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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198010409
Report Date: 10/17/2024
Date Signed: 10/17/2024 01:44:18 PM

Document Has Been Signed on 10/17/2024 01:44 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:SIERRA MADRE EARLY CHILDHOOD PROGRAMFACILITY NUMBER:
198010409
ADMINISTRATOR/
DIRECTOR:		PATRICIA GUZMANFACILITY TYPE:
850
ADDRESS:141 W. HIGHLAND AVETELEPHONE:
(626) 355-1428
CITY:SIERRA MADRESTATE: CAZIP CODE:
91024
CAPACITY: 25TOTAL ENROLLED CHILDREN: 25CENSUS: 0DATE:
10/17/2024
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Patricia Guzman TIME VISIT/
INSPECTION COMPLETED:
02:00 PM
NARRATIVE
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On 10/17/24, an announced Case Management Annual Continuation visit was conducted by Licensing Program Analyst (LPA), Shushanik Safaryan for the purpose of reviewing staff files. Files were not available during the initial visit conducted on 09/17/24 . Staff files were stored in Sierra Madre Early Childhood program office located in 524 Palisade ave, Pasadena , Ca 91103 .

Upon arrival , LPA met with Coordinator Patricia Guzman and Director Lindsay Luis . During the visit LPA reviewed requirements for the staff files and provided with the child care center checklist . Per representative , staff files will be kept in the main office and facility will obtain waiver from the Department . Per Facility Representative documents will be obtained from Pasadena Unified School District and LPA will be notified .Follow up visit will be conducted to review staff files .

There were no deficiencies issued on this date in accordance with Title 22 of the California Code of Regulations and Health & Safety Codes.

Exit interview was conducted with Patricia Guzman ,appeal rights , a copy of this report was provided, and procedures explained.



End of the Report
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE: DATE: 10/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/17/2024
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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