198019482-7-31-2024-33-CC-SPEY-D7PT2T-20240731142117

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019482
Report Date: 07/31/2024
Date Signed: 07/31/2024 02:21:46 PM

Document Has Been Signed on 07/31/2024 02:21 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:	BRIGHT HORIZONS AT FIGUEROA INFANT		FACILITY NUMBER:	198019482
ADMINISTRATOR/ DIRECTOR:	BRENDA SALGUERO		FACILITY TYPE:	830
ADDRESS:	515 S FIGUEROAT ST STE 200		TELEPHONE:	(323) 296-9720
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90071
CAPACITY: 48	TOTAL ENROLLED CHILDREN: 23	CENSUS:	DATE:	07/31/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:30 AM
MET WITH:	Brenda Salguero, Director and Tiffany Wong, Assistant Director		TIME VISIT/ INSPECTION COMPLETED:	02:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On Wednesday, July 31, 2024, Licensing Program Analyst (LPA) Staicy Perry conducted an unannounced annual inspection and met with Tiffany Wong, Assistant Director, and shortly after Brenda Salguero, Director arrived and took over inspection. Brenda Salguero, Director guided LPA Perry on a tour of the facility. This is an infant age program licensed for 48 infants which operates Monday – Friday from 8:00 AM – 6:00 PM. This facility is located on the 2^nd floor of the A Vision Young building. Per the Assistant Director there are 23 children currently enrolled. This is a combination center with a preschool component, license # 198019483. The infant program is conducted in physically separate areas both indoors and outdoors. Sign in and out takes place in the classrooms as well as parents checking in on the application called My Bright Day. When arriving to facility, parents have a key card for the elevator to have access to the second floor. Teacher and child ratio were observed, and present staff are fingerprinted cleared and at least one person present who is trained in pediatric first aid/CPR is present. LPA Perry entered the infant (6 weeks-12months old) classroom. LPA Perry observed 6 infants with 2 staff present. LPA observed age-appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age-appropriate toys accessible to children. LPA observed cleaning solutions stored inside the top diapering cabinet making it inaccessible for children to reach. LPA observed one infant in the napping room area (half wall with clear pexi glass window) inside crib on belly awake. S#2 was positioned where back was facing napping area and was holding an infant feeding a bottle and S#6 was positioned in the eating area feeding 1 infant. LPA did not observe where S#2 and S#4 were positioned, an area where supervision could have been observed. Per S#2, C#4 had just been placed in the napping area awake on her back to self soothe. S#2 and director stated that parents informed facility that child naps by self-soothing. S#2 stated that C#4 has been in the napping area for about 5 minutes only and was monitoring the time. LPA reviewed Infants needs assessment and did not see documentation of sleeping routine indicating that child self-soothes awake in order to fall asleep. LPA advised director to have parent at pick up update form. Director understood. Per S#2 and director, they do not go more than 5 minutes of

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:	DATE: 07/31/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2024

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: BRIGHT HORIZONS AT FIGUEROA INFANT	FACILITY NUMBER: 198019482
	VISIT DATE: 07/31/2024

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letting C#4 self soothe. If C#4 is not asleep already within the 5 minutes, child would be removed from napping area and placed in the main classroom area. LIC 9227 was observed to be filed out by parents indicating that child rolls on their own dated 4/26/2024. LIC 9227 section C not filled out by facility. LPA observed staff sign off section C. S#2 stated that C#4 was placed in the napping area on back awake to self soothe to sleep and that C#4 then rolled on tummy as she was crying. LPA did advise that child should have been placed back on their back to sleep. LPA did not observe teacher acknowledge C#4’s cries while entering the classroom. Per S#2, C#4 started crying when S#2 assisted another infant and that’s when LPA and director walked into the room at the same time. Per S#6, prior to LPA and director entering classroom, teachers were soothing C#4 and talking to the c#4 until S#2 or S#6 were able to get up from attending the other infant that needed attention. Declarations obtained. LPA did discuss regulations with director as well as S#2 an S#6 regarding safe sleep regulation, supervision, and personal rights. Director understood and stated that they are having a staff meeting in August 2024 and will review regulations and licensing visit with all staff. Technical given. LPA observed the cribs to be free from bumper pads, pillows, toys, blankets, hanging above items. LPA Perry observed step trash bins with a lid, for diapers and trash. LPA observed the diapering changing table to be arm’s length to the handwashing sink and a vinyl diapering mat. Per director, soiled clothing is not rinsed in the sink. It is placed in a plastic bag and the vinyl mat is disinfected with soap and water and Force of Nature solution spray and let to air dry. LPA observed children’s personal items to be in individual bins. LPA also observed infant bottles and food to be labeled with names and dated 7/31/24 inside the fridge in their own individual bins. LPA observed 1 teacher closet that is locked inaccessible to the children. Class was observed to have a working telephone.

LPA entered the infant 2 classroom (6 weeks -12 months) LPA Perry observed 0 infants with 0 staff. LPA observed age-appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age-appropriate toys accessible to children. LPA observed cleaning solutions stored inside the top diapering cabinet making it inaccessible for children to reach. LPA Perry observed step trash bins with a lid for diapers and trash. LPA observed the diapering changing table to be arm’s length to the handwashing sink and a vinyl diapering mat. Per director, soiled clothing is not rinsed in the sink. It is placed in a plastic bag and the vinyl mat is disinfected with soap and water, force of nature spray solution spray and let it air dry. LPA observed children’s personal items to be in individual bins. LPA observed 1 teacher closet that is locked inaccessible to the children. Class was observed to have a working telephone. Per director classroom is not in use due to low enrollment.

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:	DATE: 07/31/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2024

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: BRIGHT HORIZONS AT FIGUEROA INFANT	FACILITY NUMBER: 198019482
	VISIT DATE: 07/31/2024

NARRATIVE

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LPA entered the Toddler 1 classroom (12 months- 24 months) LPA Perry observed 4 toddlers with 1 staff present. LPA observed age-appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age-appropriate toys accessible to children. LPA observed cleaning solutions stored inside the top diapering cabinet making it inaccessible for children to reach. LPA Perry observed step trash bins with a lid for diapers and trash. LPA observed the diapering changing table to be arm’s length to the hand washing sink and a vinyl diapering mat. Per director, soiled clothing is not rinsed in the sink. It is placed in a plastic bag and the vinyl mat is disinfected with soap and water, force of nature spray and let it air dry. LPA observed children’s personal items to be in individual bins. LPA observed 1 teacher closet that is locked inaccessible to the children. Class was observed to have a working telephone. LPA observed another door that leads to the main hallway.

LPA entered the Toddler 2 classroom (12 months- 24 months) LPA Perry observed 8 toddlers with 2 staff present. LPA observed age-appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age-appropriate toys accessible to children. LPA observed cleaning solutions stored inside the top diapering cabinet making it inaccessible for children to reach. LPA Perry observed step trash bins with a lid for diapers and trash. LPA observed the diapering changing table to be arm’s length to the hand washing sink and a vinyl diapering mat. Per director, soiled clothing is not rinsed in the sink. It is placed in a plastic bag and the vinyl mat is disinfected with soap and water, force of nature spray and let it air dry. LPA observed children’s personal items to be in individual bins. LPA observed 1 teacher closet that is locked inaccessible to the children. Class was observed to have a working telephone. LPA observed another door that leads to the two’s classroom.

LPA entered the Toddler 3 classroom (12 months- 24 months)) LPA Perry observed 0 infants with 0 staff. LPA observed age-appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age-appropriate toys accessible to children. LPA observed cleaning solutions stored inside the top diapering cabinet making it inaccessible for children to reach. LPA Perry observed step trash bins with a lid for diapers and trash. LPA observed the diapering changing table to be arm’s length to the handwashing sink and a vinyl diapering mat. Per director, soiled clothing is not rinsed in the sink. It is placed in a plastic bag and the vinyl mat is disinfected with soap and water, force of nature spray and let it air dry. LPA observed 1 teacher closet that is locked inaccessible to the children. Class was observed to have a working telephone. Per director classroom is not in use due to low enrollment.

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:	DATE: 07/31/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2024

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: BRIGHT HORIZONS AT FIGUEROA INFANT	FACILITY NUMBER: 198019482
	VISIT DATE: 07/31/2024

NARRATIVE

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LPA entered the Toddler 4 classroom (12 months- 24 months). LPA Perry observed 0 infants with 0 staff. LPA observed age-appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age-appropriate toys accessible to children. LPA observed cleaning solutions stored inside the top diapering cabinet making it inaccessible for children to reach. LPA Perry observed step trash bins with a lid for diapers and trash. LPA observed the diapering changing table to be arm’s length to the handwashing sink and a vinyl diapering mat. Per director, soiled clothing is not rinsed in the sink. It is placed in a plastic bag and the vinyl mat is disinfected with soap and water, force of nature spray and let it air dry. LPA observed children’s personal items to be in individual bins. LPA observed 1 teacher closet that is locked inaccessible to the children. Class was observed to have a working telephone. Per director classroom is not in use due to low enrollment.

LPA Perry observed restroom located in the Toddler 1 and Toddler 2 classrooms (share a restroom) located ij the middle in between the classrooms. LPA observed toddler toilets and handwashing sinks inside the classroom. LPA observed the restroom to be in good condition and free from hazards.

Heating, lighting and ventilation were evaluated by LPA Perry. LPA observed central AC /heater and vents located on the ceiling. LPA observed the thermostat located in classrooms and the temperature to be at 73. LPA observed the fire extinguishers located in hallway and the valve on the required 2A10BC fire extinguishers indicating fully charged and serviced on 3/21/24. Smoke detectors were not tested during this visit due to the detectors being wired to the emergency pull down fire alarm system. The carbon monoxide was observed and is operable. The last emergency drill was conducted on 7/17/24.

For the mobile infants and toddlers, LPA observed sleeping cots to be in good condition. First aid kits supplies are kept inside the classrooms and LPA observed the kits to be fully equipped with band aids, gauzes, adhesive bandages, and antiseptic wipes. During this visit, director stated currently has no children with medication or severe food allergies. LPA Perry asked if there were any poisons, firearms, weapons, or bodies of water. The director stated no firearms, weapons, no poisons nor bodies of water. LPA did not observe firearms or weapons, poisons, nor bodies of water. Director stated the ill isolation area takes place in the director’s office and children utilize the staff restroom.

LPA Perry entered the outdoor play area. LPA Perry observed the playground to be fenced all around. LPA Perry observed the equipment to be in a safe condition, free of sharp, no lose or pointed parts. The surface

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:	DATE: 07/31/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2024

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: BRIGHT HORIZONS AT FIGUEROA INFANT	FACILITY NUMBER: 198019482
	VISIT DATE: 07/31/2024

NARRATIVE

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of the outdoor activity space is maintained in a safe condition and is free of hazards. LPA Perry observed play structure equipment to be age appropriate and areas around or under climbing equipment, are cushioned with granulated rubber mat that may absorb a fall. For adequate shade, LPA Perry observed shade structure. LPA observed a trash bin with a lid. For outdoor water drinking, staff bring out water pitchers and children size cups.

This program provides a.m. snack and p.m. snack. Facilities does not provide lunches. Parents have an option to bring in their personal food or can purchase lunch through an outside vendor called Hero Eats. Snacks are prepared onsite. LPA Perry informed director that any food brought from the children's homes, the container shall be labeled with the child's name and properly stored or refrigerated. For water drinking, LPA Perry observed water pitchers with cups in classrooms as well as drinking faucets. LPA observed the food preparation area to be clean and free of litter, rubbish, rodents, and/or any other vermin and storage containers for solid waste, including movable bins with tight-fitting covers that are kept on, and in good repair. The facility was observed to be free of flies, other insects and rodents.

The following documents were posted in a prominent, publicly area front lobby: Facility License, Notification of Parents' Rights (PUB 393), Personal Rights (LIC 613A), Menu, and PUB 269 Child Passenger System Poster, and Daily Schedule. Waivers were observed to be posted. One waiver was observed for outdoor play space and one waiver for electronic signatures.

LPA Perry reviewed the children’s roster, children’s files, staff files, 15-minute sleep logs (technical violations), and sign in/out sheets to be complete.

LPA Perry observed directors Pediatric First Aid/CPR certification from American Heart Association and current, Preventative Health and Safety with nutrition and lead component on file and has proof of immunization against Pertussis, MMR and Influenza declination. Director has completed the mandated reporter (AB 1207) training expires 11/25. Director was advised that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com.

The following was also discussed with director:

1. The following items are zero tolerance by Licensing: Refused Entry to a Facility or Any Part of a Facility is a violation of Section 1596.852, 1596.853 or 1597.09. Regulations 101238 (g) (2), The Presence of an Excluded Individual, Fire Clearance Violations, Accessible Bodies of Water, Accessible Firearms, Ammunition or Both

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:	DATE: 07/31/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2024

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: BRIGHT HORIZONS AT FIGUEROA INFANT	FACILITY NUMBER: 198019482
	VISIT DATE: 07/31/2024

NARRATIVE

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2. Breakfast/Lunch/Snack Menus: Menus are required to be posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days must also be available upon request.

3. Current Children’s Roster: Each childcare facility shall maintain a current roster of children who are provided care in the facility. The roster shall include the name, address, and daytime telephone number of the child's parent or guardian, and the name and telephone number of the child's physician. This roster shall be available to the licensing agency upon request.

4.LIC 125 Entrance Checklist provided, and LPA informed that forms, regulations and quarterly updates can be accessed on the Child Care Licensing website at: www.ccld.ca.gov.

5.Pediatric First Aid and CPR: At least one person trained in Pediatric First Aid and CPR and EMSA approved must be present.

6.Designated Staff: The name of the childcare center director or fully qualified teacher(s) designated to act in the director's absence must be on file.

7.Qualifications: Educational background, training, and/or experience for each staff present must be available for review.

8. Immunization Requirements: Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles or influenza declination

9.Children’s Records: must be available for review; including but not limited to, the following: Name, address and telephone number of the child's authorized representative and of relatives or others who can assume responsibility for the child if the authorized representative cannot be reached when necessary.

10. Staff Records: must be available for review; background clearance, LIC 503 Health Screening report, LIC 9108 Statement Acknowledging Requirement to Report Child Abuse, Staff Qualifications, LIC 9050 Employee Rights, LIC 501 Personnel Record, AB 1207 Mandated Child Abuse Certification, MMR, TDAP, TB, influenza or influenza declination.

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:	DATE: 07/31/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2024

LIC809 (FAS) - (06/04)

Page: 6 of 10

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: BRIGHT HORIZONS AT FIGUEROA INFANT	FACILITY NUMBER: 198019482
	VISIT DATE: 07/31/2024

NARRATIVE

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Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1CCP).

LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

LPA Perry discussed the safe sleep regulations with director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records.

For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:	DATE: 07/31/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2024

LIC809 (FAS) - (06/04)

Page: 7 of 10

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: BRIGHT HORIZONS AT FIGUEROA INFANT	FACILITY NUMBER: 198019482
	VISIT DATE: 07/31/2024

NARRATIVE

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Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Currently, facility is in compliance with Title 22 regulations and no citations.

Notice of Site Visit - A notice of site visit was given and must remain posted for 30 days. Failure to maintain posting as required will result in a $100.00 civil penalty.

Exit interview conducted and report was reviewed with Brenda Salguero, Director and Tiffany Wong, Assistant Director. Appeal rights provided and discussed.

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:	DATE: 07/31/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2024

LIC809 (FAS) - (06/04)

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