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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020175
Report Date: 09/13/2023
Date Signed: 09/13/2023 11:35:40 AM

Document Has Been Signed on 09/13/2023 11:35 AM - 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:KIDSZONE PRESCHOOL ACADEMYFACILITY NUMBER:
198020175
ADMINISTRATOR:YVONNE WITHERSFACILITY TYPE:
830
ADDRESS:1206 LINCOLN AVETELEPHONE:
(626) 345-5922
CITY:PASADENASTATE: CAZIP CODE:
91103
CAPACITY: 18TOTAL ENROLLED CHILDREN: 18CENSUS: 8DATE:
09/13/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:38 AM
MET WITH:Jessica Vance Compliance ManagerTIME COMPLETED:
11:30 AM
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On 09/13/2023, at 10:38 AM, Licensing Program Analyst (LPA) Thelma Razo conducted an unannounced Case Management inspection to verify that lead testing was completed in accordance to Written Directives outlined in PIN 21-21.1-CCP. A COVID 19 risk assessment was conducted prior to entering the facility. LPA met with Compliance Manager Jessica Vance and stated the purpose of the visit. There were 8 children and one staff present at the time of visit. Facility was within ratio and capacity.

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 childcare 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).

Licensee clarified that lead testing was not completed since they never used any water outlets for food preparation and drinking. LPA reviewed the Parent Handbook and it indicated that parents are responsible for providing lunch and snacks.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Thelma Razo
LICENSING EVALUATOR SIGNATURE: DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/13/2023
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: KIDSZONE PRESCHOOL ACADEMY
FACILITY NUMBER: 198020175
VISIT DATE: 09/13/2023
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According to Ms. Vance, a ready to eat food is available for morning and
afternoon snacks and for emergency cases. They use bottled water for drinking. LPA toured the facility and interviewed staff who confirmed that the facility use the water outlets for washing and flushing toilets only. During this visit, Ms. Vance has provided a written Declaration (LIC855) that no water outlets are being used for drinking nor for food preparation. Ms. Vance understood that if the center decides to use an outlet for drinking or food preparation in the future, center must first test for lead following the most current written directives prior to initial use.

During the visit, facility representative was reminded of outstanding annual fees.

No deficiency was cited during this inspection.

A notice of site visit was provided 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 Ms. Jessica Vance.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Thelma Razo
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
LIC809 (FAS) - (06/04)
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