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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198015390
Report Date: 08/28/2025
Date Signed: 08/28/2025 04:05:03 PM

Document Has Been Signed on 08/28/2025 04:05 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:SMITH HEAD STARTFACILITY NUMBER:
198015390
ADMINISTRATOR/
DIRECTOR:
ANGELA HULLETT & PETRINA DFACILITY TYPE:
850
ADDRESS:565 E. HILL STREETTELEPHONE:
(562) 426-6313
CITY:LONG BEACHSTATE: CAZIP CODE:
90806
CAPACITY: 104TOTAL ENROLLED CHILDREN: 104CENSUS: 39DATE:
08/28/2025
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:45 PM
MET WITH:Early Learning Center Managers Keokuk Legarde and Maricela GuidoTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) Jeanette Estrada conducted an unannounced 3 year required inspection at the facility. LPA met with Early Learning Center Managers (ELCM) Keokuk Legarde and Maricela Guido and informed them of the reason for the visit.
This facility is located on the premises of Smith Elementary school. This facility operates five programs: Class Room B 17 Early Head Start (EHS) Full day Monday through Friday 7:45 AM to 2:45 PM, Room B 18 EHS Full day Monday through Friday 7:45 AM to 2:45 PM, Room B 23 Preschool Full day Monday through Friday 7:45 AM to 2:45 PM, Room B 24 Co-Collaborative Teaching (CCT) Monday through Friday AM session 7:45 AM to 11:15 AM/ PM session 12:15 PM to 3:45 PM, Room 4 TK collab Monday through Friday 7:45 AM to 2:15 PM. The EHS classrooms provide care for children ages 2-3 years old, the preschool class provides care for children ages 3-5 years old and the TK class provides care for children 4-5 years old.

During today's visit LPA observed 7 children and 2 staff in room B 17, 8 children and 2 staff in room B18, 16 children and 2 staff in room B23, 8 children and 3 staff in room B 24 and no children present in the TK class (early dismissal). The facility was observed to be in compliance with ratio during the inspection.

All areas used by children were inspected. All classrooms were observed to have age appropriate furniture and equipment in good condition. There are cubbies available for children. The program provides the sheets and the napping cots. LPA observed medication and allergy lists posted in the classroom for staff to review. LPA inspected the medication on site and verified the required paperwork is on file. Each classroom has the required posted documents. Each class has its own isolation area. The TK class uses the nurse's office for an isolation area.
NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Jeanette Estrada
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 08/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/28/2025
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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: SMITH HEAD START
FACILITY NUMBER: 198015390
VISIT DATE: 08/28/2025
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LPA observed that drinking water is available for children in each classroom via a water container or a water fountain. The facility tested for lead in the drinking water on 6/28/23. The cleaning products were observed to be maintained inaccessible to children in latched cabinets.
LPA inspected the restrooms available for children. Rooms B 17 and B 18 share a restroom located in room B 18. This restroom contains 2 toilets and 1 sink and each class has it's own additional hand washing sink. These two EHS classrooms also have a diaper changing table available and assist children with potty training as needed. There is one restroom in room B 23 with 2 toilets and 1 sink (additional hand washing sink in the classroom), B 24 has it's own restroom with 2 toilets and 1 sink (additional hand washing sink in the classroom) and there is a waiver on file for use of the elementary school restrooms next to the TK classroom. These restrooms have a total of 6 toilets, 4 sinks and 2 urinals. All restrooms were observed to be in good, sanitary condition and stocked with supplies.
LPA inspected the outdoor area. The outdoor area is fully enclosed and used exclusively by this facility. The classrooms follow a staggered schedule for the use of the playground. LPA observed water and shade is available. There is a climbing structure labeled for ages 2-5 with cushioned material that absorbs a fall.
The facility provides breakfast, lunch and snack for the full day classrooms, breakfast for the AM CCT class, lunch for the PM CCT class and lunch for the TK class. Meals are provided by the cafeteria. Menus are posted and provided for authorized representatives. Allergies are provided an accommodation.
LPA observed an operable carbon monoxide detector in the facility. The last documented drill was conducted on 7/30/25. There are no pools/bodies of water on the premises. LPA observed a sign in sheet in each classroom.
LPA reviewed staff files. At least one person present has obtained a valid pediatric first aid/cpr certification.
LPA reviewed children's files and verified they contain the required documents.

Facility Representative 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.
NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Jeanette Estrada
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2025
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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: SMITH HEAD START
FACILITY NUMBER: 198015390
VISIT DATE: 08/28/2025
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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.
This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and
administrative records.
For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.
Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms.
To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

No citations were issued during today's inspection. A notice of site visit was given to Facility Representative and must remain posted for 30 days. Exit interview conducted and report was reviewed with Facility Representatives, Keokuk Legarde and Maricela Guido Early Learning Center Managers.
NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Jeanette Estrada
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2025
LIC809 (FAS) - (06/04)
Page: 4 of 4