<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020291
Report Date: 11/19/2024
Date Signed: 11/26/2024 09:02:44 AM

Document Has Been Signed on 11/26/2024 09:02 AM - 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:MADISON CHILD DEVELOPMENT CENTERFACILITY NUMBER:
198020291
ADMINISTRATOR/
DIRECTOR:		KYM ALLENFACILITY TYPE:
830
ADDRESS:1351 S. MAIN STTELEPHONE:
(909) 622-9805
CITY:POMONASTATE: CAZIP CODE:
91766
CAPACITY: 16TOTAL ENROLLED CHILDREN: 16CENSUS: 14DATE:
11/19/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Infant lead teacher Heather McDowellTIME VISIT/
INSPECTION COMPLETED:
01:40 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 11/19/24 at 9:45am, Licensing Program Analyst (LPA) Stephanie Li conducted an unannounced annual inspection. Upon arrival LPA met with Infant Lead Teacher Heather McDowell , who led LPA on a tour of the facility. Hours of operation are Monday-Friday 7:30am-3:15pm. The facility is an infant center with toddler component. Infant classroom operates out of Room 5 and toddler classroom out of Room 7. On site there is also a preschool program. Per teacher, there are currently 8 infants and 8 toddlers enrolled. There were 7 infants and 7 toddlers and 6 staff present during the inspection. This Early Head Start program runs for 12 months.

All areas identified on the Facility Sketch were inspected. The facility consists of 2 classrooms in Rm 5 and Rm 7 and one large outdoor play area with a separate gated playground for the older 2’s. Staff names were recorded. Teacher-child ratios were observed to be in accordance with Title 22 regulations. The Licensee is within the conditions, limitations, and capacity specified on the license. All children were observed to be under active/visual supervision of a teacher during the tour.

Licensing staff observed disinfectants, cleaning solutions, medication and other items that are dangerous to children were not accessible to children. Classroom furniture and equipment are in good condition, free of sharp, loose, or pointed parts. All floors are clean and safe. Napping equipment cots, cribs and bedding were inspected for good condition, appropriate storage, and cleanliness. Facility has a laundry service wash their linen weekly and has plenty of back up sheets to change sheets daily or as needed when soiled. Storage for children's belongings were inspected. All toilets and washing facilities are in safe and sanitary operating conditions. First Aid supplies are available and complete. Drinking water is available and provided through a Brita jug and bottled water. The office is used as an isolation area, there are chairs and cots available for an ill child to rest. LPA observed 2 doors in the toddler room (clasroom door and bathroom door) bottom hinges were damaged, splintering, with screws popping out assessable to children in care. A citation is being issued, see page lic809D. Deficiencies need to be cleared to protect the health and safety of children in care.

Page 1 of 4

Christina GabelmanTELEPHONE: (323) 981-3380
Stephanie LiTELEPHONE: (626) 366-3362
DATE: 11/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/19/2024
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 8
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MADISON CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 198020291
VISIT DATE: 11/19/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Cribs and napping equipment were observed in the infant program. Two cribs with side drop down gates were observed to be in the napping area assigned to children. LPA advised teachers that drop down cribs are banned from use in child care facilities. Per teacher, they were going to use the emergency cribs for the children for nap time today. A deficiency is being issued per Tittle 22 regulations. See page LIC809D. Mattresses have an appropriate size mattress with a fitted sheet. Crib was observed to be free of loose items. Cots were available for infants who are able to climb out of crib. Sleeping area is physically separated and cribs do not limit staff’s ability to watch infants at all times.

LPA observed the diaper changing area does not have a changing table. Infant teachers are using a drop down wall that is attached to the wall over the counter in the hallway outside of the classroom. LPA observed that the changing area does not have a changing pad. LPA advised teacher that a changing table and pad is required per California Title 22 regulations. Per teacher, she was told that she was going to receive a changing table this school year but has not received one. A citation is being issued, see page LIC809D. LPA observed a sink within arm’s reach of the changing area. There is at least one sink for every 15 children potty training. Per teacher, there is 1 child currently potty training in the toddler room.

Licensing staff observed all required forms/publications to be posted by the front entrance. Snack menus were reviewed to ensure that they are being posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request. Facility provides breakfast, lunch and pm snacks. Lunch is provided from school district nutrition department. Children’s food and bottles are labeled with individual names. All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids. LPA observed a small trash bins in the infant meal area used to discard meals did not have a tight fitting lid and a large trash can with lid was observed in the hallway. Per teacher, infant teachers are promoting self sufficiency and want to allow the children the opportunity to throw their own trash away so is using the small trash bin to provide learning opportunities. Large trash can rolls and is a hazard to crawling infants. A technical violation is being issued. See page LIC9102. LPA advised getting a small trash can with a lid to continue promoting learning. The facility was observed to be free of flies, other insects, and rodents.

Page 2 of 4

SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Stephanie LiTELEPHONE: (626) 366-3362
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2024
LIC809 (FAS) - (06/04)
Page: 2 of 8
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MADISON CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 198020291
VISIT DATE: 11/19/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Licensing staff observed the required 2A10BC fire extinguisher indicates fully charged and was serviced on 11/12/24 on service tag. Per State Fire Marshall standards, fire extinguishers shall be serviced annually. Facility has a functioning carbon monoxide and smoke detector that meets statutory requirements. Teachers state there are no weapons or firearms on the premises. The last Disaster drill was conducted in 11/08/24.

At 11:30 am, licensing staff reviewed the outdoor play area. The playground equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with material that absorbs a fall. The sandbox is covered and checked daily for debris. There is adequate shade in the play yard.

Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. Staff records and children’s records were not available to review as they are kept at Pomona Child Development center. There is at least one person trained in CPR and Pediatric First Aid Heather McDowell (exp 5/2026) present during this inspection. Mandated reporter training certificates were verified with all staff present.

Incidental Medical Services (IMS) is not currently being provided. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Teachers were 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.

Page 3 of 4

SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Stephanie LiTELEPHONE: (626) 366-3362
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2024
LIC809 (FAS) - (06/04)
Page: 3 of 8
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MADISON CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 198020291
VISIT DATE: 11/19/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
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.

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 childcare 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).

The facility has completed lead testing and have no lead exceedances. LPA referred facility representative to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

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


Based on Licensing staff interview and observations, 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.

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 representative.



Exit interview conducted, report was reviewed, and appeal rights were given to Lead teacher Heather McDowell.

Page 4 of 4

SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Stephanie LiTELEPHONE: (626) 366-3362
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2024
LIC809 (FAS) - (06/04)
Page: 4 of 8
Document Has Been Signed on 11/26/2024 09:02 AM - 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754


FACILITY NAME: MADISON CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 198020291

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/19/2024
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Section Cited
Infant Care Center Sleeping Equipment
(b) A crib or portable -crib meeting United States Consumer Product Safety Commission safety standards shall be provided for each infant who is unable to climb out of a crib.

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 in 2 out of 4 cribs, have a drop down side gate, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/02/2024
Plan of Correction
1
2
3
4
Per facilities planner, Kym Allen, will connect with EHS assistant director to obtain more cribs for the infant classroom by 12/2/24.
Section Cited
Infant Care Center Fixtures, Furniture, Equipment and Supplies
(b) The infant care center shall be equipped with appropriate furniture and equipment including, but not limited to, cribs, cots or mats; changing tables; and feeding chairs.

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 in infant class does not have a changing table to change infants in care, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/31/2024
Plan of Correction
1
2
3
4
Per facilites planner, Kym Allen, a changing table will be provided for Infant room 5 and he will remove the wall Koala changer before 12/31/24 and submit photo text to LPA S Li.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Christina GabelmanTELEPHONE: (323) 981-3380
Stephanie LiTELEPHONE: (626) 366-3362

DATE: 11/19/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/19/2024

LIC809 (FAS) - (06/04)
Page: 5 of 8
Document Has Been Signed on 11/26/2024 09:02 AM - 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754


FACILITY NAME: MADISON CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 198020291

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/19/2024
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Section Cited
Infant Care Center Fixtures, Furniture, Equipment and Supplies
(h) Infant changing tables shall: (1) Have a padded surface no less than one-inch thick and be covered with washable vinyl or plastic.

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 in 1 changing table did not have a changing padding for children in care, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/02/2024
Plan of Correction
1
2
3
4
Per facilities planner, Kym Allen, he will bring a padding for the Koala changing table before 12/02/24 and submit photo text to LPA S Li by 12/02/24.
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.
Christina GabelmanTELEPHONE: (323) 981-3380
Stephanie LiTELEPHONE: (626) 366-3362

DATE: 11/19/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/19/2024

LIC809 (FAS) - (06/04)
Page: 6 of 8
Document Has Been Signed on 11/26/2024 09:02 AM - 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754


FACILITY NAME: MADISON CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 198020291

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/19/2024
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Section Cited
Infant Care Center Fixtures, Furniture, Equipment and Supplies
(g) Furniture shall be maintained in good repair and 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 in two doors have damaged splintered hinges with screws popping out assessable to children in care, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/02/2024
Plan of Correction
1
2
3
4
Per facilities planner, Kym Allen, he will have fcaility repair crew go to site to make the neccassary repairs before 12/02/24 and submit photos of repairs to LPA S Li via text.
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.
Christina GabelmanTELEPHONE: (323) 981-3380
Stephanie LiTELEPHONE: (626) 366-3362

DATE: 11/19/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/19/2024

LIC809 (FAS) - (06/04)
Page: 8 of 8