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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198007425
Report Date: 03/21/2024
Date Signed: 03/21/2024 12:45:46 PM

Document Has Been Signed on 03/21/2024 12:45 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:CERRITOS CHILD DEV. CENTERFACILITY NUMBER:
198007425
ADMINISTRATOR:VANESSA GUZMANFACILITY TYPE:
850
ADDRESS:120 E. CERRITOS AVE.TELEPHONE:
(818) 243-3212
CITY:GLENDALESTATE: CAZIP CODE:
91205
CAPACITY: 85TOTAL ENROLLED CHILDREN: 43CENSUS: 22DATE:
03/21/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Carol Gregory and Perla Leyvas, Site SupervisorsTIME COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced case management inspection on 03/21/24 due to an incident that occurred on Monday, 03/18/24. LPA arrived at the facility at 8:30 AM and met with Perla Leyvas, Program Supervisor who guided analyst on a tour of the facility. During this inspection Carol Gregory was also present in the facility. During this inspection 22 children were present in the facility with 6 staff. This is a preschool program which consists of 4 classrooms; Room 101, Room 104, Room 105, and Room 108. Currently, due to enrollment, Room 101 is half day program and Room 105 and Room 104 are full day programs. There are school age program and Elementary program on this site. All the programs are under Glendale Unified School District.

Alleged Incident took place on 03/18/24. Incident was reported via email to case caring LPA, Eivazian at 4:12 PM, same working day. The facility reported the incident within the required 24 hour time frame.

LPA Eivazian conducted interviews with four staff. LPA obtained copies of documents from school internal investigation. LPA obtained 03/18/24 sing in/out sheet.

Based on interviews that were conducted with Staff#1 (S1) and Staff#2 (S2), on 03/18/24, first day of spring camp, there were 8 children present in Room 105 with three staff. Child#1 (C1) was dropped off at 8:00 AM. Per S2, she left the classroom 105 at 8:15 AM to bring morning snack, at that time C1 was present in the classroom. Per S1, once S2 left the classroom to bring snack, S1 was with four children on a table doing an activity, S5 took C2 to the bathroom, which is located in the classroom. Per S1, once S5 came out from bathroom noticed C1 was not present in the classroom. Per S1, they checked the bathroom and other classrooms did not find C1. Per S1, she went to the outdoor playarea and observed C1 on the playground. Per S1 and S2, the incident occurred anytime between 8:15 AM to 8:25/8:30 AM. Per S1 and S2, they did not observe when and how C1 left the classroom and left the school.

REPORT CONTINUES ON NEXT PAGE 1 OF 3
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE: DATE: 03/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/21/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: CERRITOS CHILD DEV. CENTER
FACILITY NUMBER: 198007425
VISIT DATE: 03/21/2024
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Per Staff #3 (S3), while S3 was passing by the school main entrance gate, facing Cerritos Avenue, S3, heard two adults (one female and one male) stated one child is outside the school. S3 went outside the gate and observed C1 was standing by the grass area outside the school. Per S3, she asked C1 to go inside, at that time C1 ran towards the Brand Blvd. Per S3, by the help of a male and a female unknown parents, they were able to catch C1 in the corner of Cerritos Avenue and Brand Blvd. and brought the C1 back to the school.

Per Staff#4(S4) C1 parents and school district were informed. Effective 03/18/24, for rest of the week, during Spring camp only, a staff will be present by the gate all the times.

Based on LPA's observations, C1 left Room 105, and went to main gate which LPA counted 43 foot steps, opened the gate which has push bar and left the school. C1 was found by two parents (one male and one female) on grass area in front of the school, 33-34 foot steps away from the main gate. Based on staff interviews, they did not observe when and how C1 left the school.

Based on LPA observations and interviews which were conducted and record reviews, the preponderance of evidence standard has been meet, therefore the above incident that occurred on 03/18/24 and child#1 was wondered away from facility is found to be Substantiated at this time. California Code of Regulations, 101229(a) (1)-- Responsibility for Providing Care and Supervision--(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, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation and Personal Rights-- 101223(a)(2)--Per The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs are being cited on the attached LIC9099D.

LPA Anomeh Eivazian informed Program Supervisor, Perla Leyvas that this report dated 03/21/24 documents 2 of Type A citations. Type A citations which shall be posted for 30 consecutive days as there is immediate risks to the health, safety, or personal rights of children in care.

REPORT CONTINUES ON NEXT PAGE 2 OF 3
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 03/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/21/2024 12:45 PM - It Cannot Be Edited


Created By: Anomeh Eivazian On 03/21/2024 at 11:39 AM
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: CERRITOS CHILD DEV. CENTER
FACILITY NUMBER: 198007425

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/21/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/22/2024
Section Cited
CCR
101229(a)(1)

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Responsibility for Providing Care and Supervision--(a)The licensee shall provide care and supervision as necessary to meet the children's needs. etc...

This requirement was not met as evidence by...
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Per Program Supervisor, Perla Leyvas, effective 03/18/24, a staff is present by the main gate all day long. A meeting will be held with staff to talk about active supervision and staff communication.
A written plan will be submitted to LPA by 03/22/24.
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Based on four staff interviews, On 03/18/24, Child#1 left the classroom 105 and left the school anytime between 8:15 AM to 8:25/8:30 AM and was found 33-34 foot steps away from the school. This poses an immediate health, safety and personal right risk to the children in care.
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$500 Civil Penalty was accessed.
Type A
03/22/2024
Section Cited
CCR101223(a)(2)

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The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs
This requirement was not met as evidenced by...
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Per Program Supervisor, Perla Leyvas, effective 03/18/24, a staff is present by the main gate all day long. A meeting will be held with staff to talk about active supervision and staff communication.
A written plan will be submitted to LPA by 03/22/24.
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Based on four staff interviews, On 03/18/24, Child#1 left the classroom 105 and left the school anytime between 8:15 AM to 8:25/8:30 AM and was found 33-34 foot steps away from the school. This poses an immediate health, safety and personal right risk to the children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Christina Gabelman
LICENSING EVALUATOR NAME:Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:
DATE: 03/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/21/2024


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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: CERRITOS CHILD DEV. CENTER
FACILITY NUMBER: 198007425
VISIT DATE: 03/21/2024
NARRATIVE
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Also, LPA Anomeh Eivazian informed the Program Supervisor, Perla Leyvas to provide a copy of this licensing report dated 03/21/24 that documents 2 Type A citations 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.

The Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Perla Leyvas at 1:00 p.m..
REPORT END 3 of 3
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 03/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2024
LIC809 (FAS) - (06/04)
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