<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191806528
Report Date: 12/02/2025
Date Signed: 12/02/2025 03:45:42 PM

Document Has Been Signed on 12/02/2025 03:45 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:CHILDREN'S HOSPITAL CHILD DEVELOPMENT CENTER (PS)FACILITY NUMBER:
191806528
ADMINISTRATOR/
DIRECTOR:		LAURA HERNANDEZFACILITY TYPE:
850
ADDRESS:4601 SUNSET BOULEVARDTELEPHONE:
(323) 361-4601
CITY:LOS ANGELESSTATE: CAZIP CODE:
90027
CAPACITY: 89TOTAL ENROLLED CHILDREN: 62CENSUS: 38DATE:
12/02/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:55 PM
MET WITH:Director, Laura HernandezTIME VISIT/
INSPECTION COMPLETED:
04:00 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
On December 2, 2025, Licensing Program Analysts (LPA) Priscilla Ochoa conducted an unannounced case management inspection for the above facility. LPA was greeted by the Director, Laura Hernandez, who guided LPA on a tour of the facility. The purpose of this inspection is to follow up on a self-reported incident that occurred at the facility on 10/09/2025. This is a preschool program with a toddler component which operates Monday through Friday from 6:30 am to 6:00 pm. Per director, there are 62 children enrolled, and LPA observed 38 children in care along with 7 staff members.

Brief summary of incident: Child #1 (C1) was left in the bathroom and classroom unsupervised while C1’s class went outside.

During the course of this investigation LPA reviewed video footage of incident, interviewed Staff #1(S1) - Staff #3 (S3) and staff #5(S5). LPA attempted to interview Child 1(C1) but C1 refused to speak with LPA.

LPA reviewed video footage of S5 in the classroom assisting S2 and S3 with bathroom breaks. Video footage displays that 2 children were in the restroom with S2, then S3 comes in to assist. Moments later, S5 is also seen assisting. S2 is then seen leaving the restroom to take the remaining children in the classroom outside. There are still 2 children using the restroom at this time, C1 and C2. S5 and S3 are seen conversating, and S3 is then seen leaving back to S3’s own classroom. Once C2 is done using the restroom, S5 is seen walking C2 outside with the rest of the class. S5 is then seen leaving C1 in the bathroom unattended. C1 is then seen roaming the classroom near the bathroom with no supervision. C1 was left without supervision for approximately 4 minutes.

Page 1 of 2

NAME OF LICENSING PROGRAM MANAGER: Ana Chico
NAME OF LICENSING PROGRAM ANALYST: Priscilla Ochoa
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/02/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4
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)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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: CHILDREN'S HOSPITAL CHILD DEVELOPMENT CENTER (PS)
FACILITY NUMBER: 191806528
VISIT DATE: 12/02/2025
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
26
27
28
29
30
31
32
During interviews, S5 mentions that S5 was not assisting the staff with bathroom breaks. Per S5, they walked into the classroom to retrieve paperwork and observed S2 doing bathroom breaks. S5 was in the process of prepping for a meeting. S3 mentioned that S3 overheard S2 having a hard time with a child which is why S3 was near the bathroom area to assist. S3 also mentioned that once S5 arrived at the bathroom area S3 went back to their own classroom. S3 states before leaving, S3 communicated to S5 that there were 2 children in the restroom. Per S3, S5 acknowledged S3 comment by giving S3 a thumbs up. S5 does recall having a conversation with S3 near in the bathroom area but denies that S3 made them aware that there were 2 children in the bathroom. S5 also recalls walking C2 who was in the bathroom outside where S2 was with the rest of the children. After S5 walked C2 outside, S5 went out of the classroom to finish the parent board. S5 was working on a bulletin board in the main hallway of the facility and observed C1 in the classroom through a classroom glass window to be unsupervised.

The facility has experienced multiple incidents that resulted in being cited Type A deficiencies in recent months. Since this incident, the facility has conducted multiple all staff meetings to discuss supervision and provide staff resources demonstrating what supervision is. LPA will schedule an in-person office meeting with the director, Licensing Program Manager (LPM) and LPA to discuss the facility compliance plan. The facility would also like to schedule an in-person training with the Technical Support Program to better train staff members at the facility to ensure all health and safety regulations are being followed and in compliance with title 22.

LPA P. Ochoa informed director, Laura Hernandez that this report dated 12/2/2025 documents 1 Type A citation which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA P. Ochoa informed the director to provide a copy of this licensing report dated 12/2/2025 that documents any Type A citation(s) to parents/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 (LIC 9224), 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 the director, Laura Hernandez.

Page 2 of 2

NAME OF LICENSING PROGRAM MANAGER: Ana Chico
NAME OF LICENSING PROGRAM ANALYST: Priscilla Ochoa
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2025
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 12/02/2025 03:45 PM - It Cannot Be Edited


Created By: Priscilla Ochoa On 12/02/2025 at 03:07 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: CHILDREN'S HOSPITAL CHILD DEVELOPMENT CENTER (PS)
FACILITY NUMBER: 191806528

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/02/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/09/2025
Section Cited
CCR
101229(a)(1)

1
2
3
4
5
6
7
Responsibility for Providing Care and Supervision. No child(ren) shall be left without the supervision of a teacher at any time... Supervision shall include visual observation.
This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Per Director, they will be scheduling a in person training with Technical Support Program to review supervision and discuss how supervision needs to be maintained at all times with facility's staff members.
8
9
10
11
12
13
14
Based on video footage and interviews, facility did not ensure supervision was maintained at all times which caused C1 to be left without supervision in the bathroom and classroom, which poses an immediate risk to the health, safety, and personal rights of children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Ana Chico
NAME OF LICENSING PROGRAM MANAGER:
Priscilla Ochoa
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 12/02/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/02/2025


LIC809 (FAS) - (06/04)
Page: 4 of 4