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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198014559
Report Date: 08/19/2026
Date Signed: 08/19/2026 08:12:23 PM

Document Has Been Signed on 08/19/2026 08:12 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:BPUSD-CHARLES BURSCH ELEMENTARY SCHOOLFACILITY NUMBER:
198014559
ADMINISTRATOR/
DIRECTOR:		RICARDO RIVERAFACILITY TYPE:
850
ADDRESS:4245 N. MERCED AVENUETELEPHONE:
(626) 962-3311
CITY:BALDWIN PARKSTATE: CAZIP CODE:
91706
CAPACITY: 24TOTAL ENROLLED CHILDREN: 9CENSUS: 0DATE:
08/19/2026
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:50 PM
MET WITH:Elizabeth Gaytan, Education SupervisorTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
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On Wednesday August 19, 2026, Licensing Program Analyst (LPA) Joanne Solorio Campos conducted an unannounced annual inspection and met with Education Supervisor Elizabeth Gaytan, who guided LPA on a tour of the facility. This facility is located on the campus of Charles Bursch Elementary School; the facility is located behind the elementary school and is accessible through Walnut St. This is a Preschool Program that serves children ages 3 years to 5 years old. The HeadStart program operates Monday-Friday from 8:00am to 2:30pm. Per Education Supervisor there are 9 children enrolled.

Sign in and out takes place at the main entrance area electronically through the Child Plus app. All areas identified on the facility sketch were toured and inspected both indoors and outdoors. Teacher and child ratio were observed, and present staff are fingerprinted cleared. The Education Supervisor stated no firearms, weapons, no poisons nor bodies of water are located in the premises and LPA did not observe any of the above mentioned.

The following documents were posted in a prominent, publicly area front lobby: Facility License, Notification of Parents' Rights (PUB 393), Personal Rights (LIC 613A), Menu, and PUB 269 Child Passenger System Poster, and Daily Schedule.

LPA entered the classroom and observed 0 children and 3 staff present. Children are currently on a minimum day schedule and were dismissed 11am. LPA observed age-appropriate furniture and equipment to be free of sharp, not loose, or pointed parts and age-appropriate books, toys and manipulatives accessible to children. LPA observed cleaning solutions stored in the inaccessible kitchen under the sink with a child proof lock making them inaccessible to children. Licensing staff observed trash bins with lids. LPA observed children’s personal items to be in individual bins. Mats were observed for napping equipment.

Katrina Chicote
Joanne Solorio Campos
DATE: 08/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/19/2026
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: BPUSD-CHARLES BURSCH ELEMENTARY SCHOOL
FACILITY NUMBER: 198014559
VISIT DATE: 08/19/2026
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LPA observed central AC /heater and vents located on the ceiling. LPA observed the thermostat located in classroom and the temperature at 72 degrees. LPA observed the fire extinguishers located in classroom and the valve on the required 2A10BC fire extinguishers indicating fully charged and serviced on 6/31/26. Smoke detectors were not tested during this visit due to the detectors being wired to the emergency pull down fire alarm system. Carbon monoxide detectors are in each classroom and are operable. The last emergency drill was conducted on 05/2026.

First aid kits supplies are kept inside the classroom, and LPA observed the kits to be fully equipped. During this visit, teacher stated there are no children with severe food allergies nor medication. Director stated the ill isolation area takes place in the teacher’s office and children utilize the staff restroom.

Licensing staff observed the outdoor play area to be fenced all around and the gates closed. The play yard equipment was observed to be free of sharp, no loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. LPA observed the play structure equipment to be age appropriate and areas around or under climbing equipment, are cushioned with material that may absorb a fall. For adequate shade, LPA observed trees and a canopy. For outdoor water drinking, children bring their own water bottles and water gets refilled as needed and LPA also observed water jugs and cups available.

This program provides breakfast, lunch and p.m. snack and is provided by the school cafeteria. Licensing staff informed director that any food brought from the children's homes should be labeled with the child's name and properly stored or refrigerated. For indoor water drinking, water was observed to be available for children. LPA observed the food preparation area to be clean and free of litter, rubbish, rodents, and/or any other vermin and storage containers for solid waste, including movable bins with tight-fitting covers that are kept on. The facility was observed to be free of flies, other insects and rodents.

LPA Solorio-Campos reviewed the children’s roster, children’s files, staff files, and sign in/out sheets and were observed to be complete.

There is at least one staff trained in CPR and Pediatric First Aid present during this inspection. Staff also have proof of immunization against Pertussis, MMR, and Influenza. All staff have completed the mandated reporter (AB 1207) training. Education Supervisor was advised that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com

NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Joanne Solorio Campos
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2026
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: BPUSD-CHARLES BURSCH ELEMENTARY SCHOOL
FACILITY NUMBER: 198014559
VISIT DATE: 08/19/2026
NARRATIVE
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Licensee 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.

CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES. 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 as specified in Health and Safety Code section 1597.16.

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 (Interim Licensing Standards) outlined in PIN 21-21.1-CCP. LPA referred licensee to the Department website for lead: Lead Toxicity Prevention and Water Testing Information (https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information) Lead testing was conducted on 12/2023 and had no lead exceedances.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for and removing any recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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: S 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/.

NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Joanne Solorio Campos
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2026
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: BPUSD-CHARLES BURSCH ELEMENTARY SCHOOL
FACILITY NUMBER: 198014559
VISIT DATE: 08/19/2026
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Licensee was 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.

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.

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

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

Exit interview was conducted and report was reviewed with Education Supervisor Elizabeth Gaytan.

NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Joanne Solorio Campos
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2026
LIC809 (FAS) - (06/04)
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