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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197411901
Report Date: 03/20/2025
Date Signed: 03/20/2025 01:27:19 PM

Document Has Been Signed on 03/20/2025 01:27 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:MAPLE PRIMARY CENTER STATE PRESCHOOLFACILITY NUMBER:
197411901
ADMINISTRATOR/
DIRECTOR:		SHARYN CLARKFACILITY TYPE:
850
ADDRESS:3601 S. MAPLE AVE. RM. 100 105TELEPHONE:
(323) 232-0984
CITY:LOS ANGELESSTATE: CAZIP CODE:
90011
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 22DATE:
03/20/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:40 AM
MET WITH:Jorge VillalobosTIME VISIT/
INSPECTION COMPLETED:
01:55 PM
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On 03/20/2025 at 9:40 AM an unannounced Required – Annual inspection was conducted by Licensing Program Analyst (LPA) Claudia Kam. LPA announced purpose of visit and initially met with Jorge Villalobos Principle. Facility is currently licensed for a capacity of 48. The program currently operates Monday thru Friday from 8:02 am to 2:25 pm. LPA was taken on a guided tour of the facility of both indoors and outdoors. Required postings were observed.

The facility is made up of 2 classrooms. At the initial start of the site visit, there is a total census of 22 children and a total census of 4 teachers and 2 staff present. Room 100 had 15 children and 4 staff, Room 105 had 7 children and 2 staff.

Beginning at 10:05 AM, furniture and equipment were inspected for age appropriateness and good repair. LPA observed surface of classrooms to be safe and clean, and child size tables and chairs available for children with rounded edges and well maintained. LPA observed learning stations for dramatic play, math, and science with a variety of age appropriate toys maintained free of loose and sharp parts and a library area available for quiet play. Telephone service, heating, lighting and ventilation were evaluated. There were cubbies observed as storage for children's belongings. Mats/cots were inspected. Per FR, linens are provided by the facility and washed weekly by a laundry service. Availability of drinking water was reviewed. Per FR, water is via personal bottles brought from home and bubbler in classroom with filtered water. Age appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, area safety and sanitation. LPA observed 1 Jack and Jill bathroom available for the classrooms, the bathroom has two toilets and two sinks. Changing table observed in room 100 with privacy screen and diaper supplies. Hazardous items including poisonous cleaning compounds were stored inaccessible to children. Per FR, only LAUSD approved disinfectants are present at the facility, LPA observed these items stored in the cleaning room kept locked at all times located in hopper room.
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SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Claudia Kam
LICENSING EVALUATOR SIGNATURE: DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/20/2025
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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: MAPLE PRIMARY CENTER STATE PRESCHOOL
FACILITY NUMBER: 197411901
VISIT DATE: 03/20/2025
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A first aid kit is kept in the classroom and is located on the far wall near the exit. LPA confirmed carbon monoxide detectors are hardwired to the smoke detector. LPA observed smoke detectors and fire extinguishers are present in the facility. LPA discussed requirement to have fire extinguishers serviced annually and to conduct regular checks of smoke and carbon monoxide detectors to ensure they are in operable condition. Disaster drill last conducted on 2/28/25, per FR drills are conducted weekly. Isolation area for sick children is in the nurse's office. LPA observed the area and child will have full supervision until child is picked up by Authorized Representative. Per FR, they currently do not have children that require medication.

Breakfast and Lunch menus were reviewed and observed posted. Facility provides Breakfast and lunch. Food was reviewed for availability, quantity and appropriateness to children in care. Food is prepared by the district cafeteria and food delivered to the campus. Food is warmed only on site. Food preparation area was toured and found in compliance for safety, cleanliness, and proper storage. Food waste is collected at meal time and waste bags discarded immediately after each meal.

Beginning at 10:15 AM, outdoor equipment was inspected for safety, cushioning material, good repair and age-appropriateness. LPA observed surface of outdoor play areas to be safe and maintained for activities planned such as rubber flooring under play structures, grass area for sports and other activities and smooth flooring for active play. LPA observed a variety of age appropriate toys available play house and kitchen, other toys are brought out at play time as area is shared by the primary school at staggered times. Required shade and fencing were inspected. LPA advised facility representative that the children need to be within the direct care and supervision, including visual supervision of the teachers at all times. The children have access to drinking fountains during outside play. Play area was inspected for hazards and inaccessibility to bodies of water; no bodies of water or hazards observed.

Teacher-child ratios were observed and staff names recorded. Care and supervision was evaluated to determine if the basic needs of children are met and appropriate. Sign-in and out sheets and procedures were reviewed. Personal Rights of children were observed by LPA.

Beginning at 10:45 AM, staff and children’s records were reviewed for completeness. Inspection of required forms was made and documented on the LIC 857 for children and the LIC 859 for staff. LPA did not review confidential staff files during the inspection due to the staff confidential files being stored at the administrative office. CPR card expires on 12/2025 for staff.
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SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Claudia Kam
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025
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: MAPLE PRIMARY CENTER STATE PRESCHOOL
FACILITY NUMBER: 197411901
VISIT DATE: 03/20/2025
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Staff present did have proof of the AB 1207 Mandated Reporter Training certificate on file. All staff and employees have obtained a criminal record clearance or criminal record exemption as a condition of employment with the Los Angeles Unified School District (LAUSD).

The following were discussed:

LPA advised of the requirement to report Unusual Incidents and/or injuries to the parent/guardian and to CCL within the time frame specified by the regulation, this includes any changes as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your location.

LPA advised the facility reprsentative to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

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 in the facility, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed facility. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/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.

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SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Claudia Kam
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025
LIC809 (FAS) - (06/04)
Page: 3 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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: MAPLE PRIMARY CENTER STATE PRESCHOOL
FACILITY NUMBER: 197411901
VISIT DATE: 03/20/2025
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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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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/.

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.



The facility was found in compliance per Title 22 regulations, there will be no deficiencies cited today 3/20/2025.


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

Exit interview conducted and report was reviewed with Principle Jorge Villalobos.

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SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Claudia Kam
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025
LIC809 (FAS) - (06/04)
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