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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198014887
Report Date: 06/29/2023
Date Signed: 06/29/2023 03:08:53 PM


Document Has Been Signed on 06/29/2023 03:08 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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754



FACILITY NAME:UNIQUE'S PRESCHOOL INFANT CENTERFACILITY NUMBER:
198014887
ADMINISTRATOR:LETICHA TONEYFACILITY TYPE:
830
ADDRESS:9322 S. MAIN STREETTELEPHONE:
(323) 779-2595
CITY:LOS ANGELESSTATE: CAZIP CODE:
90003
CAPACITY:27CENSUS: 4DATE:
06/29/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Johnnie Johnson, LicenseeTIME COMPLETED:
11:30 AM
NARRATIVE
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Licensing Program Analysts, Denise Gibbs and Franchesca White conducted an unannounced Plan of Correction visit today. LPAs met with Johnnie Johnson, Licensee. During the inspection Leticha Toney, Director arrived at the facility.

At 9:40AM LPA's observed four children outside with Staff One (S1) assistant and Staff Two (S2) Volunteer. LPA's did not observe a fully qualified teacher outdoors supervising the children. This is a violation of Title 22. Per Licensee, she is the qualified teacher that is supposed to be in the infant classroom and she stepped out to help the preschool children transition outside. When Director arrived, Licensee remained in the classroom with the infants and S1.

While touring the classroom LPA observed infant cereal and jars of baby food in a crate in the corner between the trash can and the changing table. LPA observed baby formula stored in the storage area under the changing table. LPA also observed infant cereal and canned baby puffs provided by facility stored in the children's cubbies. Cubbies are low to the ground and accessible to children. LPA did not observe a food preparation space in the infant room. Per Licensee, food and bottles are prepared in the kitchen by the kitchen staff. All infant food and formula was moved to the kitchen.

LPA observed two infants napping in cribs and two infants napping on mats. Cribs and mats were free of hazards. LPA reviewed 15-minute sleep checks. LPA reminded staff to add their initials along with the time of check.

LPA observed that infant daily schedule was the same as preschool daily schedule. LPA discussed the difference of the developmental needs of infants versus preschool children and advised Licensee to -------------------PAGE 1 of 2
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:
DATE: 06/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/29/2023
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 4


Document Has Been Signed on 06/29/2023 03:08 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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754


FACILITY NAME: UNIQUE'S PRESCHOOL INFANT CENTER
FACILITY NUMBER: 198014887

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/29/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/30/2023
Section Cited
CCR
101416.3(b)

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101416.3(b) Infant Care Aide Qualifications and Duties
(b) An infant care aide shall work under the direct supervision of the director... assistant director.. fully qualified teacher
This requirement is not met as evidenced by:
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Deficiency cleared during inspection. Licensee remained in infant room to supervise children and assistant. Per Director the assitant will be the staff assisting in other classrooms of needed.
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Based on observation, the licensee did not comply with the section cited above. S1, assistant was observed supervising four infants, without the direct supervision of a qualified teacher, which poses an immediate health, safety or personal rights risk to persons in care.
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Type A
07/03/2023
Section Cited
CCR101439(h)(5)

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Infant Care Center Fixtures, Furniture, Equipment and Supplies
(5) Not be located in the kitchen/food-preparation area.
This requirement is not met as evidenced by:
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All infant food was removed during inspection. Licensee will create written plan for food preparation and have all infant read and sign plan. Plan will be emailed to LPA by POC date 7/3/23.
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Based on observation, the licensee did not comply with the section cited above. LPA observed infant cereal and jars of baby food in a crate in the corner between the trash can and the changing table. LPA observed baby formula stored in the storage area under the changing table, and a can of formula in the diapering area that was just used to prepare a bottle, which poses an immediate health, safety or personal rights risk to persons 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: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:
DATE: 06/29/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/29/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4


Document Has Been Signed on 06/29/2023 03:08 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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754


FACILITY NAME: UNIQUE'S PRESCHOOL INFANT CENTER
FACILITY NUMBER: 198014887

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/29/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/07/2023
Section Cited
CCR
101229.1(a)(1)

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Sign In and Sign Out
(1) The person who signs the child in/out shall use his/her full legal signature and shall record the time of day.
This requirement is not met as evidenced by:
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Director will talk to infant staff and parents about signatures and email completed week of signatures by POC date 7/7/23.
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Based on record review, the licensee did not comply with the section cited above in 2 out of 2 signatures. Children were signed in with the time but not a full signature of guardian, which poses a potential health, safety or personal rights risk to persons 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: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:
DATE: 06/29/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/29/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: UNIQUE'S PRESCHOOL INFANT CENTER
FACILITY NUMBER: 198014887
VISIT DATE: 06/29/2023
NARRATIVE
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update schedule. When assessing the sign in and out sheets, LPA observed that two out of the four
children were signed in with the time only. LPA did not observe guardian's signatures. LPA discussed the importance of signing children in and out daily. LPA discussed the department's voluntary Technical Support Program.

Deficiencies cited on 6/22/23 have been corrected. LPA observed and reviewed the following:
  • Uncleared adult no longer in the infant program
  • Required CPR and 1st aide for licensee observed, Expiration date 6/2025.

Based on the LPA’s observations and records review, 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 & safety.

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. Licensee was provided with a copy of the parent Acknowledgement of Receipt of Licensing Reports Form during this visit.

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



Exit interview was conducted with Licensee. Appeal Rights were provided.

-------------------PAGE 2 of 2

SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2023
LIC809 (FAS) - (06/04)
Page: 4 of 4