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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019526
Report Date: 02/21/2024
Date Signed: 02/21/2024 06:13:59 PM

Document Has Been Signed on 02/21/2024 06:13 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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:FULL GOSPEL CHILD DEVELOPMENT CENTER PRESCHOOLFACILITY NUMBER:
198019526
ADMINISTRATOR:CHRISTIAN SEYMOURFACILITY TYPE:
850
ADDRESS:10700 S. SAN PEDRO STTELEPHONE:
(323) 756-1975
CITY:LOS ANGELESSTATE: CAZIP CODE:
90061
CAPACITY: 15TOTAL ENROLLED CHILDREN: 15CENSUS: 15DATE:
02/21/2024
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Director Christian SeymourTIME COMPLETED:
06:30 PM
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On February 21, 2024, at 1:30 PM, Licensing Program Analysts (LPAs) A. Wallin and T. Tran, conducted an unannounced Annual Required Inspection for the preschool license. During today’s inspection, LPA met with program director Christian Seymour, and toured the facility indoors and outdoors. Per Licensee facility operation hours are 7am to 6pm, Monday to Friday. This facility consists of 1 classroom and outdoor play area. This is a preschool program with a toddler option. LPA observed 15 children and two teachers present at time of inspection. Per director, 15 children enrolled at this time. Per record review, facility license states capacity of only 10 preschool children and 5 toddlers in care. During today's visit, LPA observed 15 preschool children in care. A type A citation issued. In addition to today's visit, LPAs observed the following areas: care and supervision, personal rights and physical plant that was addressed by TSP referral, which occurred on December 28, 2024 to ensure the quality of quarterly increase monitoring.

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. LPA observed mesh around barricade with holes. A technical violation citation issued. Telephone service, heating, lighting, and ventilation were evaluated. Carbon monoxide detectors were observed and are operable. Children have their own cubby to store their belongings. LPAs observed napping mats used in classroom. Age appropriate sinks and toilets were inspected. LPAs observed children’s bathroom located in staff only room. LPAs observed toilets and sink operable. General sanitation was observed.

Per director, drinking water provided via dispenser located in staff only room. LPAs observed outdoor drinking water located outside in orange drinking dispenser. Per director, outdoor drinking water dispenser was placed outside to be cleaned. Per PIN 21-21-CCP lead testing to be conducted for all equipment used for drinking consumption. During inspection, LPA did not observe any lead test results. Per director lead testing was conducted. No record provided with evidence of lead test date and results. A Type B Citation issued.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Angelica Wallin
LICENSING EVALUATOR SIGNATURE: DATE: 02/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/21/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: FULL GOSPEL CHILD DEVELOPMENT CENTER PRESCHOOL
FACILITY NUMBER: 198019526
VISIT DATE: 02/21/2024
NARRATIVE
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During inspection, LPAs observed Lysol spray and Raid pesticide spray easily accessible to children in care. Director immediately addressed and relocated sprays to inaccessible locked closet. A technical violation citation issued. All kitchen and storage areas are clean, free of litter, rubbish, and rodents/vermin. All food is protected from contamination. All storage containers for solid waste, including moveable bins, have tight fitting covers on and are in good repair.

Outdoor playground equipment is in a safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. There is adequate shade in the play yard. LPAs advised that no children shall be left without the supervision of a teacher at any time. All floors were observed to be clean and safe. All materials accessible to children were observed to be toxic free. There are no firearms stored on the premises. There are no pools or bodies of water at the facility.

LPA’s reviewed 15 children’s files and observed files were updated and maintained. Per staff record review, LPAs observed that two staff and director missing updated CPR/1st aid certification. Per staff record review, LPA observed one staff files are incomplete. Two type B citations issued.

The name of the child care center director or fully-qualified teacher(s) designated to act in the director’s absence has been reported to the Department. LPA reviewed sign in and out sheets. LPA observed two children missing on the sign in and out sheet for today's date. A type B citation issued. LPAs reviewed the following documentation to be kept in facility: facility license, LIC610, PUB 393, daily schedule, PUB 269, and fire drills. During inspection, director failed to show LPAs copy of fire drills conducted. A type B citation issued.



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.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Angelica Wallin
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2024
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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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: FULL GOSPEL CHILD DEVELOPMENT CENTER PRESCHOOL
FACILITY NUMBER: 198019526
VISIT DATE: 02/21/2024
NARRATIVE
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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 21-21.1- CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP
LPA referred licensee to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

LPA 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 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 does not provides Incidental Medical Services – IMS. Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, an updated Plan of Operation that includes 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) 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-care-centers/

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.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Angelica Wallin
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2024
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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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: FULL GOSPEL CHILD DEVELOPMENT CENTER PRESCHOOL
FACILITY NUMBER: 198019526
VISIT DATE: 02/21/2024
NARRATIVE
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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication

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

Upon receipt of a Type A deficiency, licensee shall post and provide copies of this licensing report to parent/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. Copies of the reports must also be provided to each parent when a serious deficiency, Type A, is cited. If a serious violation is cited, a copy of the licensing report LIC809 and LIC 809D must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed.

Exit interview conducted and report was reviewed with the director, Christian Seymour. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Angelica Wallin
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2024
LIC809 (FAS) - (06/04)
Page: 7 of 10
Document Has Been Signed on 02/21/2024 06:13 PM - It Cannot Be Edited


Created By: Angelica Wallin On 02/21/2024 at 04:24 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: 02/21/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101161(a)
Limitations on Capacity and Ambulatory Status
(a) A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in that facility license statesonly 10 preschool children and 5 toddlers in care and during today's visit LPA observed 15 preschool children in care which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 02/21/2024
Plan of Correction
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Per director, she agreed to completed LIC 855 written declaration statement stating no more than 10 preschool children accepted. LPAs collected completed LIC 855 during visit.
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:Karen Chambers
LICENSING EVALUATOR NAME:Angelica Wallin
LICENSING EVALUATOR SIGNATURE:
DATE: 02/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/21/2024


LIC809 (FAS) - (06/04)
Page: 2 of 10
Document Has Been Signed on 02/21/2024 06:13 PM - It Cannot Be Edited


Created By: Angelica Wallin On 02/21/2024 at 04:24 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: 02/21/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.16(a)(1)
Lead Testing
(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in no record provided with evidence of lead test date and results which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/06/2024
Plan of Correction
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Per director, she agreed to provide copy of lead testing results to be submitted via email and post results in facility.
Type B
Section Cited
CCR
101174(d)
Disaster and Mass Casualty Plan
(d) Disaster drills shall be conducted at least every six months.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in no record provided of conducted fire drills which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/06/2024
Plan of Correction
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Per director, she agreed to provide copy of conducted fire drills to be submitted via email.
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:Karen Chambers
LICENSING EVALUATOR NAME:Angelica Wallin
LICENSING EVALUATOR SIGNATURE:
DATE: 02/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/21/2024


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Document Has Been Signed on 02/21/2024 06:13 PM - It Cannot Be Edited


Created By: Angelica Wallin On 02/21/2024 at 04:24 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: 02/21/2024

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
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Based on record review, the licensee did not comply with the section cited above in at least one staff present with updated CPR/1st aid certificate which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/06/2024
Plan of Correction
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Per director, she agreed to provide copy of updated CPR/1st aid certificate for all staff to be submitted via email.
Type B
Section Cited
CCR
101217(a)
Personnel Records
(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in one staff recods being incomplete which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/06/2024
Plan of Correction
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Per director, she agreed to provide copy of completed staff record to be submitted via email.
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:Karen Chambers
LICENSING EVALUATOR NAME:Angelica Wallin
LICENSING EVALUATOR SIGNATURE:
DATE: 02/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/21/2024


LIC809 (FAS) - (06/04)
Page: 4 of 10
Document Has Been Signed on 02/21/2024 06:13 PM - It Cannot Be Edited


Created By: Angelica Wallin On 02/21/2024 at 06:05 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: 02/21/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101229.1(a)(1)


This requirement is not met as evidenced by: (a) In addition to the sign-in procedure requirement of Section 101226.1(b), the licensee shall develop, maintain and implement a written procedure to sign the child in/out of the child care center that shall, at a minimum, include the following: (1) The person who signs the child in/out shall use his/her full legal signature and shall record the time of day.
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in two children missing on sign in and out sheet which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/06/2024
Plan of Correction
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3
4
Per director, she agreed to provide copy of complete sign in and ouot sheet for span on 2 weeks to be submitted via email.
Section Cited
Deficient Practice Statement
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2
3
4
POC Due Date:
Plan of Correction
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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.
SUPERVISOR'S NAME:Karen Chambers
LICENSING EVALUATOR NAME:Angelica Wallin
LICENSING EVALUATOR SIGNATURE:
DATE: 02/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/21/2024


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