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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018016
Report Date: 04/03/2025
Date Signed: 04/03/2025 01:52:34 PM

Document Has Been Signed on 04/03/2025 01:52 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:PEACE OF MIND PRESCHOOLFACILITY NUMBER:
198018016
ADMINISTRATOR/
DIRECTOR:		JERRY LEWISFACILITY TYPE:
850
ADDRESS:240-250 S. PARCELS ST.TELEPHONE:
(909) 629-0600
CITY:POMONASTATE: CAZIP CODE:
91766
CAPACITY: 32TOTAL ENROLLED CHILDREN: 32CENSUS: 2DATE:
04/03/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:00 AM
MET WITH:Jerry Lewis TIME VISIT/
INSPECTION COMPLETED:
02:00 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Cynthia Reyes and Kamile Martin 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. This visit was conducted on this date as time ran out yesterday 04/02/2025, during the annual inspection of the Infant and School age inspection. LPA met with New Director Jerry Lewis. A tour of the facility was conducted and only 2 preschool children were present on this date. Staff names were documented.

During the tour of the facility and records review from 04/02/2025, LPAs observed the following citations:

Commingling of children from the preschool, infant and school age program. Per LPA observation upon entrance and walk through of the facility, preschool, infant and school age children were observed all together commingled in the common area movie room. After it was brought to the directors attention all the children were moved, however all the children again were all together commingled in the infant room which is located next to the directors office. LPA advised licensee that, per the limitations on her license and Title 22, school age, preschool, and infants can not commingle. Director was further advised that an alternate plan needs to be in place. Children are prohibited from commingling.
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During inspection of preschool classrooms LPA observed light bulbs out in room #1 and room #2, also the sink in the bathroom is leaking. The smoke detector in the hall way near the preschool and school age common area class room is not working and in need of a new battery.

LPA observed the Fire extinguisher needs to be serviced the last date of service is 4/1/24.
Christina GabelmanTELEPHONE: (323) 981-3380
Cynthia ReyesTELEPHONE: (323) 981-3369
DATE: 04/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/03/2025
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 5
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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Document Has Been Signed on 04/03/2025 01:52 PM - It Cannot Be Edited

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: PEACE OF MIND PRESCHOOL
FACILITY NUMBER: 198018016

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/03/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/03/2025
Section Cited
CCR
101161(a)

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(a) A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation.
This requirement is not met as evidenced by: Per LPA observation upon entrance and walk through of the facility, preschool, infant, and
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Licensee states the facility will submit a written declaration on the steps they will take to ensure that no commingling is conducted at all at any time. Original declaration with signature and date will be mailed and an email copy will be sent to the LPA on 4/3/25.
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school age children were observed all together commingled in the common area movie room and in the infant class room and outside in the infant play yard, which poses/posed a health, safety or personal rights risk to persons 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 GabelmanTELEPHONE: (323) 981-3380
Cynthia ReyesTELEPHONE: (323) 981-3369

DATE: 04/03/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/03/2025

LIC809 (FAS) - (06/04)
Page: 3 of 5
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: PEACE OF MIND PRESCHOOL
FACILITY NUMBER: 198018016
VISIT DATE: 04/03/2025
NARRATIVE
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At this time, the licensee is not in compliance with California Title 22 Regulations. Therefore, There were deficiency cited during today's Inspection in accordance to the California Code of Regulations Title 22, Division 12, Chapter 1. Consultation was given on this date.

Exit interview conducted and report was reviewed and given to Jerry Lewis, Director

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

LPA consulted with the Director and Owner regarding the children's sign in and sign out procedures. LPA observed a parent had signed in and signed out at the same time of drop off for the same day. (Parent signed the out time early when she dropped off the child in the morning so she would not have to sign out at pick up time.)

LPA Reyes informed Director that this report dated 04/03/2025 document(s) Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Reyes informed the Director, to provide a copy of this licensing report dated 04/03/2025 that documents any Type A citation(s) 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 parents/guardians 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. A copy of the LIC 9224 was provided to the director on this date
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2025
LIC809 (FAS) - (06/04)
Page: 4 of 5
Document Has Been Signed on 04/03/2025 01:52 PM - It Cannot Be Edited

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: PEACE OF MIND PRESCHOOL
FACILITY NUMBER: 198018016

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/03/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/14/2025
Section Cited
CCR
101238(a)

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Buildings and Grounds: The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children in care. This requirement is not met as evidenced by: All the fire extinguishers in the facility are expired and the smoke detector is not in
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Per director they will have all of the fire extinguishers serviced or replaced as well as the smoke detectors and the ceiling lights and will submit a copy of the receipt by e-mail to the LPA by POC date
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service and the battery needs to be replaced, and several ceiling light bulbs are observed to be out and not working, which poses/posed a potential health, safety or personal rights risk to persons in care.
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Type B
04/14/2025
Section Cited
CCR101239(a)

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 Fixtures, Furniture, Equipment and Supplies. All toilets, hand-washing and bathing facilities shall be kept in safe and sanitary operation and shall be ADA compliant. This requirement is not met as evidenced by: LPA's observed water a leak from a sink in the preschool bathroom.
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Director states he will have the sink repaired and submit a copy of the receipt as proof the sink was repaired and a copy of the receipt will be e-mailed to the LPA by POC dat

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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 GabelmanTELEPHONE: (323) 981-3380
Cynthia ReyesTELEPHONE: (323) 981-3369

DATE: 04/03/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/03/2025

LIC809 (FAS) - (06/04)
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