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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018017
Report Date: 08/31/2023
Date Signed: 08/31/2023 05:04:35 PM

Document Has Been Signed on 08/31/2023 05:04 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:
198018017
ADMINISTRATOR:SIMONE JONESFACILITY TYPE:
830
ADDRESS:240-250 PARCELS STREETTELEPHONE:
(909) 629-0600
CITY:POMONASTATE: CAZIP CODE:
91766
CAPACITY: 22TOTAL ENROLLED CHILDREN: 22CENSUS: 0DATE:
08/31/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Jerry Lewis, staffTIME COMPLETED:
11:30 AM
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On 08/31/2023 at 9:30AM, Licensing Program Analyst (LPA) Thelma Razo conducted a Case Management - Other visit to follow up on information received in the Regional Office. A COVID 19 risk assessment was conducted prior to entering the facility. LPA met with facility representative Jerry Lewis and stated the purpose of the visit. There were no infant in attendance during this inspection.

A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with staff Jerry Lewis.
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Thelma Razo
LICENSING EVALUATOR SIGNATURE: DATE: 08/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/31/2023
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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