191500164-5-28-2026-33-CC-VMGA-DUHTQN-20260528145614

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191500164
Report Date: 05/28/2026
Date Signed: 05/28/2026 02:56:26 PM

Document Has Been Signed on 05/28/2026 02:56 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	EL MONTE CITY S.D.-NEW LEXINGTON ELEMENTARY SCHOOL		FACILITY NUMBER:	191500164
ADMINISTRATOR/ DIRECTOR:	CLAUDIA ROJAS		FACILITY TYPE:	850
ADDRESS:	10410 E. BODGER		TELEPHONE:	(626) 575-2320
CITY:	EL MONTE	STATE: CA	ZIP CODE:	91731
CAPACITY: 28	TOTAL ENROLLED CHILDREN: 28	CENSUS: 23	DATE:	05/28/2026
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:05 PM
MET WITH:	Monica Bonilla		TIME VISIT/ INSPECTION COMPLETED:	03:15 PM

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Licensing Program Analyst (LPA) Veronica Martinez Garza conducted an unannounced Case Management Incident inspection at the above facility on 05/28/26 at 1:05 p.m. The purpose of this inspection is to follow up on an incident reported to the Department within 24 hours. At 1:10 p.m., LPA met with the facility representative Monica Bonilla who guided analyst on a tour of the facility and census was taken.

During this inspection, LPA interviewed Staff 1 (S1) and Child 1 (C1). LPA also obtained a copy of the ouch report and doctor’s note.

On 05/11/26, S1 was changing C1 diaper in the restroom and once the diaper change was done the staff opened the door, but the child’s hand was between the frame which caused the child to sustain a cut on their finger. According to the report, the staff cleaned the area, applied, ice and contacted parents. Staff also contacted the program nurse who advised to contact the parent for an early pick. During pick up, parent was advised to take C1 to the Emergency Room (ER) or urgent care. The facility was later notified that the child was taken to urgent care, glue was applied to the child's finger, and was cleared to return the following day with no restrictions.

Interview conducted with S1 revealed that they were in the restroom with C1 changing their diaper and they were placing the dirty diaper in a plastic bag when they observed C1 near the door. S1 revealed that children sit in a chair located in the restroom; however, the day of the incident C1 got up from the chair once they saw S1 tie the plastic bag since the child knew that the bag would be thrown away and they would walk out of the stall. According to S1, C1 was grabbing the door and when the staff called the child over the child was startled and let go of the door since the door was not locked. S1 re-enacted their position including the position of C1.

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NAME OF LICENSING PROGRAM MANAGER: Ana Chico
NAME OF LICENSING PROGRAM ANALYST: Veronica Martinez-Garza
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/28/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2026

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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: EL MONTE CITY S.D.-NEW LEXINGTON ELEMENTARY SCHOOL	FACILITY NUMBER: 191500164
	VISIT DATE: 05/28/2026

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Based on the re-enactment, it was observed that S1 couldn’t see that the child’s hand was in the door’s frame and when S1 called C1 the child was startled and released the door which slammed to their hand that was left on the frame. Per S1, then they heard the child say ouch and took the child to the sink to wash their hands. S1 then took C1 to sit at the table for lunch and observed that the child had blood smeared on their shirt which immediately assessed and cleaned the area. Per S1, they applied ice and observed a minor cut on the child's finger. S1 also stated that they called the program nurse who advised to call the child’s parent for an early pick up. According to S1, the incident occurred at approx. 2:00 p.m. which was near pick up. Parent of C1 arrived and was provided an ouch report and was advised to take the child to the ER or urgent care. S1 followed up with the parent of C1 who confirmed that the child was taken to urgent care and confirmed that there were no fractures. Parent of C1 provided a doctor’s note clearing the child to return to the facility the following day.

LPA attempted to interview C1 who pointed to their finger and showed the LPA where they injured their finger; however, the child couldn't explain what happened.

During today’s inspection, LPA toured the area where the incident occurred and observed 2 child sized chairs and procedures for diapering and changing soiled clothing procedures in the children’s restroom. According to S1, the incident happened so fast and will ensure that moving forward the restroom door will be locked to prevent future incidents/accidents.

At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.

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, a civil penalty of $100 can be assessed.

An exit interview was conducted, and a copy of this report was provided to the facility representative Monica Bonilla.

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NAME OF LICENSING PROGRAM MANAGER: Ana Chico
NAME OF LICENSING PROGRAM ANALYST: Veronica Martinez-Garza
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/28/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2026

LIC809 (FAS) - (06/04)

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