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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020303
Report Date: 11/20/2025
Date Signed: 11/20/2025 04:13:14 PM

Document Has Been Signed on 11/20/2025 04:13 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:PARA LOS NINOS EARLY HEAD START:VINEFACILITY NUMBER:
198020303
ADMINISTRATOR/
DIRECTOR:		ANGELA CAPONEFACILITY TYPE:
850
ADDRESS:1147 VINE STTELEPHONE:
(213) 250-4800
CITY:LOS ANGELESSTATE: CAZIP CODE:
90038
CAPACITY: 40TOTAL ENROLLED CHILDREN: 24CENSUS: 18DATE:
11/20/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Site Supervisior, Liliana RubioTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
NARRATIVE
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On November 20, 2025, Licensing Program Analysts (LPA) Priscilla Ochoa conducted an unannounced case management inspection for the above facility. LPA was greeted by Site Supervisor, Liliana Rubio, who guided LPA on a tour of the facility. The purpose of this inspection is to follow up on a self-reported incident that occurred at the facility on 11/18/2025. This is a preschool age program which operates Monday through Friday from 8:00 am to 4:30 pm. Per site supervisor, there are 24 children enrolled. LPA observed 18 children in care.

Brief summary of incident: Child #1 (C1) was locked in a shed that is located on the play yard and left unattended.

During this inspection, LPA reviewed video footage of incident, interviewed Staff #1 (S1) - Staff #5 (S5), attempted to interview Child #1(C1) and obtained other relevant documents. LPA also observed the playground and area where the incident occurred.

Based on the video footage observed by LPA, S3 was seen opening the shed that is located in the preschool play yard. S3, attempted to latch the child safety lock on the shed handles, preventing children from having access to the shed. C1 was then seen playing with other children and staff in the yard near the shed area. At 3:21 pm, C1 is seen removing the child safety lock off the shed handles and playing with the lock. C1 was seen walking by staff members holding the lock and then ultimately throwing the lock on the ground. One minute later, C1 is seen opening the shed doors and entering the shed and closing the doors. LPA observed S5 in the vicinity, when C1 entered the shed.

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NAME OF LICENSING PROGRAM MANAGER: Ana Chico
NAME OF LICENSING PROGRAM ANALYST: Priscilla Ochoa
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 11/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/20/2025
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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Document Has Been Signed on 11/20/2025 04:13 PM - It Cannot Be Edited


Created By: Priscilla Ochoa On 11/20/2025 at 03:33 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: PARA LOS NINOS EARLY HEAD START:VINE
FACILITY NUMBER: 198020303

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/20/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/25/2025
Section Cited
CCR
101229(a)(1)

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Responsibility for Providing Care and Supervision. No child(ren) shall be left without the supervision of a teacher at any time... Supervision shall include visual observation.
This requirement was not met as evidenced by:
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Per site supervisor, they will conduct a staff meeting to review supervision and discuss how supervision needs to be maintained at all times. Staff will also view a video refresher on active supervision.
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Based on video footage and interviews, and documents obtained, facility did not ensure supervision was maintained at all times which caused C1 to gain access to the shed on the playground and be locked in, which poses an immediate risk to the health, safety, and personal rights of children in care.
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Site Supervisor will submit staff meeting agenda and attendance sheet with staff signatures acknowledging attendance to LPA by POC date.

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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.
Ana Chico
NAME OF LICENSING PROGRAM MANAGER:
Priscilla Ochoa
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/20/2025


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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: PARA LOS NINOS EARLY HEAD START:VINE
FACILITY NUMBER: 198020303
VISIT DATE: 11/20/2025
NARRATIVE
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However, S5 did have their back towards the shed and did not observe C1 enter the shed. At 3:23 pm, S2 was seen finding the child safety lock on the floor and placed it on the top portion of the shed doors. S2 remained in the area with 4 other staff members. S2 was then seen at 3:25 pm opening the shed letting C1 out. C1 was left in the shed and unsupervised for approximately 3 minutes.

During the course of interviews, S3 did disclose that S3 placed the child safety lock on the handles on the shed as that is how they secure cabinets in the infant class where they are predominantly placed. S2 mentioned that when S2 found the lock on the floor, S2 went to secure the shed doors by placing the lock on the top portion of the door. S2 also disclosed that they were the staff member who found the child in the shed as they heard a double knock coming from the shed. When S2 heard the knocks, S2 rushed to the shed to remove the child safely lock and released C1. LPA asked S1 – S5 how do staff members actively supervise children on the playground. All staff responded with they have to cover the zones which are the corners of the playground. S2 – S5 mentioned that they did not see C1 enter the shed during their time on the play yard, nor did they realize C1 was missing. C1 was unharmed and was picked up by the parents shortly after. LPA attempted to interview C1, however C1 did not wish to speak with LPA.

LPA P. Ochoa, informed Site Supervisor, Liliana Rubio that this report dated 11/20/2025 documents 1 Type A citation which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA P. Ochoa informed the Site Supervisor, Liliana Rubio to provide a copy of this licensing report dated 11/20/2025 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Site Supervisor, Liliana Rubio.

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NAME OF LICENSING PROGRAM MANAGER: Ana Chico
NAME OF LICENSING PROGRAM ANALYST: Priscilla Ochoa
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2025
LIC809 (FAS) - (06/04)
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