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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019478
Report Date: 08/13/2019
Date Signed: 08/13/2019 12:49:52 PM

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:PUENTE AVE PRESCHOOL INFANT CARE CENTERFACILITY NUMBER:
198019478
ADMINISTRATOR:KIMBERLY NGUYENFACILITY TYPE:
830
ADDRESS:14032 DILLERDALE AVETELEPHONE:
(626) 338-3464
CITY:LA PUENTESTATE: CAZIP CODE:
91746
CAPACITY:30CENSUS: 8DATE:
08/13/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:18 AM
MET WITH:Phuong Mai & Alberta LockhartTIME COMPLETED:
12:55 PM
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Random inspection attempted. LPA met with teachers in charge Mai Phoung (Ms. Kelly) and Alberta Lockhart. LPA was informed that the director/owner Kimberly Nguyen is out on a field trip with the preschool today and won't return until around 3pm. LPA also observed field trip notice on the door. LPA also observed that the kitchen in the preschool building is being renovated. LPA toured the infant and toddler classroom which are located in the back and detached from the preschool building. LPA toured the toddler room and observed 2 toddlers in care and 6 infants in care between the 2 infant classrooms. Staff names were recorded and all are fingerprint cleared and associated with the facility. During the visit, some staff left to take their lunch. LPA observed food for infant/toddlers are stored in the their respective rooms.

LPA unable to do a complete random inspection today due to director/owner not present and some staff left to take their lunch and remaining staff need to stay in the classrooms.

Random inspection will be conducted at another time.

An exit interview conducted with Alberta Lockhart, copy of the report given. Notice of Site visit form was posted and shall be posted for 30 days or a civil penalty of $100 will assessed.
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 513-3793
LICENSING EVALUATOR NAME: Jennifer HuaTELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2019
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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