191570967-5-14-2025-54-CC-TTRN-DGNRZM-20250514132809

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191570967
Report Date: 05/14/2025
Date Signed: 05/14/2025 01:28:46 PM

Document Has Been Signed on 05/14/2025 01:28 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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	TRACY INFANT CENTER		FACILITY NUMBER:	191570967
ADMINISTRATOR/ DIRECTOR:	TOM WOODWARD		FACILITY TYPE:	830
ADDRESS:	12222 CUESTA DRIVE, BLDG F		TELEPHONE:	5622297762
CITY:	CERRITOS	STATE: CA	ZIP CODE:	90703
CAPACITY: 62	TOTAL ENROLLED CHILDREN: 14	CENSUS: 10	DATE:	05/14/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:45 AM
MET WITH:	Dr. Rebecca Lynch		TIME VISIT/ INSPECTION COMPLETED:	12:50 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	On 5/14/25, at 9:45AM Licensing Program Analyst (LPA) T. Tran arrived at Tracy Infant Center to conduct an annual random visit. Upon arrival, LPA met with Supervisor Child Development and Special Program, Dr. Rebecca Lynch. LPA announced the purpose of today’s visit. About 10:10AM, we toured all the accessible areas for the children in care. LPA observed proper care and supervision. All center staff that were present during today’s visit were check for fingerprint clearance and associated to the licensed facility. This is an Infant facility with Toddler children attached. Facility is currently operate one infant's class and one toddler's class. The hours of operation are from 7:30AM-2:45PM Monday-Friday. LPA observed all posting requirements for operation on the posting board LIC 203A-License, LIC-9213-Notice of site visit, LIC 610 A-Emergency Disaster Plan, LIC 9148-Earthquake Preparedness Check List, PUB 394-Notification of parent’s rights poster, LIC 613A- Personal Rights, PUB 269- Child Car Seat Law, Menus, Activity Schedule, Sudden Infant Death Syndrome, Shaken Baby Syndrome Poster, and safe sleep poster. Children files were reviewed. Staff files located at the main office. LPA will arrange another visit for records review. The facility obtained current pediatric CPR and First Aid and mandated reporter training for child abuse for all facility staff members. LPA observed the facility conducted 15 minutes safe sleep monitoring for children 0-2. Completion testing and remediated lead exceedances conducted on 12/23/23. Classroom furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting, and ventilation were evaluated. Individual storage for children's belongings observed. Classroom observed with a changing area within the arm reach of the sink. Children napping area and cribs were observed to be safe and sanitation. 15 minutes checklist observed for each infants. Isolation area located in staff's office. Trash can with tight lids, First Aid supplies, smoke detectors; carbon monoxide/fire extinguishers were observed. A review of medication policy, including administering, labeling, storage, and records was made. Sign in and out sheet procedures were reviewed.

Denise Gibbs	TELEPHONE: (323) 981-3385
Tiffanie Tran	TELEPHONE: (323) 981-3350
	DATE: 05/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: TRACY INFANT CENTER	FACILITY NUMBER: 191570967
	VISIT DATE: 05/14/2025

NARRATIVE

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Facility provided breakfast, lunch, and snack. Toddler foods are cooked here by the facility staff. Kitchen area observed to be clean and orderly. All food items are proper storages. Individual meal plan observed. All bottles, food items and snacks were observed to be efficient with label and dated.
Separated outdoor play areas observed with sufficient shade. Learning material and equipment inspected for safety and age appropriateness. LPA observed is clean and free of hazards items. No bodies of water on the premises during today's visit.
Facility was informed of responsibility to report suspected Child Abuse by calling the Child Abuse Hotline at 1-800-540-4000. LPA advised of the requirement to report Unusual Incidents and/or injuries to the parent/guardian and to CCL within the time frame specified by the regulation, this includes any changes as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your location.
LPA informed the Facility Representative of the Childcare Advocate Program (CCAP) to provide many other helpful resources to the licensees and the public. LPA advised access forms, regulations, and quarterly updates on the Childcare Licensing website at: www.ccld.ca.gov.
To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.
Facility representative (FR), was reminded that all adults 18 and over, 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 Childcare 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.
CCC COMPLETED TESTING AND REMEDIATED LEAD EXCEEDANCES.
Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Childcare 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.
LPA referred FR to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.
LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.

SUPERVISOR'S NAME: Denise Gibbs	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Tiffanie Tran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025

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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: TRACY INFANT CENTER	FACILITY NUMBER: 191570967
	VISIT DATE: 05/14/2025

NARRATIVE

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LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records.
For IMS information see PIN 22-02-CCP. 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 Childcare Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.
Facility representative was informed of the MyChildCarePlan.org website; 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 facility was found in compliance with Title 22 regulations, no deficiency was cited at this time.
A notice of site visit was given and must remain posted for 30 days.
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 and report was reviewed with the facility representative, Dr. Rebecca Lynch.

SUPERVISOR'S NAME: Denise Gibbs	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Tiffanie Tran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025

LIC809 (FAS) - (06/04)

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