191607980-9-5-2025-54-CC-JESA-DL8T9S-20250905143226

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191607980
Report Date: 09/05/2025
Date Signed: 09/05/2025 02:32:49 PM

Document Has Been Signed on 09/05/2025 02:32 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:	LBUSD-HOLMES CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	191607980
ADMINISTRATOR/ DIRECTOR:	CHRISTINA CORTEZ		FACILITY TYPE:	850
ADDRESS:	5020 BARLIN AVENUE		TELEPHONE:	(562) 531-8519
CITY:	LAKEWOOD	STATE: CA	ZIP CODE:	90712
CAPACITY: 21	TOTAL ENROLLED CHILDREN: 24	CENSUS: 5	DATE:	09/05/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:20 PM
MET WITH:	Coordinating Teacher Annaquite Featherstone		TIME VISIT/ INSPECTION COMPLETED:	02:45 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Jeanette Estrada conducted an unannounced annual inspection at the facility. LPA met with Coordinating Teacher (CT) Annaquite Featherstone and advised her of the reason for the visit. CT provided a tour of the facility. This is a preschool program located on the premises of Holmes Elementary school. This preschool program operates Monday - Friday in two half day sessions in classroom B36. The AM session operates from 8:00 AM to 11:00 AM and the PM session operates from 12:00 PM to 3:00 PM. LPA arrived during the PM session and observed 5 children supervised by 4 staff. At this time per CT there are 16 children enrolled in the AM session and 8 children enrolled in the PM session. The facility was observed to be within the license capacity and limitations. LPA inspected all areas used by children in the program. The entrance to the preschool is located on Hardwick Street. Children are escorted to the classroom by their parent and they complete the sign in procedures. In the classroom LPA observed age appropriate toys, furniture and materials available for children. There is ventilation and heating, telephone service and floors are maintained clean without hazards. LPA observed cubbies available for children to place their belongings. All documents required to be posted were observed upon the entrance to the classroom. Cleaning supplies are kept in a latched cabinet under the hand washing sink in the classroom. There is no nap time offered at this facility due to it being a half day program. There is a rest/relaxation area available to children if needed. Per CT the isolation area in case a child becomes sick is in the elementary school's nurse's office or CDC staff lounge. LPA observed medication is kept in a locked box in the classroom inaccessible to children in care. There is one child enrolled in the PM session who requires medication. LPA reviewed medication and verified it is not expired. A first aid kit is also kept in the classroom. LPA observed an operable carbon monoxide detector in the classroom.

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Jeanette Estrada
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/05/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2025

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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LBUSD-HOLMES CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 191607980
	VISIT DATE: 09/05/2025

NARRATIVE

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Drinking water is available via personal water bottles which are filled from the water fountains if needed. The facility tested for lead in drinking water in July 2023 and no lead exceedances were detected.
There are two restrooms available for children to use located in the classroom. Each restroom was observed to have one toilet and one sink, supplies and was observed to be in clean and sanitary condition for children in care. Per CT the program assists with potty training. Potty training supplies are provided by parents.
LPA toured the outdoor area. The outdoor area is fully enclosed. LPA observed drinking fountains available for children in care. There is adequate shade. Outdoor equipment is in a safe condition, free of sharp, loose or pointed parts. All areas around or under high climbing equipment and similar equipment are cushioned with material that absorbs a fall. Per CT, staff are spread throughout the yard for supervision. There are two storage sheds in the yard which are off limits to children. Per CT, if children need to use the restroom, they are escorted back to the classroom.
No poisons are kept in the classroom. There are no pools or bodies of water on the campus. There are no fire arms/weapons on the campus. Parents use an iPad for digital sign in/sign out using the Care Connect App. Disaster drills are conducted monthly during the school year. The last documented drill for the center was conducted on 6/4/25. A drill has not been conducted yet for this school year.
The facility provides breakfast for the AM session and lunch for the PM session. Food is brought to the classroom from the cafeteria and children have lunch in the classroom. Children with allergies or with food accommodations are provided alternatives and lists are posted in the classroom. Menus are posted for 30 days and a copy is also provided to parents.
LPA reviewed children's records and they were observed to contain all required documents.
Staff records were reviewed. At least one staff maintains a valid pediatric first aid/cpr certification which expires in June 2027. LPA reminded staff that pediatric first aid/cpr and mandated reporter for child care providers training certificates must be renewed every two years.

Facility Representative 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.

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Jeanette Estrada
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/05/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2025

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: LBUSD-HOLMES CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 191607980
	VISIT DATE: 09/05/2025

NARRATIVE

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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.
This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and
administrative records.
For IMS information see PIN 22-02-CCP. 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/.
Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

No citations were issued during today's inspection. A notice of site visit was given to Facility Representative and must remain posted for 30 days.
Exit interview conducted and report was reviewed with CT Annaquite Featherstone.

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Jeanette Estrada
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/05/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2025

LIC809 (FAS) - (06/04)

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