191201970-2-4-2025-33-CC-POCA-DDKW54-20250204155832

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191201970
Report Date: 02/04/2025
Date Signed: 02/04/2025 03:59:51 PM

Document Has Been Signed on 02/04/2025 03:59 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:	MOUNT OLIVE WILLA LEE NURSERY SCHOOL		FACILITY NUMBER:	191201970
ADMINISTRATOR/ DIRECTOR:	NULTY, JANETTE		FACILITY TYPE:	850
ADDRESS:	4519 WILLA LEE AVENUE		TELEPHONE:	(818) 249-9200
CITY:	LA CRESCENTA	STATE: CA	ZIP CODE:	91214
CAPACITY: 29	TOTAL ENROLLED CHILDREN: 29	CENSUS: 19	DATE:	02/04/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:30 PM
MET WITH:	Director, Ashley Staudenmeir		TIME VISIT/ INSPECTION COMPLETED:	04:15 PM

NARRATIVE

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On February 4, 2025 at 1:30 pm Licensing Program Analysts (LPA) Priscilla Ochoa conducted an unannounced random annual inspection. LPA was greeted by Director, Ashley Staudenmeir, who guided LPA on a tour of the facility. This is a preschool program that operates Monday – Friday from 7 am – 6 pm. Per director, there are currently 29 children enrolled in the program. LPA observed 19 children in care with 3 staff members.

At 1:45 pm, Director guided LPA on a tour of facility during nap time. This Preschool center consist of 3 classrooms, Caterpillar:10 children and 1 staff, Lady Bug: 9 children and 1 staff and Butterflies: 0 children and 0 staff. which were inspected. The Caterpillar and Lady Bug room are in the front entrance of the facility. The Butterfly room is accessible through the play yard and out the gate to a church driveway to the right. 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. Napping equipment was observed in the form of cots. Bedding was inspected for good condition, appropriate storage, and cleanliness. There are age-appropriate toys and supplies for children in each classroom, and in good repair. The children's restrooms are located in the Ladybug and Butterfly room. All toilets and hand washing facilities are in safe and sanitary operating condition. Drinking water is available in form of personal water bottles that are also taken outside when needed. The facility provides additional water from water bottles to children in care.

The classroom furniture and equipment were inspected for good repair, free of sharp, loose, or pointed parts. All indoor 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. When a child becomes ill, they are placed in an isolation room in the Ladybug room while parents are called. There is also a cot available if needed.

The facility only provides snacks for children in care. Parents provide children lunch from home. LPA reminded the licensee, food that is brought from home must be stored properly and in closed containers. All food preparation areas and Storage areas are clean, free of litter, rubbish, and rodents/vermin.

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Ana Chico	TELEPHONE: (323) 981-3379
Priscilla Ochoa	TELEPHONE: 323-981-3350
	DATE: 02/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2025

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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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: MOUNT OLIVE WILLA LEE NURSERY SCHOOL	FACILITY NUMBER: 191201970
	VISIT DATE: 02/04/2025

NARRATIVE

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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. The facility takes measures to keep the facility free of flies, other insects and rodents. Director states there are no weapons, firearms, or bodies of water on the premises.

LPA did observed a smoke/carbon monoxide detector in the facility. However, LPA did not test detector as children were napping. LPA observed a fully charged 2A-10BC fire extinguisher. The valve on the fire extinguisher was pointing to the fully charged green section. Fire extinguisher was serviced on 10/13/2024.

Outdoor playground is located in the back of the facility which is fenced. There is a large stand area with a playground structure and toys. Per Director, the sand is inspected daily before children are able to play outdoors. 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. All areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard.

LPA reviewed Sign in and out sheets 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 a medical assessment are on file. Child records were deemed complete. LPA consulted with Director about children’s medication being kept at the facility. LPA reviewed medication and medical consent from and advised director to add a section where parents can note how to administer the medication, while making sure it does not contradict what the instructions on the box. The facility will receive a technical violation. While inspecting medication storage LPA noticed that C5’s Epinephrine has expired. LPA brought matters to the Directors attention and expressed that the facility must be checking medications for expiration dates and lettings parents know immediately.

Staff records were reviewed and complete. Criminal Records Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed.

AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018 any person who works in a child care facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers.

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SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3379
LICENSING EVALUATOR NAME: Priscilla Ochoa	TELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2025

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: MOUNT OLIVE WILLA LEE NURSERY SCHOOL	FACILITY NUMBER: 191201970
	VISIT DATE: 02/04/2025

NARRATIVE

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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 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

CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES: 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 child care 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). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP

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

Director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

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

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

A notice of site visit was given and must remain posted for 30 days during facility’s hours of operation. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. An exit interview was conducted, and a copy of the report was provided to Director, Ashley Staudenmeir.

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SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3379
LICENSING EVALUATOR NAME: Priscilla Ochoa	TELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/04/2025 03:59 PM - It Cannot Be Edited

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: MOUNT OLIVE WILLA LEE NURSERY SCHOOL	FACILITY NUMBER: 191201970
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/04/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Section Cited

CCR

101223(a)(2)

Personal Rights

(a) The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, record review, the licensee did not comply with the section cited above in C5 had expired Epinephrine, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/11/2025
	Plan of Correction
1 2 3 4	Director will contact the parent of C1 immediately and receive new Epinephrine medication. Director will send LPA P. Ochoa proof of non expired Epinephrine medication for C1 by POC date 2/11/2025

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

Ana Chico	TELEPHONE: (323) 981-3379
Priscilla Ochoa	TELEPHONE: 323-981-3350
	DATE: 02/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2025

LIC809 (FAS) - (06/04)

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