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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198005309
Report Date: 08/12/2025
Date Signed: 08/12/2025 02:01:48 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/06/2025 and conducted by Evaluator Jonnisha Culbert
COMPLAINT CONTROL NUMBER: 54-CC-20250606093731
FACILITY NAME:FIRST EVANGELICAL CHURCH OF CERRITOSFACILITY NUMBER:
198005309
ADMINISTRATOR:GRACE CHIN LEE LINFACILITY TYPE:
850
ADDRESS:11330 E. 166TH ST.TELEPHONE:
(562) 865-2424
CITY:CERRITOSSTATE: CAZIP CODE:
90703
CAPACITY:87CENSUS: 31DATE:
08/12/2025
UNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Licensee, Grace Chin Lee LinTIME COMPLETED:
02:10 PM
ALLEGATION(S):
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Facility is not clean and safe
INVESTIGATION FINDINGS:
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On 08/12/2025, Licensing Program Analyst Jonnisha Culbert conducted an unannounced complaint inspection, and met with licensee, Grace Chin Lee Lin. It was alleged that the facility is not clean and safe.

During record review, LPA J. Culbert observed the facility was cited for related incidents on 05/21/2025 and 06/24/2025. On 05/21/2025, LPA J. Culbert observed that there was a citation issued for a contaminated water container used to refill children's water bottles. Per the report, “the container had a blotchy gray to black discoloration covering the inside lid”. On 06/24/2025, LPA J. Culbert observed the facility was cited for having water coming up from underneath bathroom floor tile leaving the floor wet. The floor was observed to be wet on three different days. Both citations were corrected.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Warren Birks
LICENSING EVALUATOR NAME: Jonnisha Culbert
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 54-CC-20250606093731
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: FIRST EVANGELICAL CHURCH OF CERRITOS
FACILITY NUMBER: 198005309
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/12/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/26/2025
Section Cited
CCR
101238(a)
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101238 (a)The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.

This requirement is not met as evvidence by
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Per licensee, they will complete the required training and provide a training for staff on identifying safety concerns and provide LPA J. Culbert proof of both trainings by plan of correction date.
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Based on record review and interview, LPA observed that the facility was cited twice, once for not providing safe drinking water and for bathroom floor being wet due to a plumbing issues. Also staff admit to using bleach and water to clean, but LPA did not observe the required training cert.
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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.
SUPERVISORS NAME: Warren Birks
LICENSING EVALUATOR NAME: Jonnisha Culbert
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 54-CC-20250606093731
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: FIRST EVANGELICAL CHURCH OF CERRITOS
FACILITY NUMBER: 198005309
VISIT DATE: 08/12/2025
NARRATIVE
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LPA conducted staff interviews. Six out of seven staff were interviewed. On 07/15/2025, two out of three staff interviewed stated that bleach and water is used to clean. During staff file review LPA J. Culbert did not observe Integrated Pest Management training certificates. This is a potential health and safety risk to persons in care. LPA reminded licensee that completion of training is required annually if bleach is used for cleaning.

Based on the evidence obtained, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, (Title22) is being cited on the attached LIC 90999D. Appeal rights were provided and exit interview conducted. The Notice of Site Visit must be posted for 30 days.
SUPERVISORS NAME: Warren Birks
LICENSING EVALUATOR NAME: Jonnisha Culbert
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3