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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018184
Report Date: 04/17/2025
Date Signed: 04/17/2025 12:59:30 PM

Document Has Been Signed on 04/17/2025 12:59 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:LBUSD-RILEY CHILD DEVELOPMENT CENTERFACILITY NUMBER:
198018184
ADMINISTRATOR/
DIRECTOR:		THERESE BASTAFACILITY TYPE:
850
ADDRESS:3319 SANDWOOD STREETTELEPHONE:
(562) 421-2924
CITY:LAKEWOODSTATE: CAZIP CODE:
90712
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 11DATE:
04/17/2025
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:50 AM
MET WITH:Coordinating Teacher Kimberly Kelly TIME VISIT/
INSPECTION COMPLETED:
01:05 PM
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Licensing Program Analyst (LPA) Jeanette Estrada and conducted a visit to the facility for the purpose of conducting a 3 year required annual inspection. LPA initially met with Teacher Doris Fielder. Coordinating Teacher Kimberly Kelly arrived at a later time.
This is a preschool program which consists of one classroom- Bungalow #33. This facility is located on the premises of Riley Elementary School. The program offers care to children 2 to 5 years old and operates Monday through Friday 6:30 AM to 5:30 PM. There were 11 children and 4 staff present during the inspection.

All areas available to children were inspected. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated and are operable. The facility has central air and heating. Lighting was observed to be in operable condition. LPA observed the required posted documents in the classroom.
Children have access to cubbies in the classrooms to store their belongings. Children are provided with a napping cot and sheets by the program. The isolation area is in the CDC office located in the classroom.
There are two restrooms in the classroom. They each have one toilet and one sink. General sanitation was observed in all restrooms inspected.
Availability of indoor drinking water was observed in the classrooms via a water container and personal water bottles. There is also a drinking fountain on the hand washing sink in the classroom. The facility initially tested for lead contamination in the water sources used for children on 7/14/23 which resulted in a lead exceedance. The facility remediated the water sources and re-tested on 10/10/23 with no further lead exceedances detected.
NAME OF LICENSING PROGRAM MANAGER: Karen Chambers
NAME OF LICENSING PROGRAM ANALYST: Jeanette Estrada
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/17/2025
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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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: LBUSD-RILEY CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 198018184
VISIT DATE: 04/17/2025
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Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Cleaning supplies are stored in a locked cabinet under the hand washing sink in the classroom. Medication is stored in a locked box in the classroom above the hand washing sink. There is currently one child enrolled who requires medication. LPA reviewed medication and verified it is not expired. LPA also reviewed forms authorizing medication be provided at the facility.
LPA observed a carbon monoxide detector in the classroom. The facility is equipped with a centralized fire alarm system throughout the school. There are no poisons stored at the facility.
The outdoor playground areas were evaluated. The outdoor area is fully enclosed.
Outdoor equipment is in a safe condition, free of sharp, loose or pointed parts. All areas around or under high climbing equipment and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard. Availability of outdoor drinking water is provided via the water container and cups or water bottles which are taken out from the classroom when children play outside. Water fountains are also available to the children.
Per facility representative there are no firearms stored on the premises. There are no pools or bodies of water at the facility.
Children’s Records were reviewed for completeness. Children's records contained all required documents and information.
Staff records were reviewed. Facility Representative was reminded Mandated Reporter training and pediatric first aid/cpr shall be completed every two years. At least one staff present had a current pediatric first aid/cpr from the American Heart Association which expires on 7/2026.
The program uses an iPad for sign in/ sign out procedures. A paper copy sign in/out sheet is available as a back up if needed.
Disaster drills are conducted every month and are documented. The last documented emergency drill was conducted on 4/14/25 (Earthquake Drill). This program provides breakfast, lunch and snack to children enrolled. Menus are posted once a month in the classroom where it is visible by the child's authorized representative. Menus are also provided to parents. Menus for the past 30 days are available upon request. Food is provided by LBUSD Nutrition Services and is delivered to the classrooms. Children with food preferences are provided alternatives and allergy lists are maintained in the classroom. At this time, there are no children enrolled who have allergies.
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NAME OF LICENSING PROGRAM MANAGER: Karen Chambers
NAME OF LICENSING PROGRAM ANALYST: Jeanette Estrada
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2025
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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: LBUSD-RILEY CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 198018184
VISIT DATE: 04/17/2025
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Facility Representative 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 Child Care 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 Child Care 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 child care 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 to the Written Directives outlined in PIN 21-21.1-CCP.
This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and
administrative records.
For IMS information see PIN 22-02-CCP. 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/.
Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.
No citations were issued during today's inspection. A notice of site visit was given to Facility Representative and must remain posted for 30 days.
Exit interview conducted and report was reviewed with Coordinating Teacher Kimberly Kelly.
NAME OF LICENSING PROGRAM MANAGER: Karen Chambers
NAME OF LICENSING PROGRAM ANALYST: Jeanette Estrada
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2025
LIC809 (FAS) - (06/04)
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