198019526-11-14-2025-54-CC-ACAN-DNESCV-20251114124609

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019526
Report Date: 11/14/2025
Date Signed: 11/14/2025 12:46:25 PM

Document Has Been Signed on 11/14/2025 12:46 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 PRESCHOOL		FACILITY NUMBER:	198019526
ADMINISTRATOR/ DIRECTOR:	CHRISTIAN SEYMOUR		FACILITY TYPE:	850
ADDRESS:	10700 S. SAN PEDRO ST		TELEPHONE:	(323) 756-1975
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90061
CAPACITY: 15	TOTAL ENROLLED CHILDREN: 18	CENSUS: 6	DATE:	11/14/2025
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:03 AM
MET WITH:	Facility Representative (Administrator) Christian Seymour.		TIME VISIT/ INSPECTION COMPLETED:	12:57 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 November 14,2025 at 9:03 AM, Licensing Program Analyst (LPA) Ashley Calderon, conducted an unannounced Annual/ Required Inspection. LPAs disclosed the purpose of the inspection and was granted entry into the facility by Facility Representative Jose Sanchez. Facility operation hours are 7am to 6pm, Monday to Friday. This facility consists of 1 classroom and outdoor play area. This facility is licensed to have Preschool Program with Capacity 15. Upon arrival, LPA Calderon observed 3 children in care with Lead Teacher (Facility Representative) Jose Sanchez and a Staff Assistant. At approximately 9:15am Administrator/ Facility Representative Christian Seymour . At approx. 9:36am additional two children arrived making census 5. The Center Facility Entrance Checklist LIC125 was provided during inspection. LPA Calderon conducted a tour of the facility with Facility Representative C.Seymour. The following was observed during the tour of the facility: furniture and equipment were inspected for age appropriateness and good repair. During inspection, LPA observed a barricade made of PCP pipe, zip ties and mesh around wall heater to prevent accessibility. Telephone service, heating, lighting, and ventilation were evaluated and found operable. Smoke Alarm has the Carbon monoxide detectors, interconnected device tested and found operable. LPA observed children having their own cubby to store their personal belongings. LPA observed napping mats used in classroom; napping mats are stored in cabinets individually stored in bags with writing of children name to identify napping equipment. At approximately, 10am an additional child arrived making census 6.

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 11/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: FULL GOSPEL CHILD DEVELOPMENT CENTER PRESCHOOL	FACILITY NUMBER: 198019526
	VISIT DATE: 11/14/2025

NARRATIVE

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LPA observed children bringing in water bottles, facility providing Gallon Bottles for water refills and cups available inside and for outdoor use. LPA observed age appropriate materials, toys and equipment for children in care.

Food served to the children is brought daily. Facility is required to use paper goods - plates, utensils, cups and etc due to not having proper sinks for food preparation. LPA Calderon observed cleaning products in the room that is by the entrance door, door is maintained locked. Knives are stored in high to reach locker cabinets. The food week's food menu was posted on the bulletin board near the entrance.

Isolation area for children waiting to be picked up by parents will use staff restroom for sick children and sick children will wait when class is outside under the tarp on a chair away and when classroom taking place inside, sick child will wait by the teachers desk on a chair or mat.

Outdoor was observed there is a play structure equipment that has slides and swings, under the equipment there is material to absorb falls (artificial grass). No bodies of water observed on premises.

LPA Calderon reviewed records: Disaster / Fire Drill was last conducted 11/10/2025, drill was recorded and reviewed. Per C.Seymour conducts drills monthly do to facility's preference, LPA informed Admin. required every 6 months per Title 22. LPA observed a fire extinguisher on premies. Sign in/ out sheets were observed paper form and Brightwheel app is used.

LPA reviewed required posters to be posted in a prominent area. LPA's observed the following posters: Facility License, PUB269 Child Passenger Restraint System, Emergency Disaster Plan , Lead Test conducted in 2023 and Notifications of Parents Rights, postages are located at the Entrance/ Exit on the left hand side wall on a bulletin board. Staff and children records were reviewed: LPA reviewed 6 children records, all had appropriate documentation. Consultation was given on Immunization records to update immunization based on Immunization Regulation 101220.1 and LPA informed Licensee to ensure Tuberculosis is completed when children get their Physician Record filled out and get a Risk Assessment completed by their physician. Administrator's Mandated Reporter Training for C.Seymour expires 7/1/26 and all staff had a valid M.R training. During today's visit there were no staff present that had a valid Pediatric First aid and cpr. Administration's pediatric CPR and First Aid from Medic First Aid had no EMSA stickers, and Staff #2 Pediatric 1st aid and cpr expired 10/31/25, deficiency cited. Staff #3 consultation was given on Immunization records.

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 11/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 11/14/2025 12:46 PM - It Cannot Be Edited

Created By: Ashley Calderon On 11/14/2025 at 12:07 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: 11/14/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101216(f)

Personnel Requirements

(f) At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on LPA Calderon record review, there were no staff present that had a valid Pediatric First aid and cpr. Administration's pediatric CPR and First Aid from Medic First Aid had no EMSA stickers, and Staff #2 Pediatric 1st aid and cpr expired 10/31/25, the licensee did not comply with the section cited above in (2) out of (2) [(objects) (persons)] [identifiers] which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/21/2025
	Plan of Correction
1 2 3 4	By POC due date, Licensee will send me verification of scheduled date of Pediatric First Aid and CPR and once completed will send me Pediatric 1st aid and cpr certification cards to LPA Calderon.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Warren Birks
NAME OF LICENSING PROGRAM MANAGER:

	Ashley Calderon
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2025

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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: FULL GOSPEL CHILD DEVELOPMENT CENTER PRESCHOOL	FACILITY NUMBER: 198019526
	VISIT DATE: 11/14/2025

NARRATIVE

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Facility representative 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 as specified in Health and Safety Code section 1597.16. 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 21-21.1-CCP.). Facility representative was referred to the Department website for lead: Lead Toxicity Prevention and Water Testing Information (https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information)

• CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.
Facility Representative 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. or 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.

Per California Code of Regulation Title 22 deficiency (1) was 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.

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 11/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2025

LIC809 (FAS) - (06/04)

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