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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198004654
Report Date: 08/29/2024
Date Signed: 08/29/2024 01:18:21 PM


Document Has Been Signed on 08/29/2024 01:18 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: DATE:
08/29/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:32 AM
MET WITH:Sandra Lizer TIME COMPLETED:
11:45 AM
NARRATIVE
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Licensing Program Analysts (LPAs) Shushanik Safaryan and Priscilla Ochoa conducted an unannounced Case Management inspection for the purpose for the following up on an unusual incident report. Upon arrival at 11:30 am , LPAs met with Director Assistant , Sandra Lizer ,to whom the purpose of the inspection was explained. Tour of the facility was provided. There were children present during the inspection.

Census was taken. There were 17 children with 2 staff members.

On 08/27/23 an unusual incident report was submitted to the Department regarding a child sustaining an injury on the facility grounds. Child #1 tripped over the child#2 blanket during nap time . Child was taken to the emergency room by a parent where the whole arm cast was placed . LPAs conducted review of the classroom where the incident took place . During the inspection, LPA interviewed two staff members , child #1 , child #2 . Based on the information obtained during the interviews ,child #2's mat was placed in the walkway area that leads to the book area. During the visit staff #1 demonstrated they way mat was placed on the day of the incident and pictures were taken . LPAs observed emergency exit in the play/book area too. Per child #1 he went to put his book back to the book area and stepped over child #2 mat and tripped. Staff members indicated children will get the book and sit on their mats , after it is time to nap they will put their books back to the book area to go to the bathroom. Per staff child #2 was preparing his bed when child #1 went to put his book and tripped .

Based on the information obtained and observations , LPAs determined that child #2's mat was obstructing walkway to the book area , which posed potential risk to the heath and safety to children in care .Based on the LPA’s observations and records reviews, 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.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative.

Exit interview conducted with the Director Assistant and Copy of the Report , Deficiency page and Appeal Rights provided.

END OF REPORT

SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Shushanik SafaryanTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/29/2024
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 08/29/2024 01:18 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: 08/29/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/12/2024
Section Cited
CCR
101239.1(d)

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101239.1 Napping Equipment (d) Napping equipment shall be arranged so that each child has access to a walkway without having to walk on or over the cots or mats of other children.This requirement was not met evidenced by:

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Director will conduct meeting with the staff to arrange napping equipment to have access to walkways and not block the exits . Agenda with the satff signatures will be send to LPA by POC date .
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Child #1 tripped over child# 2 napping equipment when he was puting his book back to the book area.
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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) 854-8930
LICENSING EVALUATOR NAME: Shushanik SafaryanTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 08/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/29/2024
LIC809 (FAS) - (06/04)
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