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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016797
Report Date: 10/05/2023
Date Signed: 10/05/2023 03:05:23 PM

Document Has Been Signed on 10/05/2023 03:05 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:KING'S KIDS PRESCHOOLFACILITY NUMBER:
198016797
ADMINISTRATOR:MUN HEEFACILITY TYPE:
850
ADDRESS:18424 S. BLOOMFIELD AVENUETELEPHONE:
(562) 417-6565
CITY:CERRITOSSTATE: CAZIP CODE:
90703
CAPACITY: 71TOTAL ENROLLED CHILDREN: 51CENSUS: 42DATE:
10/05/2023
TYPE OF VISIT:Case Management - IncidentANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Ha LeeTIME COMPLETED:
03:20 PM
NARRATIVE
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Licensing Program Analyst (LPA) T. Tran conduct an unannounced Case Management Incident at King's Kids Preschool to follow up self-reported incident occurred on 09/15/2023 regarding a child's personal rights. The Monterey Park Southwest Office received the writing report on 09/15/2023. LPA met with Ha Lee, Assistant Director and we toured the facility. LPA observed proper care and supervision.

LPA completed children and staff files review. LPA obtained personnel report, child's document, and doctor's note. Interviews were conducted with staff, children, and other. On the day of the incident, a qualified teacher supervised 9 children. Parent was notified of the incident. Based on the available information it does not appear this incident was the result of a Title 22 violation for lack of care and supervision.

No deficiency was cited at this time. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the facility representative, Ha Lee.

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Tiffanie Tran
LICENSING EVALUATOR SIGNATURE: DATE: 10/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/05/2023
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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