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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198015614
Report Date: 10/08/2026
Date Signed: 10/12/2026 11:58:22 AM

Document Has Been Signed on 10/12/2026 11:58 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:COVINA EDUCATIONAL CENTER STATE PRESCHOOLFACILITY NUMBER:
198015614
ADMINISTRATOR/
DIRECTOR:		VANESSA BURGUENOFACILITY TYPE:
850
ADDRESS:160 N. BARRANCATELEPHONE:
(626) 974-4204
CITY:COVINASTATE: CAZIP CODE:
91723
CAPACITY: 72TOTAL ENROLLED CHILDREN: 31CENSUS: 24DATE:
10/08/2026
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:15 AM
MET WITH:Supervisor Vanessa BurguenoTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
NARRATIVE
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On 10/08/2026, Licensing Program Analysts (LPA) Mary Silva conducted an unannounced case management inspection. LPA met with Supervisor Vanessa Burgueno and explained the purpose of the visit. Census was taken. LPA observed 3 children with 3 staff in classroom #1 and 21 children with 3 staff in classroom #3. LPA was led on a tour of the facility. There were no children or staff in classroom #2. Per supervisor classroom #2 is not in use.

The purpose of today’s visit is to investigate an incident that occurred on 09/16/2026 and was reported to the department on 09/16/2026. The self reported incident is regarding care and supervision.

During the course of the investigation LPA conducted interviews with supervisor, 4 staff, obtained a copy of the facility roster, and copy of a report provided by consultant that witnessed the incident.

According to interviews conducted, classroom #1 and classroom #3 were outdoors in the play yard at approximately 9:10am or 9:15am, staff #4 was standing in front of classroom #2 supervising children when child #1 was seen walking towards classroom #3, heard a door slam and alerted staff #1 of the occurrence. Staff #1 walked into classroom #3 and observed child #1. Per consultant’s report, child #1 walked into the classroom #3 unsupervised at 9:18am and at 9:20am staff #1 walked in to retrieved child#1 and return to the outdoor area. Per staff in classroom #3 there were 21 children with 3 staff on this day. Staff #2 and #3 did not witness the incident.

Based on the incident that occurred on 09/16/2026 the facility did not provide care and supervision, which poses an immediate risk to the children in care. The following deficiency listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health and safety.



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Christina Gabelman
Mary Silva
DATE: 10/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/08/2026
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: COVINA EDUCATIONAL CENTER STATE PRESCHOOL
FACILITY NUMBER: 198015614
VISIT DATE: 10/08/2026
NARRATIVE
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LPA informed supervisor Vanessa Burgueno that this report dated 10/08/26 documents 1 type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health and safety or personal rights of the children in care. Also LPA informed Vanessa Burgueno to provide a copy of this licensing report dated 10/08/2026 that documents any 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 parent/guardian 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.

Licensee shall post report documenting Type A citation along with Notice of Site Visit Form in an area accessible for review for 30 days or a civil penalty of $100 will be assessed.

Ans exit Interview was conducted, a copy of this report and appeal rights along with Notice of Site visit was provided to Supervisor Vanessa Burgueno.

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NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Mary Silva
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/12/2026 11:58 AM - It Cannot Be Edited


Created By: Mary Silva On 10/08/2026 at 12:09 PM
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: COVINA EDUCATIONAL CENTER STATE PRESCHOOL
FACILITY NUMBER: 198015614

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/08/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/09/2026
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. (1) No child(ren) shall be left without the supervision of a teacher at any time.This requirement is not met as evidence by:
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Per Supervisor a meeting will be held with staff from classroom #3 to address the importance of care and supervsion. An agenda with topics and a signed acknowledgment form will be provided.All will be submitted to LPA by 10/22/26.
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Child #1 walked into classroom #3 without supervision during morning outdoor play. Per witnessed child was left unattend for two minutes. This incident poses an immediate risk to the health and safety of 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.
Christina Gabelman
NAME OF LICENSING PROGRAM MANAGER:
Mary Silva
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/08/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/08/2026


LIC809 (FAS) - (06/04)
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