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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191598992
Report Date: 02/04/2025
Date Signed: 02/04/2025 12:22:24 PM

Document Has Been Signed on 02/04/2025 12:22 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:KATHY KREDEL NURSERY SCHOOLFACILITY NUMBER:
191598992
ADMINISTRATOR/
DIRECTOR:		GWEN BLACKMONFACILITY TYPE:
830
ADDRESS:300 W. HUNTINGTON DRIVETELEPHONE:
(626) 574-3524
CITY:ARCADIASTATE: CAZIP CODE:
91007
CAPACITY: 55TOTAL ENROLLED CHILDREN: 55CENSUS: 16DATE:
02/04/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:50 AM
MET WITH:Deanna Nancarrow - Site SupervisorTIME VISIT/
INSPECTION COMPLETED:
12:35 PM
NARRATIVE
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Licensing Program Analyst (LPA) Nolan Tcheng conducted a Case Management inspection for the purpose of following up on an incident reported to the Department on 01/28/2025. Upon arrival at 10:50am, LPA met with Site Supervisor Deanna Nancarrow, to whom the purpose of the inspection was explained. A tour of the facility was provided. Children were present during the time of inspection. Census was taken. There were 16 children with 8 staff members.

On 01/28/2025, an incident took place where Child #1 was unknowingly fed another child's breast milk bottle by Staff #3. During today's inspection, interviews were conducted with two staff members and pictures of the bottle areas were obtained. Staff #1 stated that they prepped the bottle for Child #2 and provided it to Staff #3 to give to child. Staff #1 was preparing meal time for other children when they turned around and observed the bottle for Child #2 being used to feed Child #1. Staff 1 immediately stopped the feeding. Staff #2 corroborated the incident that took place.

Based upon the information above, LPA has determined that there was a violation of Child #1's personal rights, when they were fed the incorrect bottle by Staff #3. This was an immediate risk to the health, safety, and personal rights of children in care.

LPA Tcheng informed Site Supervisor that this report dated 02/042024, documents one Type A citation, which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, and personal rights of children in care.

Also, LPA Tcheng informed the Site Supervisor to provide a copy of this licensing report dated 2/04/2025, that documents any Type A citation, to parent/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 parents/guardians for 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 and must remain posted for 30 days. Exit interview conducted and report was reviewed with Site Supervisor Deanna Nancarrow, at 12:20pm. Copy of Report provided.


END OF REPORT
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE: DATE: 02/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/04/2025
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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Document Has Been Signed on 02/04/2025 12:22 PM - It Cannot Be Edited


Created By: Nolan Tcheng On 02/04/2025 at 11:40 AM
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: KATHY KREDEL NURSERY SCHOOL
FACILITY NUMBER: 191598992

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/04/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/05/2025
Section Cited
CCR
101223(a)(2)

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Personal Rights
(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.


This requirement is not met as evidenced by:
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Per Site Supervisor, continuing training with staff for bottles, with names, for children. We have also dicussed pictures by their bottles. Counter cleaned and organized. Staff meeting agenda and staff signatures will be provided to LPA by POC date.
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Based on interview and record review, Licensee did not ensure that Child #1 was provided their own bottle, and was fed breastmilk for Child #2. This was an immeidate risk to the health, safety, and personal rights 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.
SUPERVISOR'S NAME:Ana Chico
LICENSING EVALUATOR NAME:Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:
DATE: 02/04/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/04/2025


LIC809 (FAS) - (06/04)
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