in each classroom.

All storage containers for solid waste, including movable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids. Drinking water is readily available both indoors and outdoors, children bring their own water bottles too. The facility was observed to be free of flies, other insects, and rodents. Page 2 of 5

NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Shushanik Safaryan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2025
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 PRESBYTERIAN CHURCH INFANT CARE CENTER
FACILITY NUMBER: 191290221
VISIT DATE: 10/20/2025
NARRATIVE
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The Director`s office used for the ill children. There is a crib available if needed.

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 .There is adequate shade in the play yard.



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.

Children’s Records were reviewed to ensure that Identification and Emergency form and required infants’ needs and service plan are on file . LPA observed 15-minute checks conducted by the facility and observed infant sleep plan on file. Inspection of required forms was made and documented on LIC 857.

At 11:20 am ,LPA reviewed staff records. Criminal Records Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed. LPA did not observe any staff members present with valid Pediatric First Aid and CPR present during this inspection. The review of Staff records was documented on LIC 859.

LPA observed one out of six staff members missing updated Mandated Reporter Certificate. LPA reminded facility representative, Mandated Reporter Training renewed every 2 years. 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.

At 11:26 am , LPA observed one staff member missing proof of negative test of tuberculosis. LPA discussed requirement for immunization's with the Facility Representative during this visit.

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

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NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Shushanik Safaryan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2025
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 PRESBYTERIAN CHURCH INFANT CARE CENTER
FACILITY NUMBER: 191290221
VISIT DATE: 10/20/2025
NARRATIVE
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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

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



LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.

LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Facility Representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

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

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 childcare 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)
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NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Shushanik Safaryan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2025
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 PRESBYTERIAN CHURCH INFANT CARE CENTER
FACILITY NUMBER: 191290221
VISIT DATE: 10/20/2025
NARRATIVE
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LPA verified that the lead testing was completed in accordance with the Written Directives outlined in PIN 21-21.1-CCP and no lead exceedance was detected .

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.



Based on the LPA’s observations and records reviews, the following deficiencies listed on the attached LIC 809D (Deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiency that are being cited need to be cleared up to protect the children’s health and safety.

An exit Interview was conducted, a copy of this report along with Notice of Site visit , Deficiency pages and Appeal Rights were explained and provided to the Facility Representative, Heather Henry on 10/20/2025.

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.



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NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Shushanik Safaryan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/20/2025 12:05 PM - It Cannot Be Edited


Created By: Shushanik Safaryan On 10/20/2025 at 11:35 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 PRESBYTERIAN CHURCH INFANT CARE CENTER
FACILITY NUMBER: 191290221

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/20/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101174(d)
Disaster and Mass Casualty Plan
(d) Disaster drills shall be conducted at least every six months.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations, records review and interview ,the licensee did not comply with the section cited above. During this visit , per facility representative disaster drill was conducted September 2024, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/10/2025
Plan of Correction
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Per Facility Representative , dissaster drill will be conducted and proof will be provided to LPA by POC date .
Type B
Section Cited
CCR
101216(f)
Personnel Requirements
(f) At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations , records review and interview , the licensee did not comply with the section cited above. LPA did not observe at least one staff member with valid Pediatric first aid and CPR certificate , which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/10/2025
Plan of Correction
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Per Facility Representative , Pediatric first aid and CPR certificates will be obtained and provided to LPA by POC date .
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Brandi VanOosten
NAME OF LICENSING PROGRAM MANAGER:
Shushanik Safaryan
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/20/2025


LIC809 (FAS) - (06/04)
Page: 7 of 9
Document Has Been Signed on 10/20/2025 12:05 PM - It Cannot Be Edited


Created By: Shushanik Safaryan On 10/20/2025 at 11:35 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 PRESBYTERIAN CHURCH INFANT CARE CENTER
FACILITY NUMBER: 191290221

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/20/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(g)(1)
Personnel Requirements
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations, records review and interview , the licensee did not comply with the section cited above. LPA observed one staff member without TB clearance present in the facility, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/10/2025
Plan of Correction
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Facility Representative stated TB clearance will be obtained and submitted to LPA by POC date .
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Brandi VanOosten
NAME OF LICENSING PROGRAM MANAGER:
Shushanik Safaryan
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/20/2025


LIC809 (FAS) - (06/04)
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