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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191597486
Report Date: 04/09/2024
Date Signed: 04/09/2024 12:34:10 PM


Document Has Been Signed on 04/09/2024 12:34 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:MADISON/CHILD DEVELOPMENT CENTERFACILITY NUMBER:
191597486
ADMINISTRATOR:KYM ALLENFACILITY TYPE:
850
ADDRESS:1351 S. MAIN STREETTELEPHONE:
(909) 622-9805
CITY:POMONASTATE: CAZIP CODE:
91766
CAPACITY:96CENSUS: 35DATE:
04/09/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:TIME COMPLETED:
12:45 PM
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At 9:30am (LPA) Licensing Program Analyst Stephanie Li conducted an unannounced annual inspection. Upon arrival LPA met with Teacher Christina Oceguera who led LPA on a tour of the facility. Per teacher, there are currently 42 children enrolled. Present are 35 children and and 7 teachers. Preschool program operates out of rooms HS2, L1 and L2. HS1 is currently being used as a parent social room for toddlers and infants. Hours of operation are Monday-Friday 7:30am-2:00pm for room HS2 and L1. Room L2 is full day and runs two class sessions from 7:30-11:00 and 11:45-3:15pm.

All areas identified on the Facility Sketch were inspected. The facility consists of 4 classrooms and 1 outdoor playground. The following was observed: Room HS2 had 14 children and 3 staff, Room HS1 had 0 children and 0 staff . Room L1 had 12 children and 2 staff. L2 had 9 children and 2 staff. Staff names were recorded. Teacher-child ratios were observed to be in accordance with Title 22 regulations. The Licensee is within the conditions, limitations, and capacity specified on the license. All children were observed to be under active/visual supervision of a teacher during the tour.

Licensing staff observed disinfectants, cleaning solutions, medication and other items that are dangerous to children were not accessible to children. Classroom furniture and equipment are in good condition, free of sharp, loose, or pointed parts. All floors were inspected for cleanliness and safety. LPA observed the carpet floor in Room L1 has several large water residue stains. Per teacher, the classroom floods with every rain and they have to block off that part of the room. Per teacher, she has called supervisor and maintenance to report the issue each time it occurs. They will place fans on the floor to dry up the water after leaks. Floor shows signs of potential mildew and mold. A citation is being issued. (See 809-D page) Napping equipment (mats/cots) and bedding were inspected for good condition, appropriate storage, and cleanliness. Facility has a cleaning service that take their blankets to wash weekly. Facility has two sets for a spare. Storage for children's belongings were inspected.

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SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Stephanie LiTELEPHONE: (626) 366-3362
LICENSING EVALUATOR SIGNATURE:
DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/09/2024
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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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: MADISON/CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191597486
VISIT DATE: 04/09/2024
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All toilets and washing facilities were inspected for safe and sanitary operating conditions. LPA observed that the toilets were observed to have urine build up along the toilet seats, rim, and edge. Water in the toilet bowl is observed to be brown and cloudy. The toilet bowl has a thick brown ring of water marks. Toilet appears to not be getting cleaned. Teachers confirmed that they have expressed concerns about toilet cleanliness and requested adequate cleaning from custodial and supervisors. Citation is being issued (see 809-D page) First Aid supplies are available and complete. Drinking water was readily available indoors. The back of the room and the office is used as an isolation area, there is a chair available for an ill child to rest. The restroom in HS1 is used for ill children if needed.

LPA observed all required forms/publications to be posted by the front entrance. Snack menus were reviewed to ensure that they are being posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request. Facility provides breakfast, snacks, and lunch. All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids. The facility was observed to be free of flies, other insects, and rodents.

LPA observed the required 2A10BC fire extinguisher indicates fully charged and was serviced on 03/26/24 on service tag. Per State Fire Marshall standards, fire extinguishers shall be serviced annually. Facility has a functioning carbon monoxide and smoke detector that meets statutory requirements. Teacher states there are no weapons, firearms, or bodies of water on the premises. The last Disaster drill was conducted in Jan 2024. Reminded teachers disaster drills must be conducted at least every six months. LPA observed that emergency exits in Room L1 and L2 are blocked by sand bags. This violates Title 22 section 101238 (c) and a citation is being issued. (see 809-D page)

LPA reviewed the outdoor play area. The playgrounds 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. Drinking water is readily available outdoors.

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SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Stephanie LiTELEPHONE: (626) 366-3362
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024
LIC809 (FAS) - (06/04)
Page: 2 of 6
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: MADISON/CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191597486
VISIT DATE: 04/09/2024
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Sign in and out sheets were reviewed 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 and staff records were not available for review as they are kept at the Child development Center. Documents will be reviewed at a later date. There is at least one person trained in CPR and Pediatric First Aid present during this inspection.



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

Teachers were 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 Child Care 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.

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.

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 childcare 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).

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SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Stephanie LiTELEPHONE: (626) 366-3362
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: MADISON/CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191597486
VISIT DATE: 04/09/2024
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The facility has completed lead testing and is in the process of remediating lead exceedances. LPA referred facility representative to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

Teacher 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.


Based on Licensing staff observations, 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.

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.



Exit interview and appeal rights reviewed with Christina Oceguera.

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SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Stephanie LiTELEPHONE: (626) 366-3362
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024
LIC809 (FAS) - (06/04)
Page: 4 of 6
Document Has Been Signed on 04/09/2024 12:34 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: MADISON/CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191597486

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/09/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238.3(b)
Indoor Activity Space
(b) The floors of all rooms shall have a surface that is safe and clean.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in classroom L1 carpet had several large water residue for potential mildew from flooding, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/23/2024
Plan of Correction
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Facilities planner Kym Allen is going to have the custodial team shampoo the carpet in L1 and send picture proof via email to LPA by 4/23/2024.
Type B
Section Cited
CCR
101238(a)
Buildings and Grounds
(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above in 5 out of 6 toilets were unsanitary, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/23/2024
Plan of Correction
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Facilities planner, Kym Allen will have custodial clean toilets thoroughly and send photo proof to LPA via email by 4/23/24.
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: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Stephanie LiTELEPHONE: (626) 366-3362
LICENSING EVALUATOR SIGNATURE:
DATE: 04/09/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/09/2024
LIC809 (FAS) - (06/04)
Page: 5 of 6


Document Has Been Signed on 04/09/2024 12:34 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: MADISON/CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191597486

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/09/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238(c)
Buildings and Grounds
(c) All outdoor and indoor passageways, stairways, inclines, ramps, open porches and other areas of potential hazard shall be kept free of obstruction.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above in both emergency exits in room L1 and L2 are blocked by sandbags and unable to open, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/23/2024
Plan of Correction
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Facilities planner, Kym Allen will have maintenance crew remove sandbags and make it part of the routine when there is rain and send photo proof to LPA via email by 4/23/24.
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: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Stephanie LiTELEPHONE: (626) 366-3362
LICENSING EVALUATOR SIGNATURE:
DATE: 04/09/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/09/2024
LIC809 (FAS) - (06/04)
Page: 6 of 6