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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019065
Report Date: 08/15/2024
Date Signed: 08/15/2024 03:37:26 PM

Document Has Been Signed on 08/15/2024 03:37 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:BLOOMING FLOWERS CHILD CARE CENTERFACILITY NUMBER:
198019065
ADMINISTRATOR/
DIRECTOR:		THOMAS, JAZMYNEFACILITY TYPE:
850
ADDRESS:680 E. ARROW HIGHWAYTELEPHONE:
(909) 399-0003
CITY:POMONASTATE: CAZIP CODE:
91767
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 10DATE:
08/15/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:15 AM
MET WITH:Licensee Elaine DavisTIME VISIT/
INSPECTION COMPLETED:
04:15 PM
NARRATIVE
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On 8/15/2024 at 10:15am, Licensing Program Analyst (LPA) Stephanie Li conducted an unannounced complaint investigation and during visit observed deficiencies. Upon arrival, LPA had buzzed the ringer several times and had to wait several minutes before someone came to the door. LPA observed the office light was off and asked if Elaine was here. Assistant teacher Stephanie Sanabria opened the door and stated Elaine was not present. During last visit, Teacher 1 was observed to not be fully qualified and cannot be left alone with the children. Per director, she was going to stay with the preschool group at all times until Teacher 1 gets registered in necessary courses. Citation is being issued for this. See LIC809D page.

LPA observed Teacher Jessica with 10 children. 8 preschool age and 2 school age children. School age children were sitting at tables near the entrance on their tablets. Per teacher Stephanie, the 2 school age children go to Claremont school district and begin school next week. Per Stephanie, some children began school this week and attend Pomona Unified Head start preschool and will come after they get out of preschool. LPA called Elaine and she stated that she is at the doctor’s office and asked to call me back. LPA informed her that someone either herself or the administrator is required to meet me at the facility as immediately as possible. Elaine arrived to facility at 11:15am and stated that she was not feeling well. Elaine left again at 11:25am to retrieve the LIC500 form in her other bag at home. Per director, her driver requested the day off. Per director, 3 staff 1 teacher and 2 drivers called out sick today. Elaine came back with a bag but could not provide the LIC500 and stated she had to leave again to pick kids up from school. Elaine left at 11:57am to pick up children from school. LPA informed her that when she returns, I will need to review video recordings for dates 8/6th and 8/7th as she did not send all the footage. At 11:30am, school age children had lunch and walked over to the next room with another teacher.

At 12:05pm, LPA went to the nap room to verify a child’s age and last name, LPA observed that assistant teacher Stephanie was alone with 8 children and stated that Teacher Jessica was doing pick ups.
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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE: DATE: 08/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/15/2024
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
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: BLOOMING FLOWERS CHILD CARE CENTER
FACILITY NUMBER: 198019065
VISIT DATE: 08/15/2024
NARRATIVE
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All children were awake. 3 children were running around and jumping on cots. Children ran around screaming and climbing on others cots, under the table and chairs. The children settled down around 12:18pm. Elaine returned to facility at 12:20pm with 2 more preschool age children. Teacher Jessica returned with 2 more children. There are a total of 12 preschool children present.

LPA discussed with Elaine observation of nap time and the need for structure, rules, expectations, and consequences. LPA also discussed with Director the importance and need to hire more qualified teachers. Director had to step away many times throughout the day to meet the program needs. LPA advised that all teaching staff need more training in handling difficult situations and children with challenging behaviors. LPA advised about licensing requirement for annual training/professional development for all teaching staff and highly advised to find topics with dealing with challenging behaviors. Director stated she is with the union. LPA recommended to reach out to the union for training. LPA is going to get in touch with Pomona Unified Child Development Center to inquire about free trainings for teaching staff. LPA explained and recommended TSP. Licensee is in agreement to TSP and would like to begin the referral process.

Based on Licensing staff observations, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health and safety.

Licensing staff informed licensee a copy of this licensing report dated 08/15/2024 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 notice of site visit was given and must remain posted for 30 days as there are immediate risk(s) to the health, safety, or personal rights of children in care.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.



Exit interview conducted and report was reviewed with Director Elaine Davis. Appeal Rights were issued and discussed. Page 2 of 2
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 08/15/2024 03:37 PM - It Cannot Be Edited


Created By: Stephanie Li On 08/15/2024 at 01:34 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: BLOOMING FLOWERS CHILD CARE CENTER
FACILITY NUMBER: 198019065

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/15/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/15/2024
Section Cited
CCR
101216.3(a)

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(a) There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance, except as specified in (b) and (c) below.

This requirement was not met evidenced by:
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Per Director, she is hiring a fully qualified preschool teacher to start on Monday 8/19/24 and has verified that she has the required units. Director will send LPA all her information via email by Tuesday 8/20/24.
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Based on observation, 10 children were being supervised by a teacher's aide, which poses an immediate 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.
SUPERVISOR'S NAME:Christina Gabelman
LICENSING EVALUATOR NAME:Stephanie Li
LICENSING EVALUATOR SIGNATURE:
DATE: 08/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/15/2024


LIC809 (FAS) - (06/04)
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