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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191570934
Report Date: 05/26/2023
Date Signed: 05/26/2023 05:32:47 PM


Document Has Been Signed on 05/26/2023 05:32 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:AMAR CHILDREN'S CENTERFACILITY NUMBER:
191570934
ADMINISTRATOR:CHRIS TORTORCIFACILITY TYPE:
850
ADDRESS:1000 N. CALIFORNIA AVE.TELEPHONE:
(626) 933-7101
CITY:LA PUENTESTATE: CAZIP CODE:
91744
CAPACITY:384CENSUS: 149DATE:
05/26/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Gabriel MunozTIME COMPLETED:
05:30 PM
NARRATIVE
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On 5/26/2023 an unannounced Case Management-Incident inspection was conducted by Licensing Program Analyst (LPA) Carolyn Tuba to follow up on an Unusual Incident. LPA entered main school office and was met with staff and shortly after met with Child Development Supervisor, Gabriel Munoz. Child Development Supervisor guided LPA on a tour of the facility which had a census of 149 children with 29 staff.

The incident that occurred on 04/25/2023 was reported to the Department on 04/25/2023 via a written report emailed to Community Care Licensing. The facility reported the incident in a timely manner. LPA had conducted a prior visit on 5/10/2023 to investigate and had to return to conduct interviews and further investigation. During this visit LPA interviewed Staff #1 (S1) and #2 (S2). An additional staff member who was present during the incident was not available to interview, as they no longer work at this facility, however Supervisor provided LPA with a statement from that staff member.

The Unusual Incident reported concerns of a child being left unattended by staff in a classroom. After LPA conducted interviews with S1, S2 and the Supervisor, it was disclosed that child was left unattended for 3 to 5 minutes inside the classroom during a transition when children were taken to the restroom. Staff member found child unharmed, but due to lack of supervision the facility will be cited. During the visit on 5/10/2023 LPA had obtained documentation of staff training and signatures of staff members who attended training on Care and Supervision. The training was held on 3/23/2023 prior to the incident and on 4/26/2023 after the incident. LPA and Supervisor consulted, and he has agreed to implement a name to face list of children in each classroom. The staff will be using when transitioning and Supervisor will be giving a training on this topic. Supervisor will provide LPA a copy of signatures of staff in attendance and a sample of the name to face. Staff will make sure to have all children with them before closing the door to the classroom during transition.

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.
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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn TubaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 05/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/26/2023
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 05/26/2023 05:32 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: AMAR CHILDREN'S CENTER
FACILITY NUMBER: 191570934

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/26/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/12/2023
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.
(1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.
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Per Supervisor, Staff has been provided training prior to the incident and after. Supervisor agrees to implement a name to face list and training on how to properly use when staff is transitioning with children. Staff will make sure to have all children with them before closing the door to the classroom.
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This requirement is not met as evidenced by: Based on interviews, the child was left unsupervised for 3 to 5 minutes inside the classroom with no adult supervision during transition to the restroom. This poses an immediate Health and Safety risk to children in care.
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Supervisor will provide a copy of signatures of the staff attending the training and a sample of the name to face.

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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 ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn TubaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 05/26/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/26/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3


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: AMAR CHILDREN'S CENTER
FACILITY NUMBER: 191570934
VISIT DATE: 05/26/2023
NARRATIVE
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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.

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.

Exit interview conducted, appeal rights given, and a copy of the report was reviewed and given to Child Development Supervisor, Gabriel Munoz.

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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn TubaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 05/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2023
LIC809 (FAS) - (06/04)
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