192006411-7-15-2026-54-CC-BLOT-DVZSE3-20260715134804

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 192006411
Report Date: 07/15/2026
Date Signed: 07/15/2026 04:17:28 PM

Document Has Been Signed on 07/15/2026 04:17 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:	MAYWOOD CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	192006411
ADMINISTRATOR/ DIRECTOR:	JOSEFINA PEREZ		FACILITY TYPE:	850
ADDRESS:	4801 58TH STREET		TELEPHONE:	(760) 942-3433
CITY:	MAYWOOD	STATE: CA	ZIP CODE:	90270
CAPACITY: 48	TOTAL ENROLLED CHILDREN: 48	CENSUS: 17	DATE:	07/15/2026
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:35 AM
MET WITH:	Director, Josefina Perez		TIME VISIT/ INSPECTION COMPLETED:	01:55 PM

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On 7/15/2026, Licensing Program Analyst (LPA) Brittany Lovest conducted an unannounced Annual/Random Inspection for the facility named above. LPA was greeted by Director, JOSEFINA PEREZ and toured the facility both indoors and outdoors and observed a total of 17 children in care, being supervised by 3 staff members. All staff have a criminal record clearance on file. The preschool hours of operation are from 6:30am to 5:00pm Monday- Friday. The facility is currently operating one classroom for full day sessions and offers half day programs during the school year.

The facility is located in the rear lot near YMCA pool. There is a gate surrounding facility and a separating the lot from the swimming pool. There are no swimming pools, ponds, or other bodies of water on the premises of the day care facility.

Capacity and limitations as specified on the license are being maintained during todays’ inspection.

All children are under supervision, including visual supervision, of a teacher at all times. The preschool program is in compliance with Title 22 regulations regarding staff to children ratios.

There are no firearms or ammunition allowed or stored on the premises.

LPA observed a fully charged fire extinguishers in the facility. LPA observed a carbon monoxide detectors in the Classrooms. Additionally, the entire facility has a Pull Fire Alarm system. LPA observed the First Aid Kit inside the classroom backpacks. LPA reviewed the Disaster, earthquake and fire drill log. Earthquake drill log was completed in June 2026.

NAME OF LICENSING PROGRAM MANAGER: Loyce Phillips
NAME OF LICENSING PROGRAM ANALYST: Brittany Lovest
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/15/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2026

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: MAYWOOD CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 192006411
	VISIT DATE: 07/15/2026

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All toilets and hand washing facilities are in safe and sanitary operating condition. The floors in the facility are clean and safe. LPA inspected the classrooms and observed age-appropriate toys, books, and furnishings. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts.

Playground equipment is in safe condition, free of sharp, loose, or pointed parts. The surface of the outdoor activity space is msaintained in a safe condition and is free of hazards. Areas around high climbing equipment and slides have soft padding to absorb falls.

Drinking water is readily available to children both indoors and outdoors.

Solid waste storage containers have tight-fitting covers and are in good repair.

Per Director the facility provides breakfast, am snack lunch and pm snacks to children in care. Menus are posted one month in advance where an authorized representative can view them. All food preparation and storage areas are clean, free of litter/rubbish and free of rodents/vermin. Administration was reminded that copies of the menus as served should be dated and kept on file for at least 30 days.

LPA reviewed a sample of children’s files and observed files were complete with contact information for authorized representatives and relatives or others who can assume responsibility for the child and medical assessment.

Licensing Program Analysts reviewed a sample of staff files and observed files were complete with health screening, immunization records for influenza, pertussis, measles and current documentation of completed Mandated Reporter Training.

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.

NAME OF LICENSING PROGRAM MANAGER: Loyce Phillips
NAME OF LICENSING PROGRAM ANALYST: Brittany Lovest
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/15/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2026

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: MAYWOOD CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 192006411
	VISIT DATE: 07/15/2026

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Incidental Medical Services (IMS) are not being provided. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

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

LPA reminded Director to access the Community Care Licensing website www.ccld.ca.gov for access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations. 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 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.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, there were no deficiencies cited today.

An exit interview was conducted, a copy of this report was read and provided to the Director. LIC 9213 Notice of Site Visit was provided and required to be posted for 30 days.

NAME OF LICENSING PROGRAM MANAGER: Loyce Phillips
NAME OF LICENSING PROGRAM ANALYST: Brittany Lovest
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/15/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2026

LIC809 (FAS) - (06/04)

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