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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020800
Report Date: 12/03/2024
Date Signed: 12/03/2024 12:23:27 PM

Document Has Been Signed on 12/03/2024 12:23 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:PUENTE AVE PRESCHOOLFACILITY NUMBER:
198020800
ADMINISTRATOR/
DIRECTOR:		KIMBERLY NGUYENFACILITY TYPE:
850
ADDRESS:802 VINELAND AVETELEPHONE:
(626) 277-9700
CITY:LA PUENTESTATE: CAZIP CODE:
91746
CAPACITY: 56TOTAL ENROLLED CHILDREN: 56CENSUS: 29DATE:
12/03/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:20 AM
MET WITH:Abigail MauleonTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On December 3,, 2024, at 9:20 am Licensing Program Analysts (LPAs) Carolyn Tuba and Monica Ruiz conducted a case management inspection due to an incident that was self reported, and an Unusual Incident Report (UIR) was submitted by the facility. The incident occurred on 11/13/2024 where a parent had approached staff with a concern of their child. LPAs met with Assistant Director, Abagail Mauleon. LPAs observed and took a census of 29 children with 6 staff.

The incident was reported to the Department within the required 24 hours of occurrence.
During this investigation, LPAs conducted interviews with 2 staff members and reviewed video footage of Room 2 during the month of November. LPAs attempted to interview Child #1 (C1) however C1 was not at school on this day. During this visit LPAs provided consultation and Assistant Director reviewed clearance list of staff and requested certain staff be disassociated from the facility license.

LPAs were not able to obtain the information needed and will require a return visit. No citations have been issued at this time.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Assistant Director, Abagail Mauleon.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE: DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/03/2024
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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