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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016423
Report Date: 01/02/2025
Date Signed: 01/02/2025 04:26:15 PM

Document Has Been Signed on 01/02/2025 04:26 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:KIDDIE ACADEMY OF GLENDORAFACILITY NUMBER:
198016423
ADMINISTRATOR/
DIRECTOR:		BETH HOLMESFACILITY TYPE:
850
ADDRESS:1339 SOUTH GRAND AVENUETELEPHONE:
(626) 691-0242
CITY:GLENDORASTATE: CAZIP CODE:
91740
CAPACITY: 96TOTAL ENROLLED CHILDREN: 96CENSUS: DATE:
01/02/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:15 AM
MET WITH:Florence BandaTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
NARRATIVE
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On 01/02/2025 Licensing Programming analysts (LPAs) Mariah Aguirre and Cynthia Reyes conducted an unannounced case management deficiencies inspection. This inspection is to ensure the health and safety standards as required by the regulations governing child care centers are met. LPAs met with Florence Banda, lead teacher. A tour of the facility was conducted and a census was taken. There were 64 children present with 15 staff, including lead teacher and cafeteria cook. Staff names were documented. Director Elizabeth Holmes was not present during today's visit, and inspection visit was conducted with designated lead teacher Florence Banda.

During today's tour of the facility and record review, LPAs observed the following citations:
- Director is missing Mandated Reporter training
- Director's CPR and First Aid expired on 07/25/2023
- Director's flu vaccine/declaration of declining the flu shot
- Director is not present in the facility during facility's full operable days and hours

Based on LPAs observations, the following deficiencies listed on the LIC809D(s) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be corrected to protect the children's health and safety.

A Notice of Site Visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted and report was reviewed with lead teacher, Florence Banda.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Mariah Aguirre
LICENSING EVALUATOR SIGNATURE: DATE: 01/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/02/2025
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 3
Document Has Been Signed on 01/02/2025 04:26 PM - It Cannot Be Edited


Created By: Mariah Aguirre On 01/02/2025 at 02:57 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: KIDDIE ACADEMY OF GLENDORA
FACILITY NUMBER: 198016423

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/02/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/09/2025
Section Cited
CCR
101215.1(d)

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The child care center director... shall be on the premises during the hours the center is in operation. The requirement was not met as evidence by interviews conducted with staff stating that the director is not on site during the days and hours the facility is operating.
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Per conversation with Florence Banda and Director Beth, director stated a personnel report will be udpated to reflect Florence Banda to be director.
Type B
01/09/2025
Section Cited
HSC
1596.8662(b)(1)

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On or before March 30, 2018... a licensed child day care provider, administrator... shall complete the mandated reporter training...and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.:
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Per Lead Teacher Florence Banda, Director will complete Mandated Reporter training and will send proof of completion by the plan of correction date, 01/09/2025.
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This requirement is not met as evidenced by:
staff file review.
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Type B
01/16/2025
Section Cited
HSC
1596.866(a)(1)

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 The training shall include the following components:
(A) Pediatric first aid.
(B) Pediatric cardiopulmonary resuscitation (CPR).
This requirement is not met as evidence by: staff file review.
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Per Lead Teacher Florence Banda, she states that Elizabeth Holmes will have CPR and First aid completed by January 16th 2025 and will submit the certificate as proof of completion.
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:Brandi VanOosten
LICENSING EVALUATOR NAME:Mariah Aguirre
LICENSING EVALUATOR SIGNATURE:
DATE: 01/02/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/02/2025


LIC809 (FAS) - (06/04)
Page: 3 of 3
Document Has Been Signed on 01/02/2025 04:26 PM - It Cannot Be Edited


Created By: Mariah Aguirre On 01/02/2025 at 03:21 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: KIDDIE ACADEMY OF GLENDORA
FACILITY NUMBER: 198016423

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/02/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/09/2025
Section Cited
HSC
1596.7995(a)(1)

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 Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza... Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of
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Per Lead Teacher Florence Banda, she will get either proof of the vaccine or proof of a delceration delcining the vaccine by POC date 01/09/2025.
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each year.
This requirement is not met as evidenced by:
staff file review.
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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:Brandi VanOosten
LICENSING EVALUATOR NAME:Mariah Aguirre
LICENSING EVALUATOR SIGNATURE:
DATE: 01/02/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/02/2025


LIC809 (FAS) - (06/04)
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