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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018749
Report Date: 03/22/2023
Date Signed: 03/22/2023 04:02:08 PM


Document Has Been Signed on 03/22/2023 04:02 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:KIDAZZLES LEARNING CENTERFACILITY NUMBER:
198018749
ADMINISTRATOR:CARMEN VELAZQUEZFACILITY TYPE:
850
ADDRESS:6424 LONG BEACH BLVDTELEPHONE:
(562) 612-4868
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY:30CENSUS: 12DATE:
03/22/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Director - Jasmine ThomasTIME COMPLETED:
04:20 PM
NARRATIVE
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Licensing Program Analyst (LPA) Randy Derraco conducted an unannounced case management visit to the above mentioned address on 03/22/23. LPA arrived at the facility at 2:15 PM and was met by teacher S2. LPA observed 12 children in care. The facility was observed to be clean and in good repair. LPA observed Director, Jasmine Thomas, arriving at the facility at 3:00 PM.

LPA observed the cabinet in the employee bathroom to be locked making the contents inaccessible to children in care. LPA observed the carbon monoxide detector to be operable. LPA conducted a record review of the director and the teacher's personnel file. LIC 9052 was observed to be completed.

LPA did not observe a completed Mandated Reporter AB 1207 compliant training certificate in the directors file. During file review, LPA observed that LIC 503 - Health Screening Report was not signed by the person whom conducted the screening. LPA observed that sign in/out sheets were only completed for 4 children in care. LPA advised Director that Declaration has not been received. LPA observed that the climbing structure in the outdoor play area did not have any cushioning beneath to absorb a fall.

LPA advised Director that a Health and Safety Code (HSC) section 1596.8662(b)(1), California Code of Regulation (CCR) section 101216(g)(2), 101216(l)(1)(B), and 101229.1(b) are being re-cited. LPA also advised Director that CCR section 101238.2(e) will be issued.

The following deficiencies listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Code of Regulations Title 22 and the Health and Safety Code. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

Exit interview conducted, appeal rights provided, notice of site visit given, and report was reviewed with the Director Jasmine Thomas.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Randy DerracoTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:
DATE: 03/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/22/2023
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 3


Document Has Been Signed on 03/22/2023 04:02 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: KIDAZZLES LEARNING CENTER
FACILITY NUMBER: 198018749

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/22/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/27/2023
Section Cited

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1596.8662(b)(1) - (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... and shall complete renewal mandated reporter training every two years... This requirement is not met as evidenced by:
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Director states that staff members and herself will complete Mandated Reporter AB 1207 compliant training by 03/27/23.
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Director did not complete Mandated Reporter AB1207 compliant training.
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Type B
03/27/2023
Section Cited

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101216 Personel Requirements (g) All personnel... shall be in good health and shall be physically and mentally capable of performing assigned tasks (2) Each person... shall have a health-screening report signed by the person performing the screening. This requirement is not met as evidenced by:
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Director states she will have a LIC 503 signed by the person performing the health screening by 03/27/23
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Director's file did not have a signed LIC 503.
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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: Randy DerracoTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:
DATE: 03/22/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/22/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3


Document Has Been Signed on 03/22/2023 04:02 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: KIDAZZLES LEARNING CENTER
FACILITY NUMBER: 198018749

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/22/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/27/2023
Section Cited

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101229.1 Sign In and Sign Out (b) The person who brings the child to, and removes the child from, the center shall sign the child in/out. This requirement is not met as evidenced by:
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Director states she will develop a plan to have authorized representatives properly sign in/out chldren during drop off and pick up. Director states she will provide LPA with a declaration of the plan by 03/27/23
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LPA observed sign in and sign out sheets completed for 4 out of 12 children in attendance.
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Type B
03/27/2023
Section Cited

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101238.2 Outdoor Activity Space (e) As a condition of licensure, the areas around and under high climbing equipment, swings, slides and other similar equipment shall be cushioned with material that absorbs falls. This requirement is not met as evidenced by:
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Director states she will have cushioned mats installed underneath the climb structure by 03/27/23
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Climbing structure located in the outdoor play area was observed without cushioning material to absorb a fall.
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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: Randy DerracoTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:
DATE: 03/22/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/22/2023
LIC809 (FAS) - (06/04)
Page: 3 of 3