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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016792
Report Date: 12/18/2025
Date Signed: 12/18/2025 03:38:07 PM

Document Has Been Signed on 12/18/2025 03:38 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:KINDER KOUNTRY ACADEMYFACILITY NUMBER:
198016792
ADMINISTRATOR/
DIRECTOR:		LUCY SALAZARFACILITY TYPE:
840
ADDRESS:456 W. SAN JOSE AVE. #BTELEPHONE:
(909) 621-0226
CITY:CLAREMONTSTATE: CAZIP CODE:
91711
CAPACITY: 12TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
12/18/2025
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:31 PM
MET WITH:Ana Vartevaryan, DirectotTIME VISIT/
INSPECTION COMPLETED:
03:50 PM
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On 12/18/25, Licensing Program Analyst (LPA) Diana Ortiz conducted an unannounced annual required inspection to the above facility and met with Director, Ana Vartevayan who guided LPA on a tour of the facility. This is a school age program that operates Monday through Friday from 6:30AM to 06:00PM. Per Director, the school age children arrive sometimes between 3:30pm or 4pm. There is also a preschool program on the premises with facility number #198016791. At the time of inspection, there were zero (0) school age children present. All areas identified on the facility sketch were toured and inspected both indoors and outdoors. School age program consists of 1 classroom. Per Facility director there are 8 school age children enrolled. LIC 125 Entrance Checklist provided.

The following documents were posted in a prominent, publicly accessible area at the facility: Facility License, Notification of Parents' Rights (PUB 393), Personal Rights (LIC 613A), Menu, and Earthquake Preparedness (LIC 9148). PUB 269 Child Passenger System Poster, and Daily Schedule.

Sign in and out takes place outside on the main entrance area, and two (2) side gates of Facility. This facility uses paper sign in and out sheets for parents. Sign in and outs were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. LPA did remind Director; parents are to use full signature when signing in and out their children daily. Facility has hard copies of sign in and sign out sheets as needed.

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NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Diana Ortiz
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/18/2025
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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: KINDER KOUNTRY ACADEMY
FACILITY NUMBER: 198016792
VISIT DATE: 12/18/2025
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There is a total of one (1) classroom that is used by the school-age children. Per the Director the school-age children enter the facility through the main door having to cross through the preschool area to the rear/back of the facility where the school-age classroom is located. School-age children use 2 restrooms, one (1) that is for the boys and the other is for the girls, that are located in the preschool area but are made inaccessible (door remains closed) to preschool children. The preschool children use the restroom located across from the 3-year classroom.

The following classrooms were inspected: Room 1: 0 school age children present and 0 staff present. Classrooms’ furniture and equipment were inspected for good repair, free of sharp, loose, or pointed parts. Classroom was inspected to ensure that the floors have a surface that is safe and clean. Teacher-child ratios were observed to be in accordance with Title 22 Regulations. Staff names were recorded. Licensed facility is within the conditions, limitations, and capacity specified on the license.

The facility offers PM snack for school age children. Food preparation areas were toured for safety, cleanliness, and proper equipment. LPA inspected commercialized refrigerators for cleanliness and temperature check. Items in the refrigerator were observed to have expiration dates. Menus were reviewed to ensure that they are being posted at least one week in advance and visible to an authorized representative. Facility also has a pantry where snacks are kept. The kitchen and pantry were observed to be clean, and the cleaning compounds/solutions were found to be stored away from the food.

All storage containers for solid waste, including movable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids. Drinking water is readily available both indoors and outdoors. The facility was observed to be free of flies, other insects, and rodents.

Classrooms were inspected to ensure that the floors have a surface that is safe and clean. All materials and surfaces accessible to children are toxic free. There are First Aid kits available in the hallway near the classroom and in the school’s office. The supplies were inventoried and found to be in good condition. Storage cabinets in the classroom was inspected and LPA did not observe hazardous items.

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NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Diana Ortiz
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2025
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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: KINDER KOUNTRY ACADEMY
FACILITY NUMBER: 198016792
VISIT DATE: 12/18/2025
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No poisonous cleaning compounds were found in the childcare center. The last annual maintenance on the Fire Extinguisher was on 12/19/24. Reminded facility representative that fire extinguishers should be serviced/purchased annually. LPA observed that there are functioning smoke and carbon detectors in the facility. The last emergency drill was conducted on 08/27/25.

Drinking water is readily available to children in care. Availability of drinking water was reviewed and per Director they provide bottled water and disposal cups. LPA observed gallons of water in the school age classroom during todays inspection.

Director stated the ill/isolation area takes place in the Director’s office and children will utilize the restroom which is located next to the office. The children may wait in a chair in the Director’s office while parents or authorized representatives arrive.

LPA was informed that there are currently zero (0) children on medication at this time, however, the Director has an IMS plan and LPA reviewed and provided consultation. Director stated that medication would be kept in each classroom in a locked medication box out of reach of children. LPA advised that medication should be given back to parents/guardians when child leaves the facility or medication expires.

LPA observed the outdoor play area. There is currently 1 playground for school age children, and 1 playground for the preschoolers which is separated with an iron gate. Both playgrounds are surrounded with block cement walls and iron gates near the entrance of the playground. There is adequate shade in the play yard with awnings. LPA observed the equipment to be in a safe condition, free of sharp, no lose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. LPA observed play equipment to be age-appropriate as well as benches.



Children’s Records were reviewed to ensure that Identification and Emergency form and a medical assessment are on file. Children’s records complete. LPA reviewed staff records; staff files were complete. Criminal Records Clearance for adults and verification of CPR/First Aid and Mandated Reporter Trainings documentation was reviewed.

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NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Diana Ortiz
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2025
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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: KINDER KOUNTRY ACADEMY
FACILITY NUMBER: 198016792
VISIT DATE: 12/18/2025
NARRATIVE
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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.

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. Lead test completion was on 05/08/23.

· CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES

LPA referred facility representative 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)

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/.

Facility representative 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. During the exit interview, the Licensee Sacha Lord, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Diana Ortiz
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2025
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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: KINDER KOUNTRY ACADEMY
FACILITY NUMBER: 198016792
VISIT DATE: 12/18/2025
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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.

Based on the LPA`s observations and record review, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies are being cited on today’s visit, 12/18/2025.

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

Exit interview conducted and report was reviewed with the Director Ana Vartevayan.

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NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Diana Ortiz
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2025
LIC809 (FAS) - (06/04)
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