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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198006456
Report Date: 07/18/2025
Date Signed: 07/18/2025 11:49:50 AM

Document Has Been Signed on 07/18/2025 11:49 AM - 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:MAOF/WMMC-RAINBOW CHILDREN'S CENTERFACILITY NUMBER:
198006456
ADMINISTRATOR/
DIRECTOR:		PAULA GOMEZFACILITY TYPE:
830
ADDRESS:1803/1807 PENNSYLVANIA AVENUETELEPHONE:
(323) 826-5311
CITY:LOS ANGELESSTATE: CAZIP CODE:
90033
CAPACITY: 36TOTAL ENROLLED CHILDREN: 28CENSUS: 15DATE:
07/18/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:20 AM
MET WITH:Ramiro Rivera, Director and Maria Jacobsmeier Director TIME VISIT/
INSPECTION COMPLETED:
12:00 PM
NARRATIVE
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On July 18, 2025, Licensing Program Analyst (LPA) Staicy Perry conducted an unannounced case management inspection to the above facility to follow up on an Unusual Incident Report (UIR) submitted to the department on July 10, 2025. LPA was greeted by Director Ramiro and Maria who took LPA Perry on a tour of the facility. A census was taken and LPA Perry observed 15 children with 6 staff present. According to the UIR, at approximately 2:40 PM on July 8, a child sustained superficial burns to their fingers after touching a red buggy that had been exposed to direct sunlight. The incident occurred during the transition to the outdoor playground.

During the inspection, LPA Perry conducted interviews, observed the outdoor play area and inspected playground equipment. LPA reviewed facility documentation, including the UIR and physician’s note of injury.

LPA Perry interviewed staff. S#2 confirmed the child touched the red buggy during outdoor transition and began crying in an unusual manner. The child was taken back inside for a thorough check and that’s when redness was observed on the left hand. The parent was contacted immediately and took the child to seek medical treatment, where superficial burns were confirmed.

LPA Perry reviewed that the facility conducts daily outdoor safety inspections in the early morning hours. The incident and response were reported to the Department and to the parents in a timely manner. The child has returned to the facility with no restrictions. During the visit, LPA noted that on July 8, 2025, temperatures ranged between approximately 86°F to 90°F. LPA observed that the red buggy involved in the incident remained in the same sun-exposed area as reported. LPA physically touched the buggy and confirmed it was hot to the touch, noticeably warm and potentially unsafe for children, particularly for infants and toddlers. LPA also inspected other outdoor items and confirmed that several plastic and metal surfaces were

Brandi VanOostenTELEPHONE: (323) 854-8930
Staicy PerryTELEPHONE: (323) 981-3350
DATE: 07/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/18/2025
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.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 07/18/2025 11:49 AM - It Cannot Be Edited


Created By: Staicy Perry On 07/18/2025 at 09:22 AM
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: MAOF/WMMC-RAINBOW CHILDREN'S CENTER
FACILITY NUMBER: 198006456

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/18/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/01/2025
Section Cited

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101223 Personal Rights (a) The licensee shall ensure that each child is accorded the following personal rights:...(2)To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.This requirement is not met as evidenced by:
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Based on interviews conducted and documents reviewed the facility did not comply with the section cited above as child sustained superficial burns on several fingers, which poses/posed a potential health, safety or personal rights risk to persons in care.
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Director Ramiro and Maria have also provided LPA Perry with an LIC855 declaration form to ensure daily inspections will be completed throughout the day to ensure a safe environment for the children in care. LPA Perry obtained documents on site. Also noted, a relocation of the red buggy and similar equipment to shaded areas not exposed to direct sunlight.

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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.
Brandi VanOosten
NAME OF LICENSING PROGRAM MANAGER:
TELEPHONE: (323) 854-8930
Staicy Perry
NAME OF LICENSING PROGRAM ANALYST:
TELEPHONE: (323) 981-3350
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/18/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/18/2025


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: MAOF/WMMC-RAINBOW CHILDREN'S CENTER
FACILITY NUMBER: 198006456
VISIT DATE: 07/18/2025
NARRATIVE
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warm to hot, raising concern about heat and potential risks for injury. Although the facility did perform daily safety inspections, LPA found that the inspection was conducted early in the morning, well before the incident occurred in the afternoon. This timing did not account for mid-day heat especially during summer months, which likely contributed to the unsafe environment. LPA emphasized to the directors that hazards like overheated surfaces can develop later in the day, especially in warmer/ hotter weather. LPA spoke to Directors Maria and Ramiro, reinforcing the importance of performing multiple safety inspections throughout the day, especially before outdoor play in the afternoon, checking the environment especially during sun exposure and other weather conditions, relocating items, such as buggies, into shaded or protected areas and maintaining documentation of daily checklist inspections and corrective actions if needed or observed. Directors agreed to adjust their inspection protocols to prevent recurrence.

Based on the investigation, a violation of a child’s personal rights under Title 22, Section 101223 (a)(2) Personal Rights was identified. One (1) Type B deficiency is being cited for not providing a safe environment which resulted in injury to a child. Please see LIC 809 D for deficiency being cited on this day.

The exit interview was conducted with Director Ramiro and Director Maria. A copy of the report was provided as well as a NOS (Notice of site visit) was provided and most be posted for 30 days. Appeal rights provided.

SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Staicy PerryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 07/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2025
LIC809 (FAS) - (06/04)
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