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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191500902
Report Date: 09/12/2025
Date Signed: 09/12/2025 04:41:03 PM

Document Has Been Signed on 09/12/2025 04:41 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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:BELLFLOWER UNIFIED SCHOOL DIST.-LAS FLORES SCHOOLFACILITY NUMBER:
191500902
ADMINISTRATOR/
DIRECTOR:		JANAN HUGHESFACILITY TYPE:
850
ADDRESS:10039 E. PALM STREETTELEPHONE:
(562) 461-2227
CITY:BELLFLOWERSTATE: CAZIP CODE:
90706
CAPACITY: 40TOTAL ENROLLED CHILDREN: 40CENSUS: 9DATE:
09/12/2025
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:14 AM
MET WITH:Raquel Ozuna, SupervisorTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On Licensing Program Analyst (LPA) Alicia Mooberry conducted an unannounced Required - 3 Year Inspection on this date. This facility is currently licensed for capacity of 20. Licensing staff met with Pamela Deras, Teacher. Facility is located on Bellflower USD elementary school campus. The program currently operates two part-time classes in the morning and afternoon. Morning class from 8:30 AM to 11:30 AM and Afternoon class is 12:30 PM to 3:30 PM. LPA observed there is a total census of 8 children and two staff present. LPA toured the facility both indoors and outdoors. Raquel Ozuna, Supervisor arrived at 10:20 am. LPA reviewed the required postings on bulletin board by classroom entrance including waivers for use of shared out door play yard, use of play equipment, use of elementary bathrooms, and use of Assistant for supervision.

The facility is made up of single bungalow. LPA observed furniture and equipment were inspected for age appropriateness and good repair. LPA observed child size tables and chairs, learning stations with dramatic play toys, art materials, and math manipulative toys available for children in care that is well maintained and free of loose and sharp parts. Telephone service, heating, lighting and ventilation were evaluated. There were cubbies observed as storage for children's belongings. There is no napping equipment at the facility due to part time programs. LPA observed individual water bottles labeled with child names available for children in care. Children bring their own water bottle from home. Age appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, area safety and sanitation.

A first aid kit is kept in a backpack hanging by the entrance and was inventoried for supplies. Medications (if needed) stored in first aid backpack that meet Tittle 22 Regulation requirements. Carbon monoxide and smoke detectors are present in the facility. Fire extinguishers were last serviced on 08/07/2025. Facility Representative was reminded to service Fire Extinguisher yearly. ----Page 1 - Report Continues

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Alicia Mooberry
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 09/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/12/2025
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 4
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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: BELLFLOWER UNIFIED SCHOOL DIST.-LAS FLORES SCHOOL
FACILITY NUMBER: 191500902
VISIT DATE: 09/12/2025
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Disaster and fire drill log was posted and last drill was conducted on 08/27/25

Outdoor equipment was inspected for safety, cushioning material, good repair and age appropriateness. LPA observed metal climbing dome, swing set with two seats, and a large play structure with slide, monkey bars, and balance beam with wood chips under to absorb fall all well maintained. Required shade and fencing were inspected. LPA reminded staff, that the children need to be within the direct care and supervision, including visual supervision of the teacher(s) at all times. LPA observed that children have access to their own water bottles during outside play. Play area was inspected for hazards and inaccessibility to bodies of water; no bodies of water or hazards observed.



Teacher-child ratios were observed and staff names recorded. Care and supervision was evaluated to determine if the basic needs of children are met and appropriate. Sign-in and out sheets and procedures were reviewed. All children present have been signed in with full legal signatures. Personal Rights of children were observed by LPA.

As a condition of employment for Bellflower Unified School District, all staff have been fingerprint cleared.

Per ECE Supervisor, confidential files for children and staff are kept in ECE Adm. Office and not available for review at facility. LPA reviewed available staff records inlcuding CPR card expires on 09/2026 for Staff 2.

LPA discussed requirement of AB1207 training for all staff with ECE Supervisor, per ECE Supervisor they will confirm that the training provided by the district conforms to AB1207 Mandated Reported requirements.

LPA discussed with ECE Supervisor that requirement of staff files to be made available for review during inspection, Technical assistant was provided and a Technical Violation assessed. Per ECE Supervisor, they are in the process of applying for a waiver to request staff and children's files be available at a centralized location.


Report Continues - Page 2 of 3
NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Alicia Mooberry
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2025
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: BELLFLOWER UNIFIED SCHOOL DIST.-LAS FLORES SCHOOL
FACILITY NUMBER: 191500902
VISIT DATE: 09/12/2025
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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.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

Facility representative was reminded that all adults 18 and over in the facility, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed facility. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA advised of the requirement to report Unusual Incidents and/or injuries to the parent/guardian and to CCL within the time frame specified by the regulation.

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.

LPA referred facility representative to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

The facility was found in compliance per Title 22 regulations, there will be no deficiencies cited on this date.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative.

Exit interview was conducted and report was reviewed with the Facility Representative, Raquel Ozuna.

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Alicia Mooberry
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2025
LIC809 (FAS) - (06/04)
Page: 4 of 4