<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191606400
Report Date: 02/24/2023
Date Signed: 02/24/2023 02:29:25 PM


Document Has Been Signed on 02/24/2023 02:29 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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754



FACILITY NAME:KING STATE PRESCHOOLFACILITY NUMBER:
191606400
ADMINISTRATOR:STEPHANIE RICHARDSONFACILITY TYPE:
850
ADDRESS:2270 E. 122ND STTELEPHONE:
(310) 898-6433
CITY:COMPTONSTATE: CAZIP CODE:
90222
CAPACITY:42CENSUS: 8DATE:
02/24/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Elizabeth SanchezTIME COMPLETED:
02:45 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
Licensing Program Analysts (LPAs) Austin Estrada and Jeanette Estrada conducted an unannounced annual required inspection at the above facility. LPAs met with Lead Teacher Elizabeth Sanchez, who guided analysts on a tour of the facility.
The facility has two classrooms, but currently only use one. Care is provided in classroom CD1. Upon arrival, LPAs observed 8 children supervised by the lead teacher and one additional staff member. Teacher child ratios were observed, and staff names recorded. Facility provides care to children ages three years old to five years old Monday through Friday. There are two sessions. The first session is from 8AM-11AM and the second session is from 11:45AM-2:45 PM. The following was observed during the tour of the facility: Classroom was observed to be clean and in good repair. The floors were clean and lighting was in operable condition. There were age appropriate toys and equipment. LPA observed water readily available via a drinking fountain in the classroom. LPA observed cubbies/storage area for children to store their personal belongings. Smoke detector and carbon monoxide detector were observed to be in operable condition. LPA observed Fire extinguisher indicated fully charged last serviced on 10/27/21. First Aid kit was observed and inventoried. Appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, paper towels, and general sanitation. Disinfectants and cleaning solutions were observed in a locked cabinet inaccessible to children in care. Per Lead Teacher there are no poisons stored at the facility. There is no napping at this facility due to it being a half day program. Per Lead Teacher, the isolation area is located in the classroom away from other children. Per Lead Teacher, the facility administers medication on a as needed basis. LPAs observed medication to be locked in a cabinet in the classroom inaccessible to children in care. LPAs toured the outdoor play area. Outdoor area was observed to have age-appropriate toys and material for children, free of loose, sharp, and/or pointed parts. LPA observed required cushioning under climbing structure to absorb a fall. Shade was observed in the outdoor area. Per Lead Teacher, water and cups labeled with the childrens names are provided to the children while outdoors. LPAs did not observe any large bodies of water on the premises.
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 9813362
LICENSING EVALUATOR NAME: Austin EstradaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 02/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/24/2023
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 7


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: KING STATE PRESCHOOL
FACILITY NUMBER: 191606400
VISIT DATE: 02/24/2023
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
26
27
28
29
30
31
32
LPA observed the kitchen area, food preparation area, and food storage area to be clean and free of litter, rubbish, rodents, and/or any other vermin. LPA observed refrigerator to be clean and in operable condition. LPA observed items in the refrigerator not to be expired. Food that was not in the original packaging were sealed and labeled with an expiration date. LPA observed a roster in the food preparation area that included children with allergies. During the inspection, children present was observed to be treated with dignity and respect, observed to be receiving safe, healthful, and comfortable accommodations, furnishings and equipment, and free from corporal and/or unusual punishment. LPA observed required posted documentation which included, Facility License, LIC610- Emergency Disaster Plan, Publication (PUB) 393- Notification of Parent Rights, PUB 269- Child Passenger Restraint System, LIC 613A- Notification of Personal Rights and Lunch/Snack Menus. LPAs did not observe LIC 610 (Emergency Disaster Plan) and a lunch menu posted at the time of inspection. LPA advised Lead Teacher that both the LIC 610 and lunch menu should be posted in a prominent, publicly accessible area. Per Lead Teacher, the lunch menu is posted on the school website. LPA observed Sign in/out sheets, LIC 9148 Earthquake Preparedness, Daily Activity Schedule, and Verification of Disaster and Fire Drills (last conducted on 10/20/22). LPA observed two of eight children to not be signed out while reviewing the sign in/out sheet. Children’s records were reviewed for LIC 613A- Personal Rights, Admission Agreement, Immunization Records, LIC 700- Identification and Emergency Information, LIC 701- Physician’s Report, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, All records were observed to be complete. Per LPA record review, C5 requires medication which was observed to be stored in the classroom inaccessible to children in care.

Staff records were reviewed for approved Pediatric First Aid and CPR certification, staff qualifications, LIC 508-Criminal Record Statement, LIC 503- Health Screening Report, LIC 9052- Employee Rights, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, and LIC 9108- Statement of Child and Mandated Reporter Training Certificate. There is at least one person trained in CPR and Pediatric First Aid present during this inspection. LPA observed immunization records (Measles, Pertusis, Influenza, Tuberculosis) and CPR/1st aid (expires 2/12/24) for Lead Teacher Elizabeth Sanchez. LPA did not review staff files during the inspection due to the staff files being stored at the Human Resource office. LPA will review staff files at a later time and date. If staff files were to be incomplete during the time and date that LPA reviews files, a case management inspection will occur at the facility to reflect the incomplete files.

SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 9813362
LICENSING EVALUATOR NAME: Austin EstradaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2023
LIC809 (FAS) - (06/04)
Page: 2 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: KING STATE PRESCHOOL
FACILITY NUMBER: 191606400
VISIT DATE: 02/24/2023
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
26
27
28
29
30
31
32
Lead Poisoning Facts Flyer (PUB 515) – All licensees (Child Care Centers) must provide the following flyer to parents and families upon enrolling or re-enrolling any child.

PIN 21-21-CCP: Release of the Written Directives for Lead Testing of Water in Licensed Child Care Centers Per AB 2370. Facility did not provide evidence that they conducted lead testing by the required date of 1/1/23. Please visit the Lead Toxicity Prevention and Water Testing Information website for additional information and resources regarding lead testing in licensed childcare centers by visiting the following weblink: https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information.

For any additional questions, please email: CCCWaterTesting@dss.ca.gov.
To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.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

Lead Teacher 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.

SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 9813362
LICENSING EVALUATOR NAME: Austin EstradaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2023
LIC809 (FAS) - (06/04)
Page: 3 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: KING STATE PRESCHOOL
FACILITY NUMBER: 191606400
VISIT DATE: 02/24/2023
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
26
27
28
29
30
31
32
Based on the LPA’s observations, interviews and records review, 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 & safety. Deficiencies include three type B violations.

The following deficiencies are as follows:


1) Not having LIC 610 (Emergency Disaster Plan) posted in a prominent, publicly accessible area.
2) Not having proof of Lead Testing at the time of inspection
3) 2 of 8 children not signed out at the time of inspection

A notice of site visit was given and must remain posted for 30 days. Failure to maintain posting as required will result in a $100.00 civil penalty. Exit interview was conducted and report was reviewed with the Lead Teacher Elizabeth Sanchez. Appeal rights were discussed and provided to the Lead Teacher.

SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 9813362
LICENSING EVALUATOR NAME: Austin EstradaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2023
LIC809 (FAS) - (06/04)
Page: 4 of 7
Document Has Been Signed on 02/24/2023 02:29 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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754


FACILITY NAME: KING STATE PRESCHOOL
FACILITY NUMBER: 191606400

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/24/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101174(a)
Disaster and Mass Casualty Plan
(a) Each licensee shall have a disaster and mass casualty plan of action. The plan shall be in writing and shall be readily available.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above not having LIC 610 posted in a prominent, publicly accessible area which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/24/2023
Plan of Correction
1
2
3
4
Per Lead Teacher, completed LIC 610 will be submitted via email to LPA by POC due date.
Type B
Section Cited
HSC
1597.16(a)(1)
Lead Testing
(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above by not having proof of Lead Testing by 1/1/23 which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/24/2023
Plan of Correction
1
2
3
4
Proof of scheduled lead testing will be provided to LPA via email by POC due date.
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: Valarie CookTELEPHONE: (323) 9813362
LICENSING EVALUATOR NAME: Austin EstradaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 02/24/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/24/2023
LIC809 (FAS) - (06/04)
Page: 5 of 7


Document Has Been Signed on 02/24/2023 02:29 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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754


FACILITY NAME: KING STATE PRESCHOOL
FACILITY NUMBER: 191606400

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/24/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101229.1(b)
Sign In and Sign Out
(b) The person who brings the child to, and removes the child from, the center shall sign the child in/out.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above by 2 of 8 children not being signed out at the time of inspection which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/10/2023
Plan of Correction
1
2
3
4
Proof of sign in/out for 2 of 8 children on 2/24/23 will be provided via email to LPA by POC due date.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
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: Valarie CookTELEPHONE: (323) 9813362
LICENSING EVALUATOR NAME: Austin EstradaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 02/24/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/24/2023
LIC809 (FAS) - (06/04)
Page: 6 of 7