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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192002562
Report Date: 06/03/2025
Date Signed: 06/03/2025 11:46:58 AM

Document Has Been Signed on 06/03/2025 11:46 AM - 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:ANGELINA PRESCHOOLFACILITY NUMBER:
192002562
ADMINISTRATOR/
DIRECTOR:		PEREZ, ADRIANAFACILITY TYPE:
850
ADDRESS:1336 ANGELINA STREET #108TELEPHONE:
(213) 481-0227
CITY:LOS ANGELESSTATE: CAZIP CODE:
90026
CAPACITY: 73TOTAL ENROLLED CHILDREN: 48CENSUS: 42DATE:
06/03/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:20 AM
MET WITH:Adriana Perez, Program DirectorTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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On Tuesday June 3, 2025, Licensing Program Analyst (LPA) Joanne Solorio Campos conducted an unannounced annual inspection and met with Program Director Adriana Perez, and Site Supervisor Min Hwa Lee. Program Director guided LPA on a tour of the facility. This is a preschool age program that serves children 3-5 and consists of 3 classrooms. This program operates Monday – Friday from 7:00 a.m. – 5:00 p.m. Per the Director, there are 48 children enrolled. Teacher and child ratio were observed; 42 children and 8 staff. Present staff are fingerprinted cleared.

All areas identified on the facility sketch were toured and inspected both indoors and outdoors. The facility is in an apartment complex and operates separately, having an entrance door facing the street. LPA entered the 3 classrooms and observed furniture, manipulatives, toys, games, books and art materials made accessible to the children to be age appropriate and free of sharp, loose, or pointed parts. LPA observed each classroom has a cubby for children to store their personal belongings. Water gallons were observed in the classrooms along with cups readily available for the children. For napping, cots were observed to be stored in the classroom and each with a tight-fitted sheet. Licensing staff observed trash bins with a tight-fitting lid inside the classrooms. LPA observed the children’s restroom, located in classroom P2 to have working toilets, sinks, hand soap dispenser and paper towels.

NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Joanne Solorio Campos
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/03/2025
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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: ANGELINA PRESCHOOL
FACILITY NUMBER: 192002562
VISIT DATE: 06/03/2025
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Heating, lighting, and ventilation were evaluated by LPA. LPA observed central AC/heater and vents located on the ceiling. LPA observed the thermostats located in the classrooms and temperatures to be between 70-71 degrees. LPA observed the fire extinguishers in the classroom and the valve on the required 2A10BC fire extinguishers indicating fully charged and serviced on 9/18/24. Smoke detectors were observed to be combined with the carbon monoxide detectors and are operable. A sprinkler system was also observed to be in place. The last emergency drill was conducted on 5/7/25. First aid kit supplies are kept inside the classrooms and LPA observed the kit to be fully equipped. During time of inspection LPA observed cleaning solutions stored in the kitchen in a top cabinet and are inaccessible to the children as the kitchen is an off-limits area. Director stated that they currently do not have any children on medication or severe food allergies. LPA asked if there were any poisons, firearms, weapons, or bodies of water and licensee stated they had none of the above mentioned, LPA did not observe any. LPA observed the ill isolation area to take place in the front office.

Licensing staff entered the outdoor play area and observed the two separated playground yards to be fully fenced. Per Program Director, one play yard is shared with the family childcare providers in the apartment complex while it is not in use by the facility. The outdoor play equipment was observed to be free of sharp, lose or pointed parts. Outdoor activity space surface is maintained in a safe condition as is free of hazards. Areas around and/or under climbing equipment have a cushioning material to absorb a fall. Drinking water is readily available outdoors. There is adequate shade in the play yard.


Per Program Director, the facility provides breakfast, am snack, lunch and pm snack and utilize a food program for a portion of the meals. Per Director, meals are not prepared in the facility as they are delivered and only kept warm and then served. LPA informed licensee that any food brought from the children's homes, the container shall be labeled with the child's name and properly stored or refrigerated. LPA entered the kitchen located in the P2 classroom and was observed to have a locked door in place as it is off limits to the children. The knives were observed to be stored in a top cabinet making it inaccessible for the children to reach and open. The kitchen and the facility were observed to be free of flies, other insects, and rodents.

The following documents were posted in a prominent, publicly accessible area at the facility: Facility License, Notification of Parents' Rights (PUB 393), Personal Rights (LIC 613A), Menu, and Earthquake Preparedness (LIC 9148). PUB 269 Child Passenger System Poster, and Daily Schedule.

NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Joanne Solorio Campos
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2025
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: ANGELINA PRESCHOOL
FACILITY NUMBER: 192002562
VISIT DATE: 06/03/2025
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Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. LPA reviewed the children’s roster, children’s files and staff files and observed the files to be complete.

LPA observed Site Supervisor’s Min Hwa Lee’s Pediatric First Aid/CPR certification and expires 11/18/25. Director has proof of immunization against Pertussis, MMR, and Influenza declination. Director has completed the mandated reporter (AB 1207) training and expires 6/15/25. Director was advised that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com

Program Director 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 21-21.1CCP).
LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.
Lead testing was completed on 12/16/22 and had no lead exceedances.

LPA discussed the safe sleep regulations with Licensee 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 licensee 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.
NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Joanne Solorio Campos
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2025
LIC809 (FAS) - (06/04)
Page: 4 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: ANGELINA PRESCHOOL
FACILITY NUMBER: 192002562
VISIT DATE: 06/03/2025
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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/.

Director 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.

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.


At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.

A notice of site visit was given and must remain posted for 30 days.

Exit interview was conducted and report was reviewed with Adriana Perez.

Appeal Rights were provided and discussed.
NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Joanne Solorio Campos
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2025
LIC809 (FAS) - (06/04)
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