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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191501178
Report Date: 07/20/2023
Date Signed: 07/20/2023 12:39:33 PM


Document Has Been Signed on 07/20/2023 12:39 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:BURDICK'S SCHOOL FOR LITTLE CHILDRENFACILITY NUMBER:
191501178
ADMINISTRATOR:HEREDIA, TONY F.FACILITY TYPE:
850
ADDRESS:4124 MAXSON ROADTELEPHONE:
(626) 442-6719
CITY:EL MONTESTATE: CAZIP CODE:
91732
CAPACITY:64CENSUS: 21DATE:
07/20/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Director Elodia Barnhart TIME COMPLETED:
12:50 PM
NARRATIVE
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Licensing Program Analyst (LPA) Roxana Lopez conducted a Case Management-Deficiencies visit on this date to address deficiencies revealed during a complaint investigation. A COVID risk assessment was conducted upon entry and appropriate Personal Protective Equipment (PPE) was used.

LPA initially arrived to the facility at 9:15 am- during walk through of classrooms LPA observed Staff # 1 in the preschool classroom had fingerprints in process and has not been cleared. This poses an immediate health and safety risk for children in care. Civil Penalty of $500 was assessed on this date.

Based on LPA observations and records 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.

LPA Roxana Lopez informed facility representative Elodia Barnhart that this report dated 7/20/2023 document(s) 1 Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care. Also, LPA Roxana Lopez informed the facility representative to provide a copy of this licensing report dated 7/20/2023 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.



Exit interview conducted and report was reviewed with the facility representative Elodia Barnhart.
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana LopezTELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:
DATE: 07/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/20/2023
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


Document Has Been Signed on 07/20/2023 12:39 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754


FACILITY NAME: BURDICK'S SCHOOL FOR LITTLE CHILDREN
FACILITY NUMBER: 191501178

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/20/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/20/2023
Section Cited
CCR
101170(e)(1)

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101170(e)(1) All individuals subject to a criminal record review...shall prior to working...in a licensed facility:(1)Obtain a California clearance or a criminal record exemption as required by the Department
This requirement was not met as evidenced by:
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Staff # 1 was sent home during the inspection. Per Director, Staff # 1 will not returned unti fingerprint cleared.
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Based on observation, interview and record review, Staff # 1 is pending fingerprint clearence which 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: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana LopezTELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:
DATE: 07/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/20/2023
LIC809 (FAS) - (06/04)
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