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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198010078
Report Date: 08/12/2021
Date Signed: 08/12/2021 04:50:48 PM

Document Has Been Signed on 08/12/2021 04:50 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:BEVERLY HILLS RESOURCES CORP. INFANT CARE CENTERFACILITY NUMBER:
198010078
ADMINISTRATOR:BETTY JEAN POTTSFACILITY TYPE:
830
ADDRESS:6556 FOUNTAIN AVE.TELEPHONE:
(323) 465-7902
CITY:LOS ANGELESSTATE: CAZIP CODE:
90028
CAPACITY: 24TOTAL ENROLLED CHILDREN: 0CENSUS: 15DATE:
08/12/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Cindy Santos, Acting Director TIME COMPLETED:
05:00 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Roxana Lopez and Lilli Babcock conducted a case management inspection, following a complaint investigation on this date. LPAs met with Acting Director, Cindy Santos and Teacher- Coordinator Myla Almorsolo.

LPAs conducted today's inspection for the purpose of a complaint investigation under the preschool license. During the complaint investigation the facility was inspected and the following was observed.

During the inspection LPA's observed the infant napping room. LPA's observed 5 infants with 2 staff in the nap room- one infant was laying on top of a pillow and two infants were asleep with a pacifier and the holder attached. Licensing staff observed a teacher holding a child that was swaddled and ready to be put down to sleep. Teacher's removed pillows, pacifiers holders and swaddled blankets during inspection.

Licensing staff observed a 7 year old child under the cribs where infants were sleeping. Per Teacher- Coordinatior Ms. Myla, it is her daughter, and she was at the facility because she had not started the school year and did not have child care for the day.

The following deficiencies listed on the attached 809D deficiencies page are being cited in accordance with California Code of Regulations Title 22

A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent.Director was provided with a copy of the parent --------------------------------------------------------------- Pg.1 of 2 ----------------------------------------------------------------

Brandi VanOosten
Roxana Lopez
DATE: 08/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/12/2021
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 08/12/2021 04:50 PM - It Cannot Be Edited


Created By: Roxana Lopez On 08/12/2021 at 03:19 PM
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: BEVERLY HILLS RESOURCES CORP. INFANT CARE CENTER

FACILITY NUMBER: 198010078

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 08/12/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/12/2021
Section Cited

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101361(a): Limitations on Capacity and Ambulatory Status. (A) It shall be permissible for a child whose developmental needs require continuation in an infant care center to remain in an infant care center up to a maximum age of three years. This requirement was not met as evidenced by.
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Based on LPA's observing a 7 year old child in the infant napping room under the cribs where infants were sleeping. Per Teacher Myla child was present because she does not have child care and school has not started. This poses an immediate risk for the health and safety of children in care.
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Type A
08/12/2021
Section Cited

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101439.1 Infant Care Center Sleeping Equipment. (f) Cribs shall be free from all loose articles and objects, including blankets and pillows. (1) Pacifiers shall be allowed in the crib if the following provisions are in place:(A) There shall not be anything attached to the pacifier.
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This requirement was not met as evidenced by: LPA's observed 5 infants in the nap room. 1 was sleeping on top of a pillow. 2 were observed to have pacifiers with attachments. 1 was sleeping wearing a bib. 1 was swaddled and ready for sleep. This poses an immediate risk for the health & safety of 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 VanOosten
LICENSING EVALUATOR NAME:Roxana Lopez
LICENSING EVALUATOR SIGNATURE:
DATE: 08/12/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/12/2021


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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: BEVERLY HILLS RESOURCES CORP. INFANT CARE CENTER
FACILITY NUMBER: 198010078
VISIT DATE: 08/12/2021
NARRATIVE
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Acknowledgement of Receipt of Licensing Reports Form during this visit. A copy of the Parent Notification Requirements was also provided to the licensee/Director.

Exit interview was conducted with Acting Director Cindy Santos and Supervisor Teacher Myla Almoroso. A copy of this report and appeal rights was provided.

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. Failure to maintain posting as required will result in a civil penalty of $100.00.

---------------------------------------------End Report----------------------------------------------------------------------------------

SUPERVISOR'S NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2021
LIC809 (FAS) - (06/04)
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