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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191606400
Report Date: 05/22/2025
Date Signed: 05/22/2025 02:07:20 PM

Document Has Been Signed on 05/22/2025 02:07 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:KING STATE PRESCHOOLFACILITY NUMBER:
191606400
ADMINISTRATOR/
DIRECTOR:		STEPHANIE RICHARDSONFACILITY TYPE:
850
ADDRESS:2270 E. 122ND STTELEPHONE:
(310) 898-6433
CITY:COMPTONSTATE: CAZIP CODE:
90222
CAPACITY: 42TOTAL ENROLLED CHILDREN: 42CENSUS: 7DATE:
05/22/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:45 AM
MET WITH:Alan Flores, Substitute TeacherTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On May 22, 2025, Licensing Program Analysts (LPAs) Portia Bowden and Christine Nolan conducted an unannounced Annual Inspection at the above facility. At 11:45AM LPAs met with Office Staff Ms. Skinner explained the reason for visit. Per Office Staff PM Class was cancelled today due to teacher calling out today. At 12:15PM LPAs met with PM Aide Dulce Navarro who provided a tour. Per Aide the facility operating hours are Monday through Friday from 8AM–2:35PM. LPAs observed all required documents on the facility licensing board (PUB 269, PUB 393, LIC 610, LIC 9224, LIC 613A) LPAs did not observed an Emergency Drill log, per Aide she is unsure when the last drill was conducted, a Type B Deficiency will be issued.

This is a preschool half day (AM/PM) program serving ages 2 to 5 years old, consisting of 1 classroom and 1 enclosed outdoor play area. Per Aide there are currently 14 children enrolled in AM and 3 children enrolled in PM. Facility also houses on the premises a K-6th Grade Elementary School. LPAs Observed no children in care during inspection. Capacity and limitations as specified on the license are being maintained. Per Aide no children in care require Incidental Medical Services or have food allergies.

The following was observed during the tour of the facility: furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting, and ventilation were evaluated. At 12:30PM LPAs observed a functioning Carbon monoxide detector on the classroom wall. Per Aide children in care do not nap as this is a half day program. LPAs observed 2 age appropriate toilets, 2 age appropriate sinks and 1 changing table in good repair in the bathrooms located inside the classroom. Per Aide facility assists with potty training and diaper changing.
NAME OF LICENSING PROGRAM MANAGER: Karen Chambers
NAME OF LICENSING PROGRAM ANALYST: Portia Bowden
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/22/2025
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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Document Has Been Signed on 05/22/2025 02:07 PM - It Cannot Be Edited


Created By: Portia Bowden On 05/22/2025 at 01:04 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: KING STATE PRESCHOOL
FACILITY NUMBER: 191606400

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/22/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.16(a)(1)
Lead Testing
(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above facility has not conducted required lead testing which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/05/2025
Plan of Correction
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Facility will submit proof of lead testing appointment.
Type B
Section Cited
CCR
101174(d)(2)
Disaster and Mass Casualty Plan
(d) Disaster drills shall be conducted at least every six months. (2) The drills shall be documented. This documentation shall be kept in the child care center for at least one year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in facility has not documented emergency drills which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/05/2025
Plan of Correction
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Facility will document future ER Drills on a log and post them on licensing board
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Karen Chambers
NAME OF LICENSING PROGRAM MANAGER:
Portia Bowden
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/22/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/22/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/22/2025 02:07 PM - It Cannot Be Edited


Created By: Portia Bowden On 05/22/2025 at 01:04 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: KING STATE PRESCHOOL
FACILITY NUMBER: 191606400

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/22/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on Interview and record review, the licensee did not comply with the section cited above in 1 out of 1 staff did not have a mandated reporter certificate which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/05/2025
Plan of Correction
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Aide will submit Mandated Reporter Certificate to LPA via Text or Email.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
Karen Chambers
NAME OF LICENSING PROGRAM MANAGER:
Portia Bowden
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/22/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/22/2025


LIC809 (FAS) - (06/04)
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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: KING STATE PRESCHOOL
FACILITY NUMBER: 191606400
VISIT DATE: 05/22/2025
NARRATIVE
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Per PIN 21-21-CCP lead testing to be conducted for all equipment used for drinking consumption. LPAs did not observe Lead testing results. A type B citation will be issued. Per Aide a large pitcher is filled from the communal water dispenser located outside the preschool classroom, Children bring water bottles to fill up and also have access to paper cups. Per Aide pitcher is filled up and taken outside for children’s use. LPAs observed a filtered water system in line with the building water, a large pitcher, as well as paper cups.

LPA observed Disinfectants stored in a cabinet at the front of the classroom on the highest shelf, inaccessible to children in care. Per Aide there are no poisons on the premises. Per Teacher outside food is not permitted in the facility. Facility supplies Breakfast, and Lunch.

Kitchen is located on elementary school campus. All food preparation, and storage areas are clean, free of litter, rubbish, and rodents/vermin. All food is protected from contamination. All storage containers for solid waste, including moveable bins, have tight fitting covers on and are in good repair.



Outdoor play area was observed to be enclosed with playground equipment is in a safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. There is adequate shade in the play yard. LPA advised that no children shall be left without the supervision of a teacher at any time. All floors were observed to be clean and safe. All materials accessible to children were observed to be toxic free. There are no firearms stored on the premises. There are no pools or bodies of water at the facility. Per Aide outdoor area is shared with TK class on a staggered schedule.

LPAs did not review a Current Mandated Reporter certificates for Teacher or aide. Per Aide she will obtain one and submit certificate to LPA via email. A Type B citation will be issued. LPAs did not observe a Pediatric CPR/ First Aid for teacher or Aide. Per Aide she does not have one, a type B deficiency will be issued.

LPAs reviewed 5 Children’s files and observed them to be complete.

The name of the child care center director or fully-qualified teacher(s) designated to act in the director’s absence has been reported to the Department. The person who signs the child in/out of the facility shall use their full legal signature and record the time of day.

NAME OF LICENSING PROGRAM MANAGER: Karen Chambers
NAME OF LICENSING PROGRAM ANALYST: Portia Bowden
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2025
LIC809 (FAS) - (06/04)
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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: KING STATE PRESCHOOL
FACILITY NUMBER: 191606400
VISIT DATE: 05/22/2025
NARRATIVE
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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.

Licensee was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for


drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.
For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).
LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

NAME OF LICENSING PROGRAM MANAGER: Karen Chambers
NAME OF LICENSING PROGRAM ANALYST: Portia Bowden
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2025
LIC809 (FAS) - (06/04)
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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: KING STATE PRESCHOOL
FACILITY NUMBER: 191606400
VISIT DATE: 05/22/2025
NARRATIVE
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Facility representative was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

Three Type B Deficiencies were observed during today’s inspection for lead testing, mandated reporter certificate, and CPR Certificate.

Exit interview conducted and report was reviewed with Office Staff Ms Skinner, Appeal Rights, and A notice of site visit was given and must remain posted for 30 days

NAME OF LICENSING PROGRAM MANAGER: Karen Chambers
NAME OF LICENSING PROGRAM ANALYST: Portia Bowden
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2025
LIC809 (FAS) - (06/04)
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