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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191806530
Report Date: 03/13/2025
Date Signed: 03/13/2025 05:02:34 PM

Document Has Been Signed on 03/13/2025 05:02 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 INFANT CARE CENTERFACILITY NUMBER:
191806530
ADMINISTRATOR/
DIRECTOR:		LAURA HERNANDEZFACILITY TYPE:
830
ADDRESS:4601 SUNSET BOULEVARDTELEPHONE:
(323) 361-4601
CITY:LOS ANGELESSTATE: CAZIP CODE:
90027
CAPACITY: 27TOTAL ENROLLED CHILDREN: 37CENSUS: 8DATE:
03/13/2025
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Laura Hernandez, DirectorTIME VISIT/
INSPECTION COMPLETED:
05:10 PM
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On 3/13/2025 at 1:00 p.m., Licensing Program Analyst (LPA) Saul Valenzuela conducted an unannounced required inspection. LPA met with Site Supervisor, Marife Adriano, and Director, Laura Hernandez who guided LPA on a tour of the facility. This is a preschool age program located across the street of the Children's Hospital Los Angeles. Facility is currently licensed for a capacity of 27 children. and operates Monday – Friday from 6:30 a.m. – 8:00 p.m. Per the Site Supervisor there are 37 children enrolled. Facility also has an preschool program, license number 191806528.

All areas identified on the Facility Sketch were inspected. The following staff were present during this inspection: Infant 1: one staff with 2 infants; Infant 2: two staff with 6 children. Teacher-child ratios were observed to be in accordance with Title 22 Regulations. Staff names were recorded. LPA confirmed all individuals present have obtained a criminal record clearance. All children were observed by LPA to be under supervision, including visual supervision, of a teacher at all times. The licensed facility is within the conditions, limitations, and capacity specified on the license.



All areas were inspected and the following was observed:Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Infant changing tables have a padded surface no less than one inch thick and are covered with washable vinyl or plastic and have raised sides at least three inches high. Changing table is within an arm’s reach of a hand washing sink. Toys were observed to be clean. Napping equipment including cribs, mats and bedding were inspected for good condition. Per Director, crib sheets are washed on a daily basis. There are safe toys, play equipment and materials observed for children in the classrooms. Page 1 of 4
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE: DATE: 03/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/13/2025
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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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 INFANT CARE CENTER
FACILITY NUMBER: 191806530
VISIT DATE: 03/13/2025
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Per Director, the isolation area is located in the office, and one staff member will provide 100% supervision until ill child is picked up from the facility.

Per Director, facility provides food and water, and parent provide the bottles. Bottles, dishes, and containers were observed by LPA to be labeled with infants’ names. LPA observed the facility to have an operable carbon monoxide detector on this day. Last Disaster Drill was conducted on 1/21/25. LPA advised that a disaster drill must be completed once every 6 months. LPA observed all required posted forms to be posted in the lobby..

Disinfectants, cleaning solutions, medications and other items that are dangerous to children, were inaccessible to children. Per Director, there are no poisons on the premises. First aid kits were located in each classroom and observed to have complete supplies. All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish, rodents, and/or any other vermin. LPA observed all storage containers for solid waste, including moveable bins have tight-fitting covers that are kept on, and in good repair and trash cans used to discard food have tight fitting lids. LPA observed the floors to be clean and safe.

Outdoor 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 are safe toys, play equipment and materials observed for children outside on playground.

Staff records were reviewed. LPA observed at least one person trained in Pediatric CPR and Pediatric First Aid present during this inspection. LPA observed staff immunization records (Influenza, Measles, and Pertussis) to be complete for files reviewed. During record review, LPA observed that 3 out 7 staff did not have current Mandated Reporter.
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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2025
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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: CHILDREN'S HOSPITAL INFANT CARE CENTER
FACILITY NUMBER: 191806530
VISIT DATE: 03/13/2025
NARRATIVE
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Children’s Records were reviewed and inspection of required forms were made. In review of children’s records, files contain information including, but not limited to the following: Name, address and telephone number of the child's authorized representative and of relatives or others who can assume responsibility for the child if the authorized representative cannot be reached when necessary. LPA observed and reviewed Sleep logs and Needs and Services Plans for the infants.

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.

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.

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. PIN 22- 05-CCP


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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2025
LIC809 (FAS) - (06/04)
Page: 3 of 5
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 INFANT CARE CENTER
FACILITY NUMBER: 191806530
VISIT DATE: 03/13/2025
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LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care­ licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.


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-carecenters/. LPA observed that 1 out of 2 infants did not have an original packaging for their medication with an unaltered label indicating the child's name. Per Director, they will return medication to parent or discard medication.

Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.


A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with facility representative Laura Hernandez. Page 4 of 4
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/13/2025 05:02 PM - It Cannot Be Edited


Created By: Saul Valenzuela On 03/13/2025 at 03:50 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 INFANT CARE CENTER
FACILITY NUMBER: 191806530

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/13/2025

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 record review, the licensee did not comply with the section cited above in 3 out of 7 staff did not have current Mandated Reporter on file, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/10/2025
Plan of Correction
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Director stated that they will have staff complete Mandated Reporter and send to LPA by POC due date.
Type B
Section Cited
CCR
101226(e)(3)(A)
Health-Related Services
(e) In centers where the licensee chooses to handle medications: (3) Prescription medications may be administered if all of the following conditions are met: (A) Prescription medications shall be administered in accordance with the label directions as prescribed by the child's physician.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in 1 out of 2 infants did not have a unaltered label on their medication, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/03/2025
Plan of Correction
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Director stated that the family no longer attends the program and will either provide the medication back to the family or dispose of the medication.
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:Brandi VanOosten
LICENSING EVALUATOR NAME:Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:
DATE: 03/13/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/13/2025


LIC809 (FAS) - (06/04)
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