198021231-7-6-2023-33-CC-CGRN-CTGVFZ-20230706162445

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198021231
Report Date: 07/06/2023
Date Signed: 07/06/2023 04:25:04 PM

Document Has Been Signed on 07/06/2023 04:25 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:	BRIDGE MONTESSORI PRESCHOOL		FACILITY NUMBER:	198021231
ADMINISTRATOR:	CYNTHIA DAVILA		FACILITY TYPE:	850
ADDRESS:	393 N LAKE AVENUE		TELEPHONE:	(626) 817-2205
CITY:	PASADENA	STATE: CA	ZIP CODE:	91101
CAPACITY: 138	TOTAL ENROLLED CHILDREN: 138	CENSUS: 0	DATE:	07/06/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Lydia and Rajeev Nandakumaran		TIME COMPLETED:	04:35 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	An announced pre-licensing site inspection was conducted today by Licensing Program Analyst (LPA) Crystal Green to inspect and measure facility for capacity determination. Licensing staff met with Applicants, Lydia Nandakumaran and Rajeev Nandakumaran, who guided analyst on a tour of the facility. The applicant is requesting to operate a Preschool Program. This proposed Preschool Program will operate from Monday through Friday from 7:30 AM until 5:00 PM. This facility is located on the premises of Lake Avenue Congregational Church. Parents will utilize the main parking lot for parking which is accessible from Maple Street or Villa Street. Children will be escorted by their parents to their designated classroom. There will be a parent board with the required postings located within each classroom. LPA was provided a tour of the facility. This facility will have a total of nine classrooms which will HH 105, HH 106, HH 107, HH 108, HH 109, OH 103, OH 104, OH 105, and MS 110. LPA observed a total of 11 toilets and 12 sinks accessible to the preschool children throughout the premises. LPA also observed changing tables located within the classrooms. All toilets and sinks are in safe and sanitary operating conditions. Furniture and equipment were inspected for age appropriateness and good repair. Individual storage space was observed located within each classroom. All classrooms were observed to contain storage area for children cots. Drinking water will be available to children via water fountains located within each classroom. Children will also have their personal sippy cups. There are smoke detectors and fire extinguishers located throughout the premises. The isolation area for an ill child will be located in the main office. There is also a fully equipped first aid kit and a locking medication cabinet located in the main office. Page 1 of 2

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:	DATE: 07/06/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 2

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: BRIDGE MONTESSORI PRESCHOOL	FACILITY NUMBER: 198021231
	VISIT DATE: 07/06/2023

NARRATIVE

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Facility will provide snacks and parents will provide lunches for their child. LPA observed each classroom to have a kitchen prep area. No transportation will be conducted by the facility. Licensing staff was guided through the preschool outdoor activity space. There will be three designated outdoor play areas (Main Open area, Playground with sandbox, Preschool play yard). The children will have access to the Preschool play from classroom HH 105. The designated outdoor play area was observed to be enclosed by a fence. LPA observed the outdoor area to contain picnic tables, art equipment’s, a sandbox area, age-appropriate play structure, and multiple themes play sections. There is adequate shade provided in the outdoor play area.

Applicants was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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 Information Line at (800) 514-0301 (voice) or (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

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

The Department has received an approved Fire Clearance from the Pasadena Fire Department. Based on measurements obtained today, the capacity for the preschool program will be one hundred and sixty (160) children.

Exit interview conducted and report was reviewed with the Applicant, Rajeev Nandakumaran
Page 2 of 2

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:	DATE: 07/06/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2023

LIC809 (FAS) - (06/04)

Page: 2 of 2