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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191570895
Report Date: 02/06/2026
Date Signed: 02/09/2026 08:47:56 AM

Document Has Been Signed on 02/09/2026 08:47 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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:LINDBERGH FULL DAYFACILITY NUMBER:
191570895
ADMINISTRATOR/
DIRECTOR:		VERONICA BLOOMFIELDFACILITY TYPE:
850
ADDRESS:12120 LINDBERGH ROADTELEPHONE:
(310) 631-7308
CITY:LYNWOODSTATE: CAZIP CODE:
90262
CAPACITY: 73TOTAL ENROLLED CHILDREN: 73CENSUS: 27DATE:
02/06/2026
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Facility Representative, Mabel CariasTIME VISIT/
INSPECTION COMPLETED:
04:15 PM
NARRATIVE
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On 2/6/26 at 2:30 PM, Licensing Program Analyst (LPA) Alicia Mooberry conducted an unannounced case management inspection to follow up on an incident that was reported to the Department on 2/3/26. Upon arrival, LPA met with Facility Representative, Mabel Carias. The facility has 2 classrooms (T-11 and T-13 There were 27 children and 6 staff present during inspection.

During this inspection LPA inspected outside playground, interviewed Staff 1 and staff 2 who were present during the incident, LPA also conducted phone interview with Child #1 authorized representative.

On 2/6/26 the facility reported to the department that child #1 was taken to the doctor due to finger was injured. The child received medical care for nail avulsion (left 4th digit). Per staff interviewed, on 1/27/26 at approximately 9:50am, children from room T11 walked back to the classroom after outdoor playtime. Staff 1 stated they observed child 1 biting nail and pulling at cuticle and asked Staff 2 to get Child #1 a Band-Aid. Staff 2 stated they placed a bandaid on child #1 finger. Staff 2 stated they did not see any bleeding nor that the nail was cut or separated. The child's authorized representative stated child #1 informed parent that child hurt their hand on the play equipment during outdoor play. Record review, shows that the classroom was within the required child-teacher ration during the incident on 1/27/26. LPA observed outside play yard, and equipment is good repair with no tripping hazards. Record review showed that the incident occurred on 1/27/26, the facility was made aware of the injury requiring medical treatment on 1/29/26 and reported to the department on 2/3/26, not within the required 24 hours of occurrence, posing a potential risk to the health and safety of children in care. One (1) "B" deficiency cited today, 2/06/2026.

A notice of site visit was provided and must be posted for 30 days in a public place. Exit interview was conducted and report was reviewed with the Facility Representative Courtney Gillette. Appeal Rights were discussed and a copy provided.

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Alicia Mooberry
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 02/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/06/2026
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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Document Has Been Signed on 02/09/2026 08:47 AM - It Cannot Be Edited


Created By: Alicia Mooberry On 02/06/2026 at 03:34 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LINDBERGH FULL DAY
FACILITY NUMBER: 191570895

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/06/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/20/2026
Section Cited
CCR
101212(d)(1)(B)

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Upon the occurrence, during the operation of the child care center... a report shall be made to the Department by telephone or fax within the Department's next working day... Any injury to any child that requires medical treatment.
This requirement is not met as evidenced by:
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Per facility representative, a plan is put in place to ensure the staff receives a refresher on communicating incidents in a timely manner. A confirmation email will be sent to LPA by POC due date 2/20/26
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Based on Interview and record review, the facility did not comply with the above regulation; an injury requiring medical treatment was not reported to Licensing within 24 hours of the time the facility was made aware, posing a potential risk to the health and safety of 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.
Warren Birks
NAME OF LICENSING PROGRAM MANAGER:
Alicia Mooberry
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 02/06/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/06/2026


LIC809 (FAS) - (06/04)
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