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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018405
Report Date: 03/13/2025
Date Signed: 03/13/2025 05:05:52 PM

Document Has Been Signed on 03/13/2025 05:05 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:KEYSTONE MONTESSORI PRESCHOOLFACILITY NUMBER:
198018405
ADMINISTRATOR/
DIRECTOR:		NOHELLY RIOSFACILITY TYPE:
850
ADDRESS:7056 WASHINGTON AVE.TELEPHONE:
(562) 303-7273
CITY:WHITTIERSTATE: CAZIP CODE:
90602
CAPACITY: 53TOTAL ENROLLED CHILDREN: 18CENSUS: 7DATE:
03/13/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:40 AM
MET WITH:Director, Nohelly RiosTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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On 3/13/25, Licensing Program Analysts (LPAs) Lilli Babcock and Monica Ruiz conducted an unannounced annual inspection. A Covid risk assessment was conducted. LPAs met with Director, Nohelly Rios, to whom the reason for the visit was explained. This is a preschool program which is currently licensed for a capacity of 53 children and operates Monday – Friday from 7:00 AM – 6:00 PM. Per Director there are 18 children enrolled.

Census was taken upon arrival and the following staff and children were observed by LPAs to be present: Navigators Room (Room 117): 2 Staff with 7 children. The facility has a toddler option with a capacity of 8 children. Staff names were recorded. Staff were observed to have fingerprint clearance. All children were observed by LPAs to be under supervision, including visual supervision, of a teacher at all times. Administrator, Hasitha Weerasinghe arrived at the facility at approximately 9:40 am. Licensee, Bhagya Wijewardane arrived at the facility at approximately 10:00 am.

All areas identified on the Facility Sketch were inspected and the following was observed: All indoor classrooms were inspected to ensure that furniture and equipment are age-appropriate and in good repair, and the floors have a surface that are safe and clean. Napping equipment including cots and bedding were inspected. Per Director, children take their

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE: DATE: 03/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/13/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: KEYSTONE MONTESSORI PRESCHOOL
FACILITY NUMBER: 198018405
VISIT DATE: 03/13/2025
NARRATIVE
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bedding home to wash weekly. In the 2 preschool classrooms, LPAs observed the cots to be stacked with bedding on each cot, Bedding on the cots were observed by LPAs to be touching other bedding in multiple instances. Storage for children's belongings were inspected and LPAs observed children have their own labeled cubbies to store their belongings. Children bring water bottles from home and are allowed to drink freely at any time. Water bottles are refilled on demand from a water filtration spout on the sink.

LPAs observed toys and materials for children in the classrooms. Age-appropriate sinks and toilets were inspected for availability and good repair in restrooms used by children.

Food menus were reviewed. LPAs observed the food menu posted in the hallway to be for February 2025. Licensee, Bhagya Wijewardane confirmed the menu was not current and the facility was working on a current menu for March 2025. Licensee stated if the menu item for the day changes, the facility notifies parents at pick up of the menu change for that day. Licensee and Director stated the facility does not notify the parents of menu changes prior to the menu being changed. The facility provides breakfast, lunch, and AM/PM snack. LPAs inspected the kitchen, food preparation, and food storage areas. LPAs observed the food storage area (closet) in Room 117 to have bleach, hand soap, disinfectant wipes, toilet bowl cleaner, and cans of paint on the shelf and the door to the food storage closet to be unlocked. LPS also observed a cart in the food storage closet with 2 pans and a pot with dried food on them from a prior day. LPAs also observed 2 pizza boxes on top of the pans and pot. The top pizza box had an egg carton and a half filled yogurt container with a metal spoon inside the pizza box.


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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2025
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: KEYSTONE MONTESSORI PRESCHOOL
FACILITY NUMBER: 198018405
VISIT DATE: 03/13/2025
NARRATIVE
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LPAs observed Lysol Disinfecting Wipes and Elmers Rubber Cement with a lid that was easy to open, in cabinets in the Toddler room which were accessible for children in care. Director states that there are no poisons or firearms on the premises.

Per Director there are no children at the facility that currently use medications. First aid kits were located. Telephone service, heating, lighting, and ventilation were evaluated. Per Director, preschool
has their own land line. LPAs observed the facility to have operable carbon monoxide and smoke detectors on this day.

The facility has an outdoor play area that is fully fenced. Outdoor playground equipment is free of sharp, loose, or pointed parts. LPAs observed the paint on the play structure to be cracked and chipped. Per Licensee, the facility is hoping to paint the play structure in the near future. LPAs also observed a rubbermaid storage container in the outdoor play yard. Licensee stated they will remove the rubbermaid storage container from the facility. There is adequate shade in the play yard. There are safe toys, play equipment and materials observed for children outside on playground. Availability of outdoor drinking water was observed. Per Director, children bring their water bottles with them each time the classroom goes outdoors.

LPA reviewed Disaster Drill log. Last drill was conducted on 8/24/24.

Staff Records and Children’s Records were reviewed. LPAs observed 4 of 7 children’s files reviewed to be missing the LIC 701 Physicians Report.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2025
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: KEYSTONE MONTESSORI PRESCHOOL
FACILITY NUMBER: 198018405
VISIT DATE: 03/13/2025
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LPAs reviewed staff files. LPA observed one staff to be missing current Mandated Reporter Training (AB1207).

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 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.

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.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2025
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: KEYSTONE MONTESSORI PRESCHOOL
FACILITY NUMBER: 198018405
VISIT DATE: 03/13/2025
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LPA discussed the safe sleep regulations with facility representative 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 facility representative 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/. PIN 22-05-CCP

Facility Representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Based on LPA’s observations and record 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 and safety.

A notice of site visit was given and must remain posted for 30 days.


An exit interview was conducted, and the report was reviewed with the facility representative, Nohelly Rios.
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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2025
LIC809 (FAS) - (06/04)
Page: 5 of 11
Document Has Been Signed on 03/13/2025 05:05 PM - It Cannot Be Edited


Created By: Lilli Babcock On 03/13/2025 at 04:11 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: KEYSTONE MONTESSORI PRESCHOOL
FACILITY NUMBER: 198018405

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/13/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101174(d)
Disaster and Mass Casualty Plan
(d) Disaster drills shall be conducted at least every six months.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above in 1 out of 1 disaster drills not conducted every 6 months, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/11/2025
Plan of Correction
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Director states they will conduct a disaster drill and note the date and time on the drill log.
Type B
Section Cited
CCR
101239.1(c)(2)
Napping Equipment
(c) Each cot or mat shall be equipped with a sheet to cover the cot or mat and, depending on the weather, a sheet and/or blanket to cover the child. (2) Bedding shall be individually stored so that each child's bedding is identifiable and no child's used bedding comes into contact with other bedding.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in cots in the 2 preschool classrooms which are stacked with bedding on top of each cot and the bedding touches other bedding, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/17/2025
Plan of Correction
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Director states they will remove the bedding from the cots and store the bedding elsewhere.
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:Lilli Babcock
LICENSING EVALUATOR SIGNATURE:
DATE: 03/13/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/13/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/13/2025 05:05 PM - It Cannot Be Edited


Created By: Lilli Babcock On 03/13/2025 at 04:11 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: KEYSTONE MONTESSORI PRESCHOOL
FACILITY NUMBER: 198018405

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/13/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238.4(d)
Storage Space
(d) Combustibles, cleaning equipment and cleaning agents shall be stored in an area separate from food supplies in a locked cabinet or in a location inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation the licensee did not comply with the section cited above as the food storage area (closet) in Room 117 was observed to have bleach, hand soap, disinfectant wipes, toilet bowl cleaner, and cans of paint on the shelf and the door to the food storage closet to be unlocked, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/17/2025
Plan of Correction
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Director states the facility will remove the cleaning agents and paint and place them in an inaccessible area of the facility.
Type B
Section Cited
CCR
101238(g)
Buildings and Grounds
(g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above LPAs observed Lysol Disinfecting Wipes and Elmers Rubber Cement with a lid that was easy to open, in cabinets in the Toddler room which were accessible for children in care, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/13/2025
Plan of Correction
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Teacher removed the items from the cabinet during the visit and placed them in an inaccessible area of the classroom.
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:Lilli Babcock
LICENSING EVALUATOR SIGNATURE:
DATE: 03/13/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/13/2025


LIC809 (FAS) - (06/04)
Page: 7 of 11
Document Has Been Signed on 03/13/2025 05:05 PM - It Cannot Be Edited


Created By: Lilli Babcock On 03/13/2025 at 04:11 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: KEYSTONE MONTESSORI PRESCHOOL
FACILITY NUMBER: 198018405

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/13/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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4
Based on record review, the licensee did not comply with the section cited above in 1 out of 4 staff files reviewed to be missing proof of current mandated reporter training which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/11/2025
Plan of Correction
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Director states she will have Staff #3 complete the Mandated Reporter Training and place a copy of the certificate in the staff file.
Type B
Section Cited
CCR
101220(a)
Child's Medical Assessments
(a) Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child. This medical assessment enables the licensee to assess whether the center can provide necessary health-related services to the child.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 4 of 7 children’s files reviewed to be missing the LIC 701 Physicians Report, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/11/2025
Plan of Correction
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Director states the facility will obtain the LIC 701, Physicians Report for the 4 children's files missing the report and place the form in the children's files.
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:Lilli Babcock
LICENSING EVALUATOR SIGNATURE:
DATE: 03/13/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/13/2025


LIC809 (FAS) - (06/04)
Page: 8 of 11
Document Has Been Signed on 03/13/2025 05:05 PM - It Cannot Be Edited


Created By: Lilli Babcock On 03/13/2025 at 04:11 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: KEYSTONE MONTESSORI PRESCHOOL
FACILITY NUMBER: 198018405

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/13/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101227(a)(18)
Food Service
(18) All kitchen, food-preparation and storage areas shall be kept clean and free of litter and rubbish; and measures shall be taken to keep all such areas free of rodents and other vermin.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above as LPAs observed 2 pizza boxes on top of the pans and pot in the food storage closet. The top pizza box had an egg carton and a half filled yogurt container with a metal spoon inside the pizza box, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/13/2025
Plan of Correction
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2
3
4
The pizza boxes and trash were removed during the visit and thrown away.
Type B
Section Cited
CCR
101227(a)(20)
Food Service
(20) All equipment (fixed or mobile), dishes and utensils shall be kept clean and maintained in safe condition.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above as LPAs observed a cart in the food storage closet with 2 pans and a pot with dried food on them from a prior day which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/14/2025
Plan of Correction
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2
3
4
Director states the facility will make sure all dishes are done daily and no dishes are left overnight without being washed.
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:Lilli Babcock
LICENSING EVALUATOR SIGNATURE:
DATE: 03/13/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/13/2025


LIC809 (FAS) - (06/04)
Page: 9 of 11
Document Has Been Signed on 03/13/2025 05:05 PM - It Cannot Be Edited


Created By: Lilli Babcock On 03/13/2025 at 04:11 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: KEYSTONE MONTESSORI PRESCHOOL
FACILITY NUMBER: 198018405

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/13/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101227(a)(6)
Food Service
(6) Menus shall be in writing and shall be posted at least one week in advance in an area accessible for review by the child's authorized representative. Copies of the menus as served shall be dated and kept on file for at least 30 days. Menus shall be made available for review by the child's authorized representative and the Department upon request.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation and record review, the licensee did not comply with the section cited above as the menu posted for parents is not current, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/14/2025
Plan of Correction
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2
3
4
Director stated she will update the menu and ensure that menus are current at all time, posted at least one week in advance, and that parents are aware of any changes to the menu prior to the day of the change.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
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:Lilli Babcock
LICENSING EVALUATOR SIGNATURE:
DATE: 03/13/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/13/2025


LIC809 (FAS) - (06/04)
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