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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191602046
Report Date: 06/23/2025
Date Signed: 06/23/2025 04:06:24 PM

Document Has Been Signed on 06/23/2025 04:06 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:LONG BEACH DAY NURSERY - WEST BRANCHFACILITY NUMBER:
191602046
ADMINISTRATOR/
DIRECTOR:		LINDA BLACKSHIREFACILITY TYPE:
850
ADDRESS:1548 CHESTNUT AVETELEPHONE:
(562) 591-0509
CITY:LONG BEACHSTATE: CAZIP CODE:
90813
CAPACITY: 95TOTAL ENROLLED CHILDREN: 95CENSUS: 29DATE:
06/23/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:40 AM
MET WITH: Director Linda Blackshire and Executive Director Jennifer Harper TIME VISIT/
INSPECTION COMPLETED:
04:15 PM
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On 6/23/25 at 10:40am Licensing Program Analysts (LPA) Ashley Calderon and Susann Sanchez conducted an unannounced random/ annual inspection and measured for a Capacity Increase for the Toddler Component and Capacity Decrease for Preschool.LPA met with Director Linda Blackshire and Executive Director Jennifer Harper and discussed purpose of today's visit. Hours of operation are Monday through Friday from 7:30am to 5:00pm. Currently this is a preschool program licensed for 65 preschoolers with toddler option licensed for 30 toddlers.

Director L. Blackshire guided analysts on tour of the indoor and outdoor facility space.

All areas identified on the Facility Sketch were inspected. Required postage was observed in the front entrance of the facility. The following staff were fingerprinted cleared, associated and facility was found to be in compliance for teacher- child ratios. The Licensee is within the conditions, limitations, and capacity specified on the license. All children were observed to be under visual supervision of a teacher at all times. 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.

Storage for medication was inspected to ensure that medications are in a safe place inaccessible to children currently (1) child in Room 2 has medication, medication was not expired. All materials and surfaces accessible to children are toxic free. At this time, the office is used as an isolation area. There are chairs in the office and parents are contacted immediately when children are determined to be ill.

(Pg 1/ Cont...)

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/23/2025
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 5
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: LONG BEACH DAY NURSERY - WEST BRANCH
FACILITY NUMBER: 191602046
VISIT DATE: 06/23/2025
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All toilets and hand washing facilities are in safe and sanitary operating conditions. Preschoolers use (1) restroom in the hallway and restroom in room 3 (total 7 toilets), children toilet-sink ratio in compliance. Toddlers have (1) restroom in the hallway , restroom in room 1 and 6 (total 6 toilets), children toilet-sink ratio in compliance for capacity / capacity request.

Menus were reviewed to ensure that they are being posted at least one week in advance and visible to an authorized representative. The facility provides breakfast, lunch, and an afternoon snack. All kitchen, food preparation, and storage areas are clean, free of litter, rubbish, and rodents/vermin. All food is protected from contamination, and LPAs inspected that any contaminated food is discarded immediately (if applicable). There is drinking water available in all indoor classrooms and drinking containers / jugs are taken outdoors and per Director Blackshire children do not use drinking fountains. Water sources used for drinking and food preparations have been tested for lead. No water sources were found to have high levels of lead.

All storage containers for solid waste, including moveable bins, have tight fitting covers on and are in good repair. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are stored in an area inaccessible to children. Storage areas for poisons are locked. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. The Director takes measures to keep the facility free of flies, other insects and rodents.

Outdoor play equipment was observed to be in good condition, free of sharp, loose or pointed parts. Outdoor activity space surface is maintained in a safe condition as is free of hazards. LPA's observed that there are no bodies of water on the premises. Areas around and/or under climbing equipment and swings have cushioning material to absorb a fall; climbing apparatuses are single level only.

(Pg 2 / Cont...)

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2025
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: LONG BEACH DAY NURSERY - WEST BRANCH
FACILITY NUMBER: 191602046
VISIT DATE: 06/23/2025
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Children’s records were reviewed for Licensing Forms, LPAs reviewed file for children on medication and with allergies. Toddlers 18-24 months had 15 min sleep log and Toddler needs and service Plan in place was reviewed. Staff records were reviewed for appropriate documentation. Approved Pediatric First Aid and CPR certification for at least one staff member on site was valid. Director and teachers file reviewed had valid Mandated Reporter Child Care Provider certification and appropriate vaccination and health screening forms in place.

Facility is asking for capacity Increase for the Toddler Component and Capacity Decrease for Preschool. Toddlers ages 18 months - 36 months in Rooms 1, 2 and 6 and Preschoolers ages 2- 6 years in Rooms 3, 4 and 5. Facility is requesting 48 Toddlers and 64 Preschoolers.

Director L. Blackshire guided analysts on tour of the indoor and outdoor facility space. During today's visit LPA's measured detached bangalow, Room 6, indoor square footage measured 20.785449, which is sufficient to accommodate the requested capacity of (48) Toddler Children.

The facility currently has (3) fully fenced playground areas, (2) designated as the Toddler play yard and (1) Preschool play yards. LPAs observed each play yard is fenced. The total square footage for designated toddler outdoor activity space is 68.216 square feet, which is sufficient to accommodate the requested toddler capacity. Shade is provided via shade structured awing. There are sufficient outdoor age-appropriate toys and play equipment available on the playgrounds. There are age appropriate climbing structure on the toddler play yard area. There is adequate cushioning in fall zones of climbers provided by outdoor wood chips. Drinking water is available via pitchers. All hazardous items on the playground are screened/blocked off, inaccessible to children.

Toddler restroom has changing table at hands reach to a sink.

(Pg 3/ Cont..)

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2025
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: LONG BEACH DAY NURSERY - WEST BRANCH
FACILITY NUMBER: 191602046
VISIT DATE: 06/23/2025
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During today's LPA's collected:
-Updated LIC500 Personnel Roster
-Facility Sketch of the 2nd floor.
-LIC 309 Administrative Organization form.

The following corrections are needed prior to the issuance of the license:
- Facility Sketch with off limit areas and length X width measurements for the first floor.
-Carbon Monoxide device for Room 6.

Director L.Blackshire understands that all proof of corrections must be provided to the Department within 30 days, or the application may be denied.LPA's will obtain by correct Std850 Approval with correct capacity requested by the facility from Fire Inspector.
  • Facility representative was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.”
  • This facility plans provides Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A 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) or (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. “

  • Facility representative was informed of the MyChildCarePlan.org site, 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. “

  • A notice of site visit was given to the facility representative and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Exit interview conducted and report was reviewed with the facility representative Linda Blackshire. (Pg 4/ End of Report)
NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2025
LIC809 (FAS) - (06/04)
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