198006455-10-22-2025-33-CC-SPEY-DMPTKD-20251022144747

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198006455
Report Date: 10/22/2025
Date Signed: 10/22/2025 02:48:05 PM

Document Has Been Signed on 10/22/2025 02:48 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:	MAOF/WMMC-RAINBOW CHILDREN'S CENTER		FACILITY NUMBER:	198006455
ADMINISTRATOR/ DIRECTOR:	MARIA ELENA JACOBSMEIER		FACILITY TYPE:	850
ADDRESS:	1803/1807 PENNSYLVANIA AVENUE		TELEPHONE:	(323) 826-5311
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90033
CAPACITY: 46	TOTAL ENROLLED CHILDREN: 46	CENSUS: 36	DATE:	10/22/2025
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:25 PM
MET WITH:	Director, Maria Elena Jacobsmeier		TIME VISIT/ INSPECTION COMPLETED:	03:00 PM

NARRATIVE

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On October 22, 2025, Licensing Program Analyst (LPA) Staicy Perry conducted an unannounced case management incident inspection at the above facility. This visit was in response to a self-reported unusual incident submitted to the Department on October 20, 2025. Upon arrival, LPA Perry met with MARIA ELENA JACOBMEIER, director. LPA Perry explained the purpose of the visit, and a walk through of the facility was conducted. During the inspection, LPA Perry observed 36 children in care, and the facility was found to be operating within its licensed capacity and maintaining appropriate staff-to-child ratios.

On October 20, 2025, the Department received an Unusual Incident Report (LIC 624) and call on regarding an incident that occurred at the facility on October 17, 2025. The facility reported the incident to the Department within the required time frame, per Title 22 regulations. The incident involved Child #1, who was playing in the house area in the outdoor play area and holding onto a window when a peer closed the window, causing Child #1’s right hand ring finger to be pinched. Staff interviewed stated, S#2 observed the incident immediately rendered first aid. Parents were notified right away and informed staff they would take Child #1 to the doctor as a precautionary measure. Parents did not disclose or confirm if Child #1 was taken to seek medical attention. Child returned the following day and with no restrictions.

During today’s inspection, LPA Perry conducted staff interviews,photos obtained, observed the facility environment in the outdoor play area, and reviewed incident documentation. Based on the information gathered. Staff responded appropriately at the time of the incident. S#2 did have supervision on the incident. The facility reported the incident in a timely manner. LPA attempted several times to reach parents of C#1 and was unsuccessful.

There is no evidence to substantiate a violation of Title 22 regulations. The facility is operating in compliance with Title 22 at this time. No deficiencies are being cited. A Notice of Site Visit was issued and must remain posted for 30 consecutive days. An exit interview was conducted with the Director MARIA ELENA JACOBMEIER. Appeal Rights were discussed and provided.

NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Staicy Perry
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2025

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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