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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198002801
Report Date: 08/18/2025
Date Signed: 08/18/2025 11:58:44 AM

Document Has Been Signed on 08/18/2025 11:58 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:NUEVA MARAVILLA CHILD DEVELOPMENT CENTERFACILITY NUMBER:
198002801
ADMINISTRATOR/
DIRECTOR:		CLAUDIA GUTIERREZFACILITY TYPE:
850
ADDRESS:4909 CESAR E. CHAVEZ AVENUETELEPHONE:
(323) 981-0028
CITY:LOS ANGELESSTATE: CAZIP CODE:
90022
CAPACITY: 76TOTAL ENROLLED CHILDREN: 34CENSUS: 23DATE:
08/18/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:11 AM
MET WITH:Silvia Gonzalez-CamposTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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Licensing Program Analyst (LPA) Veronica Martinez Garza conducted an unannounced Case Management Incident inspection at the above facility on 08/18/25 at 09:11 a.m. The purpose of this inspection is to follow up on an incident reported to the Department on 08/12/25. LPA met with Site Director, Silvia Gonzalez-Campos who guided LPA on a tour of the facility. Census was taken.

On 08/08/25 at approximately 03:34 p.m. Child #1 (C1) was participating in a music and movement activity in the block area of the Older Preschool Classroom. C1 was dancing, spun around, lost their balance, fell, and hit their forehead on the corner of the shelf. C1 began to bleed and Staff #4 immediately provided first aid. S2 assisted as well in providing first aid and then called S1 for assistance. S1 took over and once there was no blood observed, parents of C1 were called. C1 was picked up, parents were given an ouch report and was taken to the hospital and received stitches. According to S1, the child returned on 08/12 without restrictions; however, parents did not provide a doctor’s note. S1 stated that the doctor’s note has been requested via Class Dojo. LPA conducted interviews with C2 who made no disclosures. Interviews with C3 revealed that during the music and movement activity they should be careful with the shelf and then child pointed to their head. C3 then imitated what it is believed to have observed C1 fall and hit their head on the shelf. LPA toured the area of where the incident occurred and observed furniture is age appropriate and in good repair. LPA took a picture of the shelf and did not observe any sharp edges.

Interviews revealed that C1 has a lot of energy and is constantly redirected when there’s a safety concern due to the child’s excitement during an activity. Per staff, this is the first incident involving C1 and there are no concerns regarding the child’s behavior. The facility has hired additional staff to shadow children when needed. Per S1, the facility is also working with the family of C1 to meet the child’s needs.

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NAME OF LICENSING PROGRAM MANAGER: Ana Chico
NAME OF LICENSING PROGRAM ANALYST: Veronica Martinez-Garza
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 08/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/18/2025
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: NUEVA MARAVILLA CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 198002801
VISIT DATE: 08/18/2025
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LPA discussed with the site director reporting requirements since the department received the incident report on 08/12. Per site director, the unusual incident report was faxed on 08/11; however, there was an error message received. The site director then called the Monterey Park Regional Office to confirm if the fax machine was working. Once confirmed that the fax machine was working, the site director was given the email address to submit the unusual incident report. The unusual incident report was submitted; however, an error message was received until the next day. Site director then received the correct email address and submitted the unusual incident report. Due to the technical difficulties the unusual incident report was not received in a timely manner. LPA advised that if there are technical difficulties it is best to call the regional office and speak with the On-Duty LPA to report any unusual incidents.

Also, during the walk through of the facility LPA observed that the cushioning material that absorbs a fall is torn. Per site director, the area will be patched. LPA provided a technical violation.

During this inspection, LPA interviewed Staff 1 (S1 thru 4), Child 2 (C2 thru 3).



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

The Notice of Site Visit (LIC 9213) must remain posted for 30 days during the hours of operation after each site visit by a licensing representative, a civil penalty of $100 can be assessed.

An exit interview was conducted, and a copy of this report was provided to site director Silvia Gonzalez-Campos.


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NAME OF LICENSING PROGRAM MANAGER: Ana Chico
NAME OF LICENSING PROGRAM ANALYST: Veronica Martinez-Garza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2025
LIC809 (FAS) - (06/04)
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