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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019526
Report Date: 03/05/2025
Date Signed: 03/05/2025 02:06:19 PM

Document Has Been Signed on 03/05/2025 02:06 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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:FULL GOSPEL CHILD DEVELOPMENT CENTER PRESCHOOLFACILITY NUMBER:
198019526
ADMINISTRATOR/
DIRECTOR:		CHRISTIAN SEYMOURFACILITY TYPE:
850
ADDRESS:10700 S. SAN PEDRO STTELEPHONE:
(323) 756-1975
CITY:LOS ANGELESSTATE: CAZIP CODE:
90061
CAPACITY: 15TOTAL ENROLLED CHILDREN: 15CENSUS: 13DATE:
03/05/2025
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH: Administrator/ Teacher Christian SeymourTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
NARRATIVE
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On February 05, 2025, at 09:35 AM, Licensing Program Analysts (LPAs) Ashley Calderon and Tyler Reyes, conducted an unannounced Case Management Annual Continuation Inspection. LPAs disclosed the purpose of the inspection and was granted entry into the facility by Facility Representative Christian Seymour.

Facility regular hours of operation are Monday to Friday 5am-5pm and Saturday-Sunday from 5am-5pm are available if needed. Weekday Director is Christian Seymour and Weekend Director is Dominique Huffman. This facility consists of 1 classroom and outdoor play area. This facility is licensed to have Preschool Program Facility is licensed to have children ages 2 years old until entry into 1st grade (Children enrolled in elementary school/ kindergarten cannot be enrolled at the facility).

Upon arrival LPA observed 12 children, 2 staff aids, 1 teacher and 1 teacher/director.
  • On today's visit LPA Calderon and LPA Reyes reviewed (4) staff records. Staff #3 and Staff #4 was missing Education/ Transcripts. Licensee Angela Huffman arrived at the facility approximately at 11:20am. Based on record review Staff #1, Staff #2, and Staff #4 files did not have LIC503 Health Screening. Staff #2 is missing there Measles, Tuberculosis (TB) and Pertussis and Staff #4 is missing TB.
  • Five (5) children files were reviewed. Child #1 missing immunization's. Child #1 and Child #2 missing LIC 702 Health Screening and LIC701 Physician Report. LPA Reyes conducted staff interview with Director Christian Seymour.
  • LPA Calderon consulted on Parent Handbook.
Per California Code of Regulation Title 22 deficiencies were provided on LIC 809-D. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with facility representative Christian Seymour.
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Ashley Calderon
LICENSING EVALUATOR SIGNATURE: DATE: 03/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/05/2025
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 3
Document Has Been Signed on 03/05/2025 02:06 PM - It Cannot Be Edited


Created By: Ashley Calderon On 03/05/2025 at 01:08 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: FULL GOSPEL CHILD DEVELOPMENT CENTER PRESCHOOL
FACILITY NUMBER: 198019526

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/05/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(g)(1)
Personnel Requirements
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review staff #1, staff #2 and staff #4 are missing LIC 702 Health Screening the licensee did not comply with the section cited above in [3] out of [4] children files reviewed which pose a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/04/2025
Plan of Correction
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Facility will send LPA copies of Child #1 and Child #2 Health Screening form to LPA Calderon via email by POC due date.
Type B
Section Cited
CCR
101216.1(b)(1)
Teacher Qualifications and Duties
(b) Prior to employment, a teacher shall meet the requirements of (b)(1) or (b)(2) below: (1) A teacher shall have completed, with passing grades, at least six postsecondary semester or equivalent quarter units of the education requirement specified in (c)(1) below; or shall have obtained a Child Development Assistant Permit issued by the California Commission on Teacher Credentialing.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review Staff #2 and Staff #3 do not have early education CDC units, the licensee did not comply with the section cited above in (2) out of [4] staff education records missing which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/04/2025
Plan of Correction
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Licensee will enroll staff #1 and #2 into early education/child development units until fully qualified, facility will provide proof of enrollment and CDC course enrolled and sent proof by poc due date.
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:Denise Gibbs
LICENSING EVALUATOR NAME:Ashley Calderon
LICENSING EVALUATOR SIGNATURE:
DATE: 03/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/05/2025


LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 03/05/2025 02:06 PM - It Cannot Be Edited


Created By: Ashley Calderon On 03/05/2025 at 01:11 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: FULL GOSPEL CHILD DEVELOPMENT CENTER PRESCHOOL
FACILITY NUMBER: 198019526

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/05/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
(1) 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. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.


This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review staff #1 did not have MMR, TB, TDAP immunization's on file, the licensee did not comply with the section cited above in [1] out of [4] persons immunization records poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/04/2025
Plan of Correction
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Staff #1 will get Measles, TB and Pertussis vaccination and send immunization records to LPA Calderon via email by POC
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Denise Gibbs
LICENSING EVALUATOR NAME:Ashley Calderon
LICENSING EVALUATOR SIGNATURE:
DATE: 03/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/05/2025


LIC809 (FAS) - (06/04)
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