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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191596182
Report Date: 03/20/2025
Date Signed: 03/20/2025 02:01:28 PM

Document Has Been Signed on 03/20/2025 02:01 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:CHILD DEVELOPMENT CENTERFACILITY NUMBER:
191596182
ADMINISTRATOR/
DIRECTOR:		TAMIKA ADDISONFACILITY TYPE:
850
ADDRESS:1100 N. GRAND AVE., BLDG. 70TELEPHONE:
(909) 274-4920
CITY:WALNUTSTATE: CAZIP CODE:
91789
CAPACITY: 182TOTAL ENROLLED CHILDREN: 116CENSUS: 94DATE:
03/20/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Lupe Medina, Education CoordinatorTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
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On 03/20/2025, Licensing Program Analyst (LPA) Kruz Long conducted an unannounced Case Management inspection. A COVID-19 risk assessment was conducted. LPA met with Lupe Medina, Education Coordinator and explained the purpose of the visit. There are 21 children and 5 staff present in the P1 classroom during today's visit.

The purpose of the visit is to follow up on an incident that occurred on 03/13/25 and was reported to the department on 03/14/25. The self reported incident is regarding supervision.

During today's visit, LPA obtained a copy of email correspondences, facility investigation notes and reviewed video footage for Classroom #P1 dated 03/13/25 in which the alleged incident may have occurred. LPA observed that there was adequate staffing on that date.

Based on record review and video footage viewed, there were no corroborating information to determine that there was a lack of supervision or that the alleged incident had occurred. The facility is not being cited any deficiencies today.

An exit interview was conducted and a copy of this report and appeal rights was provided to the Education Coordinator.

A Notice of Site Visit was provided; Notice of Site Visit must be posted for 30 days.

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Kruz Long
LICENSING EVALUATOR SIGNATURE: DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/20/2025
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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