198005392-2-27-2025-54-CC-JCUT-DEAURV-20250227144921

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198005392
Report Date: 02/27/2025
Date Signed: 02/27/2025 02:49:52 PM

Document Has Been Signed on 02/27/2025 02:49 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:	ST. TIMOTHY LUTHERAN INFANT CENTER		FACILITY NUMBER:	198005392
ADMINISTRATOR/ DIRECTOR:	VELIA GUERRA		FACILITY TYPE:	830
ADDRESS:	4645 WOODRUFF AVENUE		TELEPHONE:	(562) 421-8441
CITY:	LAKEWOOD	STATE: CA	ZIP CODE:	90713
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 7	DATE:	02/27/2025
TYPE OF VISIT:	Case Management - Annual Continuation	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:08 PM
MET WITH:	Director, Beatriz Villea		TIME VISIT/ INSPECTION COMPLETED:	03:00 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) Jonnisha Culbert conducted an unannounced continuation annual/random inspection. The purpose of this inspection is to complete an annual/random conducted on 02/13/2025. LPA met with Director Beatriz Villela and discussed the purpose of the visit. Director guided analysts on a tour of the facility. This is an infant center which consists of one classroom. The program operates from Monday through Friday from 7:30am to 5:30pm. The program offers care to children 4 months to 18 months. Present during today's inspection were Director, 7 children, and 2 staff.

Please note that the information presented in this report was gathered from 02/13/2025.

Upon arrival, LPA observed all required postings in a prominent publicly accessible area. Disaster drills were logged and available. The last drill was conducted on 12/11/2024. Children's roster was reviewed and is current. Parents sign children in and out via sheets. LPA reviewed parent signatures for children present.

All areas used by children were inspected for safety. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting, and ventilation were evaluated. A combination carbon monoxide and smoke detectors (2) were observed. LPA check one of them and it is operable. Fully charged fire extinguishers are available if needed. The facility uses central heating and air for ventilation. Lighting was observed to be in operable condition. Children have their own cubby to store their belongings. Cribs are available to children for napping. LPA observed first aid kit located near entrance. Per Director, they make use of Director’s office for accommodating children who become ill.

Availability of indoor and outdoor drinking water was observed in classroom via bottles and sippy cups. Per Site Director, water is provided via water dispenser, and they do not use the facilities water fountains.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Jonnisha Culbert
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 3

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: ST. TIMOTHY LUTHERAN INFANT CENTER	FACILITY NUMBER: 198005392
	VISIT DATE: 02/27/2025

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
26
27
28
29
30
31
32

Page2
LPA verified that the water lead testing was completed in accordance with written directive outlined in Provider Information Notification (PIN) 21-21.1-CCP. Per Director, water testing was recently performed, and they are currently waiting for results.

LPA inspected the food preparation area. The kitchenette was observed to be clean and free of litter. Bottles and food storage packs were observed and were labeled with child’s name and dates. The facility does not provide meals.

Disinfectants, cleaning solutions, and other items that are dangerous to children, were inaccessible. Disinfectants and cleaning solutions are kept in locked cabinets in the room. Per Director, no medications are kept at the facility. Poisons were not observed during visit. Per Director, there are no poison on the premises. LPA reminded Director that if poisons are purchased, they are to remain in an area that is locked and inaccessible to children.

The outdoor playground area was evaluated. LPA observed all areas around and under high climbing equipment are cushioned with sand. LPA did not observe a shaded area on the playground. Per Director, there is an exterior motorized shade device that is used during outdoor play. Per Director, there are no pools or bodies of water on the premises.

Children’s Records were reviewed for completeness. LPA observed that 3 out 7 records. During review LPA observed that all children are missing an Identification and Emergency Information form (LIC 700). Child1 and Child 2 are missing Preadmission health form (LIC 702). Child 1 is missing Infant Sleep Plan (LIC 9227). This poses a potential health and safety risk to persons in care.

Staff records were reviewed for completeness. LPA observed that Director, Staff 1 and Staff 2 were missing proof of immunization against pertussis and measles. Staff 2 is missing Health Screening Report (LIC503) and proof of immunization against Tuberculosis. This is a potential health and safety risk to persons in care.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Jonnisha Culbert
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2025

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: ST. TIMOTHY LUTHERAN INFANT CENTER	FACILITY NUMBER: 198005392
	VISIT DATE: 02/27/2025

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
26
27
28
29
30
31
32

Page 3
regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.Director 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 Childcare 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 Childcare 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 childcare 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 with the Written Directives outlined in PIN 21-21.1-CCP.LPA discussed the safe sleep regulations with Director Beatriz Villela 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.Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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) 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/Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

3 Type B deficiencies were cited on 02/13/2025. Please review 809D on that date for more information. No deficiencies were cited during today’s visit. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director, Beatriz Villela.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Jonnisha Culbert
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2025

LIC809 (FAS) - (06/04)

Page: 3 of 3