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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191501775
Report Date: 11/05/2025
Date Signed: 11/05/2025 02:57:07 PM

Document Has Been Signed on 11/05/2025 02:57 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:CLAREMONT UNITED CHURCH OF CHRIST ECCFACILITY NUMBER:
191501775
ADMINISTRATOR/
DIRECTOR:		KNIGHT, KRISTYFACILITY TYPE:
850
ADDRESS:233 W HARRISON AVETELEPHONE:
(909) 624-2916
CITY:CLAREMONTSTATE: CAZIP CODE:
91711
CAPACITY: 64TOTAL ENROLLED CHILDREN: 64CENSUS: 59DATE:
11/05/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:25 AM
MET WITH:Director Kristy KnightTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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LPAs Ruiz and Li conducted an unannounced case management inspection for deficiencies observed during complaint investigations. LPAs met with Director Kristy Knight to whom the reason for the visit was explained. Director led LPAs on a tour of the facility. Census was taken, LPAs observed there to be 59 children with 10 staff members.

Throughout the course of the investigation, interviews were conducted and disclosed that on 7/28/2025, Director called Parent and informed them that their child had been electrocuted. Facility did not document injury on an ouch report but did document communication with parent through their classroom app. Staff interviews and record review revealed that this unusual incident was not reported to licensing, which causes a potential risk to children in care. A deficiency is being issued, see page LIC809D.

During today's visit, in Grandmas Room, LPAs observed there to be 17 children with 4 staff members. LPAs observed the off-limits kitchen in Grandmas House was not made 'off limit's to children in care. During prior visits, a baby gate was installed restricting access to the kitchen. There was no gate observed today. LPAs asked Director Knight if kitchen is still off-limits. Per Director, the kitchen is off-limits and that there used to be a gate but thought it was okay to remove it since the children in Grandmas House are now TK age and would not go into the kitchen.

Upon inspection, LPAs observed a 4 inch pairing knife tee drying dish rack on top of the counter and 8 inch chefs knife in the unlocked kitchen drawer. LPAs advised Director to move the knives so that they are out of reach of children in care. LPAs observed Director move the kitchen knives to the second top shelf in the kitchen so they are inaccessible to children. LPA's advised to inform teachers about storing knives out of reach of children and advised to re-install baby gate to restrict access to kitchen. There is a second exit in the kitchen that leads into the back yard and parking lot. A deficiency is being issued, see page LIC809D.

NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Monica Ruiz
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 11/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/05/2025
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: CLAREMONT UNITED CHURCH OF CHRIST ECC
FACILITY NUMBER: 191501775
VISIT DATE: 11/05/2025
NARRATIVE
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Based on LPAs interviews and observations the following deficiencies listed on the attached 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 children's health and safety.

At this time, a Type-A deficiency is being cited. Deficiencies that are being cited need to be cleared immediately to protect the children’s health & safety. California Code of Regulations, Title 22 are being cited on the attached LIC 9099D.

LPA informed Director to provide a copy of this licensing report dated 11/05/25 that documents any Type-A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled children for the next 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC9224), or other written statement, must be placed in the child’s file for verification.

A notice of site visit was given to Director and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director Kristy Knight.

Appeal rights were provided.

NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Monica Ruiz
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/05/2025 02:57 PM - It Cannot Be Edited


Created By: Monica Ruiz On 11/05/2025 at 12:18 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: CLAREMONT UNITED CHURCH OF CHRIST ECC
FACILITY NUMBER: 191501775

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/05/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/14/2025
Section Cited
CCR
101212(d)(1)(c)

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Reporting Requirements...a report shall be made..within the next working day.. following the occurrence... (C)Any unusual incident... that threatens the physical or emotional health or safety of any child.This regulation was not met as evidenced by:


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Director states they will have a meeting with the assistant teachers on 11/12 and lead teachers on 11/13 to review reporting requirements and Director will make it a program policy and will email meeting agendas and staff sign-in sheets by 11/14/2025.
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Based on observations, interviews and record review, Director did not report child getting electrocuted within the next working day of incident.
This poses an immediate health, safety, or personal rights risk to children in care.
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Type B
11/05/2025
Section Cited
CCR101238(b)(1)

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(b) All children shall be protected against hazards...within the center through provision This regulation was not met as evidenced by:
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Director states they will store knives on the top shelf in the kitchen and install a baby gate and submit photos to LPA by 11/14/2025.
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Based on LPA observation and interview, knives were not made off limits in kitchen while children were in care .This poses a potential health, safety, or personal rights risk to children in care.
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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.
Katrina Chicote
NAME OF LICENSING PROGRAM MANAGER:
Monica Ruiz
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/05/2025


LIC809 (FAS) - (06/04)
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