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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019281
Report Date: 12/18/2024
Date Signed: 12/18/2024 05:02:29 PM

Document Has Been Signed on 12/18/2024 05:02 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:HAPPY BIRCH PRESCHOOL- TAMARINDFACILITY NUMBER:
198019281
ADMINISTRATOR/
DIRECTOR:		SOLEDAD GUEVARAFACILITY TYPE:
850
ADDRESS:1429 TAMARIND AVETELEPHONE:
(323) 380-7311
CITY:LOS ANGELESSTATE: CAZIP CODE:
90028
CAPACITY: 46TOTAL ENROLLED CHILDREN: 40CENSUS: 29DATE:
12/18/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Mali Rand, DirectorTIME VISIT/
INSPECTION COMPLETED:
05:15 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Saul Valenzuela and Roxana Lopez conducted a Case Management Deficiencies visit on this date to address deficiencies revealed on 12/18/2024 during an POC visit. Census was taken.

On 12/18/2024 at 10:00 a.m. LPAs observed Adult #1, Adult #2, and Adult #3 without criminal record clearance attending to children. According to the Director Mali Rand the Adults are assigned to three children as their “shadows”. When LPAs asked Director what the title “shadow” meant that it means “To support the children with self-regulation, circle, transition, and behavior support”, and that the parents of the children are paying for the “shadows” to be on premises with the children. Based on interviews and documentation reviewed only Adult #3 is fingerprinted via their agency and providing professional support.

During interviews, Adult #1 and Adult #2 stated that they do not work for an organization and that they were hired and paid by Child #1 and Child #2 parents directly to regulate children behavior while at school. According to Adult #2 they have not been fingerprinted or been asked to be fingerprinted by school staff. Per Adult #2 they do not have specialized training to support children’s behaviors in a classroom setting. Per Title 22 Regulation 101170 Criminal Record Clearance, an individual is exempt from the requirement to submit fingerprints if “A volunteer who is a relative, legal guardian, or foster parent of a child in the facility”.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE: DATE: 12/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/18/2024
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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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: HAPPY BIRCH PRESCHOOL- TAMARIND
FACILITY NUMBER: 198019281
VISIT DATE: 12/18/2024
NARRATIVE
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During staff interviews it was disclosed that “shadows” and children more than they were originally assigned to provide support were observed to be alone with no teachers present in the area for approximately 30 minutes.

LPAs conducted record review for Child #1, Child #2 and Child #3 and LPAs observed no evidence of documents in children’s files that support the Director’s claim that children require “shadows” to assist with children’s behavior. This poses an immediate health and safety risk for children in care. Civil Penalty of $1000 was assessed on this date.

Based on LPA 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.

LPA Saul Valenzuela informed Director Mali Rand that this report dated 12/18/2024 document(s) 1 Type A citation 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 Saul Valenzuela informed the Director to provide a copy of this licensing report dated 12/18/2024 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. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the facility representative, Mali Rand.
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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/18/2024 05:02 PM - It Cannot Be Edited


Created By: Saul Valenzuela On 12/18/2024 at 03:40 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: HAPPY BIRCH PRESCHOOL- TAMARIND
FACILITY NUMBER: 198019281

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/18/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/18/2024
Section Cited
CCR
101170(b)(1)

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101170 Criminal Record Clearance

(b) (1) A volunteer who is a relative, legal guardian, or foster parent of a child in the facility.This requirement was not met was evidence by:
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Director will have Adult #2 fingerprinted as Adult #1 will no longer be on the premises as their children will no longer be attending the school. Director will send proof of Adult #2 criminal record clearance.
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Based on LPA observation,interviews, and record reviews that Adult #1 and Adult #2 have not been fingerprinted, and have been left alone with children. This poses an immediate health and safety risk for children 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:Brandi VanOosten
LICENSING EVALUATOR NAME:Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:
DATE: 12/18/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/18/2024


LIC809 (FAS) - (06/04)
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