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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198014604
Report Date: 02/16/2022
Date Signed: 02/18/2022 08:12:52 AM

Document Has Been Signed on 02/18/2022 08:12 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:MOTHERS CLUB FAMILY LEARNING CENTERFACILITY NUMBER:
198014604
ADMINISTRATOR:ANDREA HUICOCHEAFACILITY TYPE:
830
ADDRESS:980 NORTH FAIR OAKS AVENUETELEPHONE:
(626) 792-2687
CITY:PASADENASTATE: CAZIP CODE:
91103
CAPACITY: 20TOTAL ENROLLED CHILDREN: 6CENSUS: 0DATE:
02/16/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Andrea Huicochea TIME COMPLETED:
04:40 PM
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Licensing Program Analysts (LPAs) Crystal Green and Carolyn Tuba conducted an unannounced required 1- year inspection. LPAs met with designated facility Director, Andrea Huicochea also present during this inspection was Assistant Director, Judy Bestamante. Due to COVID- 19 precautionary measures were taken, individuals present during inspection wore appropriate personal protective equipment. Facility was observed to be adhering to local public health guidelines.

The infant program has two sessions which are a part of California State Preschool- Early Head Start. Per Director, Prior to COVID-19 Infant Program would be held in sessions from 8:30 a.m. to 12:00 p.m. and from 1:00 p.m. to 4:30 p.m. As a COIVD precautionary measure sessions are held remotely. This facility also houses a preschool program (#198014603). There are no shared areas and no waivers granted by the Department. The following was observed during this visit.

This infant program consists of 2 classrooms (Infant room and Toddler room). At approximately 12:40 PM, Licensing staff was provided a tour of the facility. No children were observed present during the initial tour. LPAs observed the facility to be clean, safe, sanitary and in good repair. Furniture and equipment were inspected for good repair, free of sharp, loose, or pointed parts. Napping equipment was observed in form of cribs. Children's linens for the infant program are to be washed or replaced daily. There are age appropriate toys and supplies for children in the classroom, in good repair. There is a changing table within arm's reach of a sink in the classroom. LPA observed it to be clean. The facility was observed to have diapers and wipes available in each classroom near the changing table. Drinking water is available in form of personal water bottles that are also taken outside when needed. At this time, the Director's Office is used as an isolation area. Parents are contacted immediately when children are determined to be ill and staff are ensuring that children with obvious symptoms of illness are not being accepted.

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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE: DATE: 02/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/16/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MOTHERS CLUB FAMILY LEARNING CENTER
FACILITY NUMBER: 198014604
VISIT DATE: 02/16/2022
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The licensee has a full kitchen area where food is prepared. The facility provides Breakfast, AM snack, Lunch, and PM snack. All kitchen, food preparation, and storage areas are clean, free of litter, rubbish, and rodents/vermin. All storage containers for solid waste, including moveable bins, have tight fitting covers on and are in good repair. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are stored in an area inaccessible to children. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. The facility takes measures to keep the facility free of flies, other insects and rodents.

The Infant program has their own outdoor play yard, LPA observed it to be physically separated from the preschool outdoor play yard. Outdoor play equipment is in good condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe and is free of hazards.

Facility uses application called Learning Genie for electronic Sign in and out. Director made print out available for review to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. Staff Records were reviewed to ensure that a health screening report is on file. Children’s Records were reviewed to ensure that Identification and Emergency form and a medical assessment are on file. Criminal Records Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed.

This facility provides Incidental Medical Services – IMS. Per Director, no children are currently requiring IMS services. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today. Exit interview was conducted with Director, Andrea Huicochea, Appeal Rights and Procedures explained and provided.

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. Failure to maintain posting as required will result in a civil penalty of $100.00. Page 2 of 2.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:

DATE: 02/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2022
LIC809 (FAS) - (06/04)
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