197416573-7-1-2025-33-CC-SVAA-DJ6VHX-20250701162753

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197416573
Report Date: 07/01/2025
Date Signed: 07/01/2025 04:28:13 PM

Document Has Been Signed on 07/01/2025 04:28 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:	WILLIAM R. ANTON EARLY EDUCATION CENTER		FACILITY NUMBER:	197416573
ADMINISTRATOR/ DIRECTOR:	CYNTHIA CORCOLES		FACILITY TYPE:	850
ADDRESS:	831 NORTH BONNIE BEACH PLACE		TELEPHONE:	(323) 981-3670
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90063
CAPACITY: 168	TOTAL ENROLLED CHILDREN: 101	CENSUS: 65	DATE:	07/01/2025
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:30 PM
MET WITH:	Scarlett Holguin, Principal		TIME VISIT/ INSPECTION COMPLETED:	04:45 PM

NARRATIVE

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Licensing Program Analyst (LPA) Saul Valenzuela conducted an unannounced Case Management inspection due to three incidents that were reported to the Department on 6/4/2025, 6/6/2025, and 6/23/2025. LPA met with Principal Scarlett Holguin who guided LPA on a tour of the facility. Census was taken.

On June 4th, 2025, an incident was self-reported to the Department via Email by the facility who reported that a child wandered away from the facility.

On June 6th, 2025, an incident was self-reported to the Department via Email by the facility who reported that a child disclosed that their personal rights were violated in care by a staff.

On June 23rd, 2025, an incident was self-reported to the Department via Email by the facility who reported that a child experienced an allergic reaction while in care.

All reports were reported within the required 24 hours. The purpose of the inspection was to obtain additional information regarding the incidents reported to the Department.

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NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Saul Valenzuela
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/01/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2025

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: WILLIAM R. ANTON EARLY EDUCATION CENTER	FACILITY NUMBER: 197416573
	VISIT DATE: 07/01/2025

NARRATIVE

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Regarding the incident that was reported on 6/4/2025, during interviews Staff #2 stated that they observed Child #1 outside of the premises by the emergency gate located next to the office. According to Staff #3 that they observed Staff #4 call for Staff #2 to go grab the child from outside. Per staff that they "believe" that child was outside of the premises for less than 5 minutes. Staff #3 stated that they went out to the playground at 3:00 p.m. and less than 10 minutes later is when Child #1 was found outside by staff. According to Staff that Staff #4 was the first person to observe the child outside near the emergency gate. Staff did not disclosed that they observe the child leave through the gates.

Principal Scarlett Holguin provided LPA a copy of Parent #1 written statement. Per Parent #1 statement that they observed another parent leaving the gate when they were arriving. According to Parent #1 statement that the same parent came back to the office to notify the school that Child #1 was outside by themselves. Parent #1 stated that "I didn't see anyone outside so it must have been quick". Per staff that child was unharmed and did not appeared to be distressed. Staff stated that child must have went through the gates during pick up time by parents.

During the investigation LPA Valenzuela used a tape measure to measure the distance from the entrance of the play yard to the emergency gate where the child was found. It was determined to be a total of 33 feet that the child traveled within a "5 minute" time frame that the staff claim during the time the child was unsupervised.

Regarding the incident that was reported on 6/6/2025, LPA observed written statements that Staff #6 stated that Child #2 was throwing blocks and climbing the playhouse after being told to get down by Staff #6 and #7. Per Staff #7 they tried to redirect Child #2 to prevent the child from throwing blocks and climbing the playhouse. No disclosures were made by staff that child's personal rights were violated.

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NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Saul Valenzuela
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/01/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2025

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: WILLIAM R. ANTON EARLY EDUCATION CENTER	FACILITY NUMBER: 197416573
	VISIT DATE: 07/01/2025

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Regarding the incident that was reported on 6/23/2025, during interviews principal stated that child #2 was experiencing rashes. According to principal that parent was notified to come pick up child from school. Per principal when parent arrived at school that they requested the child's Epi-pen due to the parent stating that the child was having an allergic reaction to coconut. Per staff, that child was signed out from the school, and that parent took Epi-pen with them. According to staff, Parent took child to urgent care, and was told by doctors that child experienced a second hand allergic reaction to coconut. Per principal that they conducted a meeting with staff to discuss food items in the class rooms that can be a potential risk to children in care. According to Staff #5 they do not serve any coconut products at school, and that the child was not experiencing any difficulty breathing or complaining about the rash.

During record review LPA observed Child #2 file that child is allergic to coconut and is prescribed an Epi-pen to administer for allergic reactions. During an Annual inspection on 7/1/2025, LPA observed that Child #2 medication expired on 5/2025. LPA issued a Type-B deficiency for expired medication on 7/1/2025.

Based on LPA's observations record reviews and interviews, 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 and safety. LPA Saul Valenzuela informed facility representative Scarlett Holguin that this report dated 7/1/2025 document(s) 1 Type A citation(s) 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. A copy of this licensing report dated 7/1/25 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 facility representative, Scarlett Holguin.---------------- pg. 3 of 3 ----------------

NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Saul Valenzuela
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/01/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/01/2025 04:28 PM - It Cannot Be Edited

Created By: Saul Valenzuela On 07/01/2025 at 03:54 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: WILLIAM R. ANTON EARLY EDUCATION CENTER	FACILITY NUMBER: 197416573
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/01/2025

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 07/08/2025 Section Cited CCR 101229(a)(1)	1 2 3 4 5 6 7	(a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time...(1). Supervision shall include visual observation.This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Principal has conducted a meeting and training regarding incident with staff. Principal stated they will submit a copy of agenda and signing sheet to LPA by POC Due Date
	8 9 10 11 12 13 14	Based on interviews, the licensee did not comply in the section above which Child #1 was unsupervised which caused child to wandered away from the premises. This poses an immediate health and safety risk to 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.

	Brandi VanOosten
NAME OF LICENSING PROGRAM MANAGER:

	Saul Valenzuela
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/01/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2025

LIC809 (FAS) - (06/04)

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