<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198012202
Report Date: 03/27/2025
Date Signed: 03/27/2025 12:11:35 PM

Document Has Been Signed on 03/27/2025 12:11 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:COLLINS STATE PRESCHOOLFACILITY NUMBER:
198012202
ADMINISTRATOR/
DIRECTOR:		GARCIA, ELIDAFACILITY TYPE:
850
ADDRESS:6125 COKE STREETTELEPHONE:
(562) 602-6909
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY: 25TOTAL ENROLLED CHILDREN: 25CENSUS: 11DATE:
03/27/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Program Coordinator- Rita CruzTIME VISIT/
INSPECTION COMPLETED:
12:55 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On March 27, 2025, at 9:15a.m., Licensing Program Analyst (LPA) Keneisha Dunlap arrived at the above facility for the purpose of an unannounced Annual Inspection. LPA Dunlap announced the purpose of the visit and was granted entry into the facility by Teacher - Cecilia Rosas. There are 14 children enrolled, and 11 children present, and 8 staff present at the time of inspection. There are 3 staff present at the time of the inspection. This is a preschool program with the hours of operation Monday- Friday from 7:50a.m-10:50a.m. All adults at the facility were discussed and background and fingerprinted cleared. LPA Dunlap met with Program Coordinator- Rita Cruz at a collateral visit.

LPA observed all posting requirements for operation on the licensing board LIC 203A-License, LIC 610, PUB 393, PUB 269, LIC 9148, LIC 613A, Activity Schedule, and completion testing and remediated lead exceedances.



At 10:10a.m., LPA Dunlap observed the parent board missing monthly/daily/weekly menu. This poses a potential health and safety risk to children in care. Type B violation issued today.

Documentation of current Fire & Earthquake drill was observed with last drill conducted on 1/28/25.
Fire extinguisher(s) observed with a service tag date of 7/22/24.

LPA observed an operable smoke detector, and carbon monoxide detectors.
LPA inspected the classroom was equipped with age-appropriate furniture and learning materials. Classroom has mounted TV, area rugs, reading area, manipulative play area, dramatic play area, arts & craft area, language center, Page 1 of 4
NAME OF LICENSING PROGRAM MANAGER: Karen Chambers
NAME OF LICENSING PROGRAM ANALYST: Keneisha Dunlap
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/27/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 6
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)
Page: 2 of 6
Document Has Been Signed on 03/27/2025 12:11 PM - It Cannot Be Edited


Created By: Keneisha Dunlap On 03/27/2025 at 11:52 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: COLLINS STATE PRESCHOOL
FACILITY NUMBER: 198012202

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/27/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101227(a)(6)
Food Service
(6) Menus shall be in writing and shall be posted at least one week in advance in an area accessible for review by the child's authorized representative. Copies of the menus as served shall be dated and kept on file for at least 30 days. Menus shall be made available for review by the child's authorized representative and the Department upon request.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above in did not have a menu posted or available for review, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/03/2025
Plan of Correction
1
2
3
4
The Program Coordinator will print out a menu and have Teacher post it.
The Program Coordinator and Teacher will ensure that menus will be posted monthly.
The Program Coordinator will email LPA a copy of the menu and showing it posted by POC date.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Karen Chambers
NAME OF LICENSING PROGRAM MANAGER:
Keneisha Dunlap
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 03/27/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/27/2025


LIC809 (FAS) - (06/04)
Page: 3 of 6
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: COLLINS STATE PRESCHOOL
FACILITY NUMBER: 198012202
VISIT DATE: 03/27/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
science area, soft furnishings and age-appropriate tables and chairs. The facility uses a sink with waterspout for drinking source. When the children are outside the facility has a water fountain. The children do not nap in the classroom. The First Aid supplies were inventoried in classroom backpack. All cleaning supplies and/or hazardous materials stored in cabinets and drawers with safety latches. LPA observed classroom, equipment, and materials to be in good condition, free of sharp, loose, or pointed parts.

Classroom has 2 separate Bathrooms for boys and girls. Each bathroom has an age-appropriate sink and 1 toilet. The bathroom was in good working condition.

The playground area has shade structure covering climbing slide structure with wet pour, bikes, balls, and age-appropriate tables and chairs. LPA observed playground care area to be in good condition, free of sharp, loose, or pointed parts.



All electrical outlets are covered.

All trash cans have lids.

The facility does breakfast. The food is prepared in the cafeteria area of the facility. LPA observed the kitchen area where food is distributed to be clean and organized.
LPA Dunlap observed sign in and out sheets for 3/27/25 to have all required parent signatures.

The facility was reminded that smoking is prohibited on the premises.

The isolation area is in the school’s front office when any child is sick.

The Program Coordinator stated they do administer medication to at this time. If children were to have medications that they get training on how to administer the medication. The medication is located in locked a cabinet in the classroom.


The facility uses a landline.

The Program Coordinator stated there are no firearms at the facility.
Page 2 of 4
NAME OF LICENSING PROGRAM MANAGER: Karen Chambers
NAME OF LICENSING PROGRAM ANALYST: Keneisha Dunlap
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2025
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: COLLINS STATE PRESCHOOL
FACILITY NUMBER: 198012202
VISIT DATE: 03/27/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
The Program Coordinator stated that they do not provide transportation for children.

There are no large bodies of water on premises.

At 12:35p.m., LPA Dunlap reviewed Staff Files at a collateral visit.

Staff Files



Staff #1
File has all required licensing documents and immunization record in folder.

CPR expiration date of 10/7/25

Mandated Reporter expiration date of 9/7/26

At 11:15a.m., LPA Dunlap reviewed Children Files at a collateral visit.

Child #1


All required licensing forms, and Immunization record

Child #2


All required licensing forms, and Immunization record

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.

Criminal Record Clearance - Child Care Centers- Program Coordinator- Rita Cruz was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Page 3 of 4

NAME OF LICENSING PROGRAM MANAGER: Karen Chambers
NAME OF LICENSING PROGRAM ANALYST: Keneisha Dunlap
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2025
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: COLLINS STATE PRESCHOOL
FACILITY NUMBER: 198012202
VISIT DATE: 03/27/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Lead Testing

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. 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)

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, a Plan for Providing 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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about

Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

MyChildCarePlan.org

Program Coordinator- Rita Cruz 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.

1 Type B deficiency issued during today’s inspection.

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

Appeal rights reviewed and given to the Program Coordinator- Rita Cruz

Exit interview conducted and report was reviewed with the Program Coordinator- Rita Cruz

Page 4 of 4

NAME OF LICENSING PROGRAM MANAGER: Karen Chambers
NAME OF LICENSING PROGRAM ANALYST: Keneisha Dunlap
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2025
LIC809 (FAS) - (06/04)
Page: 6 of 6