191871356-7-22-2025-54-CC-JESA-DJTU2N-20250722151214

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191871356
Report Date: 07/22/2025
Date Signed: 07/22/2025 03:12:27 PM

Document Has Been Signed on 07/22/2025 03:12 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:	LA SANTA CRUZ STATE PRESCHOOL		FACILITY NUMBER:	191871356
ADMINISTRATOR/ DIRECTOR:	MARIA LABRADA		FACILITY TYPE:	850
ADDRESS:	2747 WHITTIER BLVD.		TELEPHONE:	(213) 262-1123
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90023
CAPACITY: 40	TOTAL ENROLLED CHILDREN: 40	CENSUS: 11	DATE:	07/22/2025
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:00 AM
MET WITH:	Angelica Olvera Site Supervisor		TIME VISIT/ INSPECTION COMPLETED:	03:15 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) Jeanette Estrada and Christine Nolan conducted an unannounced required 3 year inspection. LPAs met with Site Supervisor Angelica Olvera and advised her of the reason for the visit. Site Supervisor provided a tour of the facility. Upon arrival LPAs observed 3 staff supervising 11 children in the outdoor play area. The facility operates Monday through Friday from 6:30 AM to 6:00 PM and it served children ages 2 years old to 5 years old. All areas accessible to children were inspected. This program operates in one classroom. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. There is cental air/heating in the facility. Children have their own cubbies to store their belongings. Napping cots are available for rest time. Per facility representative the sleeping linens are sent home on a weekly basis. The Site Supervisor's work area is used as the isolation area for ill children waiting to be picked up. The isolation restroom is the staff restroom in the hall way. There is one restroom available for children in the facility. The restroom has 4 toilets and 3 sinks. General sanitation was observed in the children's restroom. The facility offers potty training. There is a changing table in the restroom. Per Facility Representative, parents provide the diapering supplies. Availability of indoor drinking water was observed in classrooms via water containers. Per Facility Representative, the water container is refilled from the kitchen. Disposable cups are available for children and staff assist children if needed. The facility tested for lead in drinking water in October 2022 with no lead exceedances reported. Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Cleaning supplies are stored in the kitchen/food preparation room. The facility administers medication if needed. Medication is stored in a medication box located in the kitchen.

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Jeanette Estrada
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2025

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: LA SANTA CRUZ STATE PRESCHOOL	FACILITY NUMBER: 191871356
	VISIT DATE: 07/22/2025

NARRATIVE

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At this time there are no children enrolled who require medication. Per Facility Representative there are no poisons stored at the facility. There is at least one operable carbon monoxide/ smoke detector in the facility. The facility has a central fire alarm installed.
The outdoor playground area was evaluated. The outdoor playground is fully fenced. All areas around or under high climbing equipment and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard. There is a play structure in the play yard. There are several areas with different activities available for children. Availability of outdoor drinking water was observed via a water dispenser. During the inspection LPAs observed spider webs on different parts of the play equipment, a broken off piece of wood on a fence and a jagged piece of plastic placed along a part of the fence. This is a potential risk to the safety of children in care. The broken off piece of wood and the jagged piece of plastic were removed by maintenance staff during the inspection. A type B citation was issued.
Per Facility Representative there are no firearms stored on the premises. There are no pools or bodies of water at the facility. There is a 2A10BC fire extinguisher in the classroom. Sign-In and Sign-Out sheets were reviewed. A disaster drill log was available. Last drill documented was held in June 2025.
Children’s Records were reviewed and were verified to contain the required documents.
LPAs conducted a visit during the inspection to the International Institute of Los Angeles administrative office to conduct the review of staff files. LPAs conducted file reviews for staff 1-4 present during the inspection. All staff files contained the required documents. At least one staff present during the inspection has obtained the required EMSA Pediatric first aid/cpr certificate.
Menus are provided to parents/ authorized representatives one month in advance and the menus are also posted at the entrance of the classroom. Separate menus are provided for breakfast, lunch and snacks. Menus for the past 30 days are available upon request. The facility provides breakfast, lunch and a PM snack. Per Site Supervisor, food is prepared at the International Institute of Los Angeles Headquarters and is brought over to the site. Facility staff then set up and distribute the food to children. All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish, rodents, and/or any other vermin. All storage containers for solid waste, including moveable bins have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids. Per Site Supervisor, there are no children currently enrolled with food allergies. Alternative food would be provided if any child had a food allergy.

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Jeanette Estrada
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2025

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: LA SANTA CRUZ STATE PRESCHOOL	FACILITY NUMBER: 191871356
	VISIT DATE: 07/22/2025

NARRATIVE

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Facility Representative 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 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.
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).
LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.
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 Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.
Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms.
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.

A type B citation was issued during today's inspection.

A notice of site visit was given to Facility Representative and must remain posted for 30 days. Exit interview conducted and report was reviewed with Site Supervisor, Angelica Olvera

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Jeanette Estrada
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/22/2025 03:12 PM - It Cannot Be Edited

Created By: Jeanette Estrada On 07/22/2025 at 02:46 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LA SANTA CRUZ STATE PRESCHOOL	FACILITY NUMBER: 191871356
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/22/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101238.2(d)(1)

Outdoor Activity Space

(d) The surface of the outdoor activity space shall be maintained: (1) In a safe condition for the activities planned. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above. LPAs observed spider webs on the equipment, a broken piece of wood along the fence and a jagged piece of plastic along another fence which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/29/2025
	Plan of Correction
1 2 3 4	LPAs observed the broken piece of wood and the jagged piece of plastic were removed during the inspection. Spider webs along the playground will be removed by due date. Photos/videos will be submitted for proof

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.

	Warren Birks
NAME OF LICENSING PROGRAM MANAGER:

	Jeanette Estrada
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2025

LIC809 (FAS) - (06/04)

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