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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191596182
Report Date: 06/11/2024
Date Signed: 06/11/2024 03:17:15 PM

Document Has Been Signed on 06/11/2024 03:17 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:CHILD DEVELOPMENT CENTERFACILITY NUMBER:
191596182
ADMINISTRATOR/
DIRECTOR:		TAMIKA ADDISONFACILITY TYPE:
850
ADDRESS:1100 N. GRAND AVE., BLDG. 70TELEPHONE:
(909) 274-4920
CITY:WALNUTSTATE: CAZIP CODE:
91789
CAPACITY: 182TOTAL ENROLLED CHILDREN: 102CENSUS: 77DATE:
06/11/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:01 PM
MET WITH:Lupe Hernandez, Assistant DirectorTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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On 06/11/2024, Licensing Program Analysts (LPAs) Kruz Long and Priscilla Ochoa conducted an unannounced Annual/Random inspection. A COVID-19 risk assessment was conducted prior to entering the facility. LPAs met with Lupe Hernandez, Assistant Director who guided LPAs on a tour of the facility. Operating hours are from Monday through Friday from 8:00AM to 5:00PM. LICENSEE SERVES AMBULATORY CHILDREN AGES 2 UNTIL ENTRY INTO FIRST GRADE IN ROOMS 1400, 1600, 1620, 1640 AND 1660.

These classrooms were inspected: Classroom #1400: Teacher-child ratio (5 staff and 18 children), Classroom #1600: Teacher-child ratio (5 staff 13 children), Classroom #1620: Teacher-child ratio (4 staff 17 children), Classroom #1640: Teacher-child ratio (3 staff 13 children), Classroom #1660: Teacher-child ratio (4 staff 16 children) were observed to be in accordance with Title 22 Regulations. All children were observed to be under supervision, including visual supervision. Licensed facility is within the conditions, limitations, and capacity specified on the license.

The classroom furniture and equipment was 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 toilets and washing facilities are in safe and sanitary operating conditions. All materials and surfaces accessible to children are toxic free. Cleaning compounds/solutions were found to be stored inaccessible to children. LPA observed that there are functioning smoke and carbon detectors in the facility. LPA observed a fully charged and serviced fire extinguisher. The facility provides breakfast, lunch and snacks. Kitchen area, food preparation and storage areas is kept clean and free of litter and rubbish. Napping equipment is maintained in safe condition.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Kruz Long
LICENSING EVALUATOR SIGNATURE: DATE: 06/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/11/2024
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 06/11/2024 03:17 PM - It Cannot Be Edited


Created By: Kruz Long On 06/11/2024 at 02:21 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191596182

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/11/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101174(d)
Disaster and Mass Casualty Plan
(d) Disaster drills shall be conducted at least every six months.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care. Emergency disaster drill was last conducted during October 2023 for all 5 Classrooms.
POC Due Date: 06/18/2024
Plan of Correction
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Licensee shall conduct and document disaster drill for all 5 Classrooms and provide proof to the department by the POC date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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 Chico
LICENSING EVALUATOR NAME:Kruz Long
LICENSING EVALUATOR SIGNATURE:
DATE: 06/11/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/11/2024


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: CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191596182
VISIT DATE: 06/11/2024
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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.

There are 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 and day. LPA reviewed Staff and Children records which were complete.

Emergency disaster drill was last conducted during October 2023 for all 5 Classrooms.

SB792 (Immunization Requirements for Staff and Employees) was discussed with the Assistant Director.

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.


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

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Kruz Long
LICENSING EVALUATOR SIGNATURE:

DATE: 06/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2024
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: CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191596182
VISIT DATE: 06/11/2024
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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). Facility was built after January 1, 2010, therefore facility is exempt from lead testing.

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



Assistant 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.

Assistant 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.

Deficiency was cited in accordance with the Title 22 of the California Code of Regulations and Health & Safety Codes. Please see 809D for documentation of deficiency.

An exit interview was conducted and a copy of this report and appeal rights was provided to the Assistant Director. 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.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Kruz Long
LICENSING EVALUATOR SIGNATURE:

DATE: 06/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2024
LIC809 (FAS) - (06/04)
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