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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198004654
Report Date: 09/26/2023
Date Signed: 09/26/2023 03:01:05 PM


Document Has Been Signed on 09/26/2023 03:01 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:LIGHTED WINDOW PRESCHOOL, INC.FACILITY NUMBER:
198004654
ADMINISTRATOR:SUZANNE JOHNSONFACILITY TYPE:
850
ADDRESS:1200 FOOTHILL BLVD.TELEPHONE:
(818) 790-8207
CITY:LA CANADASTATE: CAZIP CODE:
91011
CAPACITY:103CENSUS: 64DATE:
09/26/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:35 PM
MET WITH:Suzanne Johnson, DirectorTIME COMPLETED:
02:45 PM
NARRATIVE
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Licensing Program Analysts (LPA) Thelma Razo conducted an unannounced Case Management – Incident inspection on this date, 09/26/2023. A COVID-19 risk assessment was made prior to entry to the facility. LPA met with facility Director Suzanne Johnson. LPA stated the reason of the inspection is due to Unusual Incident which occurred on 8/23/2023 and was self-reported via email by Office Manager Shannon Lyons-Heberger to Community Care Licensing on 09/20/2023. The Unusual Incident was not reported within the required time frame.
LPA interviewed Director Johnson. LPA toured the facility to include playground and classrooms. LPA observed 64 children and 10 staff at the facility during inspection. Staff-child ratio was met.

A deficiency was cited per California Code of Regulations, Title 22 Division 12 Chapter 1 and is on LIC809-D.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted. Report and Appeal Rights provided to Director Suzanne Johnson.

SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Thelma RazoTELEPHONE: (323) 981-3387
LICENSING EVALUATOR SIGNATURE:
DATE: 09/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/26/2023
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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Document Has Been Signed on 09/26/2023 03:01 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: LIGHTED WINDOW PRESCHOOL, INC.
FACILITY NUMBER: 198004654

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/26/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/09/2023
Section Cited
CCR
101212(d)

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Reporting Requirements
Upon the occurrence, during the operation of the childcare center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. In addition,
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Director is to submit to LPA a plan to ensure that reporting requirement is being followed at all times. This should include but not limited to designating responsible person(s), training on Licensing reporting requirement and so on. Plan Of Correction due on 10/9/23.
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a written report containing the information specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event.
This requirement was not met as evidenced by the incident that happened on 8/23/2023 but was reported on 9/20/2023 by email which was beyond the required time frame as indicated under this section. This poses a potential health and safety risk to the children in care.
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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: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Thelma RazoTELEPHONE: (323) 981-3387
LICENSING EVALUATOR SIGNATURE:
DATE: 09/26/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/26/2023
LIC809 (FAS) - (06/04)
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