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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198013437
Report Date: 01/09/2024
Date Signed: 01/09/2024 01:23:33 PM

Document Has Been Signed on 01/09/2024 01:23 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:FIREHOUSE PRESCHOOLFACILITY NUMBER:
198013437
ADMINISTRATOR:CATHERINE MARCELLINEFACILITY TYPE:
850
ADDRESS:1923 N. ALLEN AVENUETELEPHONE:
(626) 798-2865
CITY:ALTADENASTATE: CAZIP CODE:
91001
CAPACITY: 51TOTAL ENROLLED CHILDREN: 37CENSUS: 34DATE:
01/09/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Sonam Gehi and Catherine MarcellineTIME COMPLETED:
11:30 AM
NARRATIVE
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On January 9, 2024, Licensing Program Analyst (LPA) Carolyn Tuba conducted an unannounced Case Management Deficiency inspection. A COVID risk assessment was conducted. LPA met with staff in charge, Sonam Gehi due to Director, Catherine Marcelline was not available but was on her way to the facility. LPA took a tour and gained a census of 34 children with 4 staff in care. During the visit Director arrived at approximately, 10:15 am.

At approximately 10:00 am while LPA was conducting a census of the children along with staff, Sonam Gehi, and entering the 2-year-old classroom staff, Sonam Gehi and LPA observed 2 children unsupervised. It was observed there was no staff member in the classroom. LPA observed 2 staff outside with 10 additional children and the back door leading outside was closed. Staff, Sonam Gehi opened the back door to ask staff about the children inside the classroom and lead teacher stated that they were coming inside from outside play time. LPA stated to staff that children require 100% visual supervision at all times.

The following deficiency listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiency that are being cited need to be cleared to protect the children’s health & safety.

One (1) Type A - A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent.Licensee/Director was provided with a copy of the parent Acknowledgement of Receipt of Licensing Reports Form during this visit.

An exit interview was conducted with Director, Catherine Marcelline and a copy of this report and Notice of Site Visit was provided and shall be posted for 30 days in an area accessible for review.
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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE: DATE: 01/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/09/2024
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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Document Has Been Signed on 01/09/2024 01:23 PM - It Cannot Be Edited


Created By: Carolyn Tuba On 01/09/2024 at 11:22 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: FIREHOUSE PRESCHOOL
FACILITY NUMBER: 198013437

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/09/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/12/2024
Section Cited
CCR
101229(a)(1)

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101229(a)(1) Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs. No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) & 101230(c)(1).
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Per Director she will be conducting a staff meeting and discuss care & supervision. LPA will send a training module for staff viewing. Director will provide a itinerary of what was discussed and signatures of staff who attended meeting sent to LPA via email.
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Supervision shall include visual observation. This requirement is not met as evidenced by: Based on LPA observation that children were left unsupervised inside the classroom with no adult supervision. This poses an immediate Health and Safety risk to children in care.
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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.
SUPERVISOR'S NAME:Ana Chico
LICENSING EVALUATOR NAME:Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:
DATE: 01/09/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/09/2024


LIC809 (FAS) - (06/04)
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