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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198004154
Report Date: 05/14/2025
Date Signed: 05/14/2025 01:03:14 PM

Document Has Been Signed on 05/14/2025 01:03 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:WOODBURY VILLAGE, INC.-INFANT CENTERFACILITY NUMBER:
198004154
ADMINISTRATOR/
DIRECTOR:		DANIELLE SVIHOVEC-MESQUITAFACILITY TYPE:
830
ADDRESS:712 W. MT. VIEW ST.TELEPHONE:
(626) 794-3211
CITY:ALTADENASTATE: CAZIP CODE:
91001
CAPACITY: 41TOTAL ENROLLED CHILDREN: 29CENSUS: 20DATE:
05/14/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Director, Danielle Svihovec-MesquitaTIME VISIT/
INSPECTION COMPLETED:
01:15 PM
NARRATIVE
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On May 14, 2025 at 9:00 am Licensing Program Analysts (LPA) Priscilla Ochoa conducted an unannounced random annual inspection. LPA was greeted by Director, Danielle Svihovec-Mesquita, who guided LPA on a tour of the facility. This is an Infant program with a toddler component that operates Monday – Friday from 7:30 am – 6:00 pm. Per Director, there are 19 infants and 10 toddlers enrolled in the program. LPA observed 15 infants and 5 toddlers in care along with 8 staff members.

There is also has a preschool license (#198004153) which operates on the same grounds. The infant and preschool program do not have any shared areas. The are on opposite sides of the property and are separated by gates.

At 9:15 am, the director guided LPA on a tour of facility. Parents enter through the front gate which lead them to the facilities parking lot. The parents then walk to their child’s classroom and sign in their child. This Infant program that consists of 3 classrooms: Pandas (6 weeks – 12 mon.): 6 children and 3 staff, Koalas (12 – 24 mon.): 9 children and 3 staff and Roos (18 – 36 mon.): 5 children and 2 staff. Teacher-child ratios were observed to be in accordance with Title 22 Regulations. Staff names were recorded. All children were observed to be under supervision, including visual supervision. Napping equipment was observed in the form of portable cribs in the panda room and cots in the Koala and Roos room. Bedding was inspected for good condition, appropriate storage, and cleanliness. Mattresses for the portable cribs were observed to be firm and covered with fitted sheets that is appropriate to the mattress size, fits tightly on the mattress, and overlaps the underside of the mattress so it cannot be dislodged. Children's linens for the infant program are to be washed or replaced daily.

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Ana ChicoTELEPHONE: (323) 981-3379
Priscilla OchoaTELEPHONE: 323-981-3350
DATE: 05/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/14/2025
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.

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Document Has Been Signed on 05/14/2025 01:03 PM - It Cannot Be Edited


Created By: Priscilla Ochoa On 05/14/2025 at 12:20 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: WOODBURY VILLAGE, INC.-INFANT CENTER
FACILITY NUMBER: 198004154

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/14/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101220(a)
Child's Medical Assessments
(a) Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child. This medical assessment enables the licensee to assess whether the center can provide necessary health-related services to the child.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in 3 out of 9 children were missing Physicians Reports in their file for LPA to review which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/20/2025
Plan of Correction
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Director will ensure that all 3 children have a completed Physicians Repor and provide a copy to LPA by POC date.
Type B
Section Cited
CCR
101220.1(a)
Immunizations
(a) Prior to admission to a child care center, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, commencing with Section 6000.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in 1 out of 9 children were missing proof immunization record for LPA to review which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/30/2025
Plan of Correction
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Director will ensure that the child's parents provide proof of immunization record and provide a copy to LPA by POC 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.
Ana Chico
NAME OF LICENSING PROGRAM MANAGER:
TELEPHONE: (323) 981-3379
Priscilla Ochoa
NAME OF LICENSING PROGRAM ANALYST:
TELEPHONE: 323-981-3350
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/14/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/14/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/14/2025 01:03 PM - It Cannot Be Edited


Created By: Priscilla Ochoa On 05/14/2025 at 12:30 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: WOODBURY VILLAGE, INC.-INFANT CENTER
FACILITY NUMBER: 198004154

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/14/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(g)(2)
All personnel, including the licensee, administrator and volunteers, shall be in good health and shall be physically and mentally capable of performing assigned tasks.

Each person specified in (g) above shall have a health-screening report signed by the person performing the screening. This report shall indicate the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in 1 out of 6 staff members did not have proof of a completed health screen in their file for LPA to review, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/20/2025
Plan of Correction
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Director will ensure that S5 completed health screen and provides a copy to LPA by 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.
Ana Chico
NAME OF LICENSING PROGRAM MANAGER:
TELEPHONE: (323) 981-3379
Priscilla Ochoa
NAME OF LICENSING PROGRAM ANALYST:
TELEPHONE: 323-981-3350
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/14/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/14/2025


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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: WOODBURY VILLAGE, INC.-INFANT CENTER
FACILITY NUMBER: 198004154
VISIT DATE: 05/14/2025
NARRATIVE
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LPA did not observe any loose objects, bumpers, pillows, blankets or pacifier attachments in the napping area/cribs. There is a changing table within arm's reach of a sink located in all classrooms. LPA observed changing areas to be clean. LPA did observe that the facility had diapers and wipes available in each classroom near the changing tables. Per Director, all bedding is changed daily and taken home by parents every Friday. There are age-appropriate toys and supplies for children in each classroom and are in good repair. Each child was observed to have their own cubbie to store personal belongings. All toilets and hand washing facilities are in safe and sanitary operating condition. Drinking water is available in form of personal water bottles that are also taken outside when needed. The facility provides additional water which is dispensed in each classroom for children in care.

The classroom furniture and equipment were 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 materials and surfaces accessible to children are toxic free.

Each classroom has their own outdoor playground for children in care was observed and fenced. 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. There is adequate shade in the play yard.

At this time, the Main Office is used as an isolation area. Parents are contacted immediately. There is also a cot available if needed.

The facility provides morning and afternoon snack for children in care. There is a kitchen area in each classroom and LPA observed lunch/meals for children in care stored properly, labeled with the child’s name and or refrigerated. The kitchen area was observed to be clean, and the cleaning compounds/solutions were found to be away from the food. Storage areas are clean, free of litter, rubbish, and rodents/vermin. 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. The facility takes measures to keep the facility free of flies, other insects, and rodents. Per Director there are no weapons, firearms, or bodies of water on the premises.

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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3379
LICENSING EVALUATOR NAME: Priscilla OchoaTELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025
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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: WOODBURY VILLAGE, INC.-INFANT CENTER
FACILITY NUMBER: 198004154
VISIT DATE: 05/14/2025
NARRATIVE
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The Licensee is within the conditions, limitations, and capacity specified on the license. All areas were identified on the Facility Sketch were inspected. The following documents were posted: Facility License, Notification of Parents' Rights (PUB 393), Personal Rights (LIC 613A), PUB 269 Child Passenger System Poster, and Daily Schedule.

LPA observed a functioning smoke/carbon monoxide detector. LPA observed a fully charged 2A-10BC fire extinguisher. The valve on the fire extinguisher was pointing to the fully charged green section. Fire extinguisher was serviced on 04/16/2024. Per Director, the company who services their fire extinguisher have not been able to service them. Director called to schedule an appointment to get the fire extinguishers serviced. Per Title 22 Emergency Disaster Drill must be conducted at least every 6 months. LPA observed the last Emergency Disaster Drill was conducted and documented on 05/12/2025.

The facility uses an application called Brightwheel where parents scan a barcode and sign in and out their child. There are multiple barcode through out the classrooms for parents to sign in and out. Each sign in and sign out is time stamped along with the person who sign in and out the child. LPA reviewed Sign in and out through the brighwheel app.

Children’s Records were reviewed to ensure that Identification and Emergency form and a medical assessment are on file. Child records were deemed not complete. 3 out of 9 children missing Physicians Reports and 1 out of 9 children were missing proof immunization record.

Staff records were reviewed to ensure Criminal Records Clearance for adults and verification of CPR/First Aid and health preventative practices documentation. Staff records were deemed not complete. 1 out of 6 staff were missing a health screen.

LPA consulted with Director about safe sleep and how infants are placed to nap in the cribs. Per Director, infants are placed on their backs. LPA explained that how infants are placed in their cribs should reflect on their 15-minute sleep log and if an infant is able to roll over, that information should also be updated in the individual sleep plan. The facility will be receiving a technical violation.

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.

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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3379
LICENSING EVALUATOR NAME: Priscilla OchoaTELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025
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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: WOODBURY VILLAGE, INC.-INFANT CENTER
FACILITY NUMBER: 198004154
VISIT DATE: 05/14/2025
NARRATIVE
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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

LPA discussed the safe sleep regulations with director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES: 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

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

Licensee 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.

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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3379
LICENSING EVALUATOR NAME: Priscilla OchoaTELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025
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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: WOODBURY VILLAGE, INC.-INFANT CENTER
FACILITY NUMBER: 198004154
VISIT DATE: 05/14/2025
NARRATIVE
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Licensee 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.

Based on the LPA’s observations and record 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 and safety.

A notice of site visit was given and must remain posted for 30 days during facility’s hours of operation. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted, and a copy of the report was provided to Director, Danielle Svihovec-Mesquita.

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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3379
LICENSING EVALUATOR NAME: Priscilla OchoaTELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025
LIC809 (FAS) - (06/04)
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