<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020819
Report Date: 08/27/2026
Date Signed: 08/27/2026 01:22:18 PM

Document Has Been Signed on 08/27/2026 01:22 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:GATEWAY MONTESSORI & PRESCHOOL LLCFACILITY NUMBER:
198020819
ADMINISTRATOR/
DIRECTOR:		ELIZABETH CRUZFACILITY TYPE:
830
ADDRESS:14121 COTEAU DR.TELEPHONE:
(562) 331-4221
CITY:WHITTIERSTATE: CAZIP CODE:
90604
CAPACITY: 8TOTAL ENROLLED CHILDREN: 5CENSUS: 4DATE:
08/27/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Owner Ruwani De SilvaTIME VISIT/
INSPECTION COMPLETED:
02:00 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 08/25/2026, Licensing Program Analysts (LPA) Mariah Aguirre conducted an unannounced Annual/Random inspection at the above facility. Upon arrival, LPA met with infant teacher, Brizel Soria who informed LPA that the owner had left to run an errand and would be back shortly. Licensee/Owner Ruwani De Silva arrived to the facility at 10:00AM and guided LPA on a tour of the facility. This is an infant licensed facility providing care to infants ages 0-2 years old, licensed for 8 infants. The facility’s hours of operation are Monday through Friday, 7:00AM to 6:00PM. During the inspection, LPA MAguirre observed 4 infants in care with 1 staff member.
The following classrooms were inspected: Infant Classroom, separated into a classroom and a napping room by a plexi-glass divider. 4 infants with 1 fully qualified staff member present. Teacher-child ratios were observed to be in accordance with Title 22 Regulations. All children were observed to be under supervision, including visual observation. Licensed facility is within the conditions and limitations specified on the license. Staff names were recorded and documented. Per the Director, the isolation area for children is in the main office.
The classroom furniture and equipment was inspected for good repair, free of sharp, loose, or pointed parts. All indoor classrooms were inspected to ensure that the floors have a surface that is safe and clean. All toilets, changing tables, and washing facilities are in safe and sanitary operating conditions. All materials and surfaces accessible to infants are toxic free. LPA observed cribs for each infant enrolled. All cribs had tight fitted sheets, free of blankets, bedding, and loose articles. Per licensee, all children’s bedding is sent home every Friday to be washed and is returned to the facility every Monday. At the time of inspection, LPA MAguirre did not observe a current 15-minute sleep log for children over the age of 1 and under the age of 2.

Page 1 of 5

Christina Gabelman
Mariah Aguirre
DATE: 08/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/27/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 9
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)
Page: 2 of 9
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: GATEWAY MONTESSORI & PRESCHOOL LLC
FACILITY NUMBER: 198020819
VISIT DATE: 08/27/2026
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
26
27
28
29
30
31
32
Per Title 22 regulations, staff shall physically check on a sleeping infant(s) every 15 minutes and document the following: labored breathing, signs of distress, which includes but it not limited to, flushed skin color, increase in body temperature and restlessness. Per the facility Director, a 15-minute sleep log is not kept for children under 2, but they do document when the child falls asleep and when they wake up. LPA MAguirre informed the licensee that all children under 2 years of age must have a current 15-minute sleep log on file. As a result, one Type B citation was issued.

The facility provides meals to infants in care over the age of 1. Per the Licensee, parents of infants under 1 are to provide breast milk or formula, and solids. The facility provides meals to infants over the age of 1 and meals provided are Breakfast, Lunch, and PM snacks. A meal and snack menu was available for review on the parent board outside of the infant classroom. Per the Licensee, they are apart of a meal program through a program called Children and Adult Care Meal Program. Filtered water is provided to children in care from a water cooler that is available in each classroom. The facility receives gallons of water from a water store located near the facility. Licensee could not recall the name of the water supply store at the time of inspection. Per the Licensee, when a gallon is finished, the facility replaces as needed. Per Director, parents provide water bottles for children in care that is refilled at the facility as needed. LPA observed all cleaning compounds and solutions to be stored away from children in care in the staff bathroom located in the Director’s office.

LPA observed that there is a dual in line functioning smoke and carbon monoxide detectors throughout the premises. LPA observed a fully charged and serviced fire extinguisher last serviced on 03/06/2026. Emergency disaster drill was last conducted in December of 2025. Per Title 22 regulations, Emergency Disaster drills should be conducted at the facility every six months. As a result, one type B citation was issued. Per Licensee, a disaster drill will be conducted today 08/27/2026.

At the time of inspection, LPA observed an outdoor playground for infants in care. The 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. All areas around or under high climbing equipment, slides, and similar equipment are cushioned with material that absorbs a fall. The material provided to absorb a sponge like surface. There is adequate shade in both play yard.




Page 2 of 5
NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Mariah Aguirre
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2026
LIC809 (FAS) - (06/04)
Page: 3 of 9
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: GATEWAY MONTESSORI & PRESCHOOL LLC
FACILITY NUMBER: 198020819
VISIT DATE: 08/27/2026
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
26
27
28
29
30
31
32
Sign in and out sheets are available for viewing outside of the main office. LPA observed that the person who signs the child in and out uses their full legal signature and records the time of the day. LPA reviewed staff records, staff files were incomplete as Staff #3 did not have a completed health screening on file. As a result, one type B citation was issued. Children’s Records were reviewed to ensure that Identification and Emergency form and a medical assessment are on file. Upon review of children’s records, LPA observed that children’s files were incomplete due to missing immunization records, and missing completed physicians reports. As a result, 2 type B citations were issued. (See attached LIC809D). Verification of CPR/First Aid and health preventative practices documentation was reviewed. SB792 (Immunization Requirements for Staff and Employees) was discussed with the Licensee.

AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018 any person who works in a childcare facility shall complete the training and renew the training every 2 years. At this time, all staff have a current Mandated Reporter Training Certification. Website provided: https://www.mandatedreporterca.com/training/child-care-providers.

LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed facility representative 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. LPA advised that children under 12 months need to have LIC 9227 individual sleeping plan on file.

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/.

Page 3 of 5

NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Mariah Aguirre
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2026
LIC809 (FAS) - (06/04)
Page: 4 of 9
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: GATEWAY MONTESSORI & PRESCHOOL LLC
FACILITY NUMBER: 198020819
VISIT DATE: 08/27/2026
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
26
27
28
29
30
31
32
CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES: 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.). LPA verified that the lead testing was completed in accordance to the Written Directives (Interim Licensing Standards) outlined in PIN 21-21.1-CCP. LPA referred the Director 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)

LPA advised the Licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.


The Licensee 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.

The Licensee 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.

During the exit interview, the Licensee Ruwani De Silva confirmed that there are no Registered Sex Offenders working in the facility and LPA completed the RSO profile in FAS.

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.

Page 4 of 5

NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Mariah Aguirre
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2026
LIC809 (FAS) - (06/04)
Page: 5 of 9
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: GATEWAY MONTESSORI & PRESCHOOL LLC
FACILITY NUMBER: 198020819
VISIT DATE: 08/27/2026
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
26
27
28
29
30
31
32
A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements will result in an immediate civil penalty of $100. A copy of this report along with appeal rights were provided to the Licensee.

Exit interview conducted and report was reviewed with the Licensee Ruwani De Silva.

Page 5 of 5

NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Mariah Aguirre
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2026
LIC809 (FAS) - (06/04)
Page: 6 of 9
Document Has Been Signed on 08/27/2026 01:22 PM - It Cannot Be Edited


Created By: Mariah Aguirre On 08/27/2026 at 12:00 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: GATEWAY MONTESSORI & PRESCHOOL LLC
FACILITY NUMBER: 198020819

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/27/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
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
1
2
3
4
Based on record review, the licensee did not comply with the section cited abov as the last disaster drill conducted took place in December of 2025, which posesses a potential risk to the health, safety, and personal rights of infants in care.
POC Due Date: 09/10/2026
Plan of Correction
1
2
3
4
Licensee will conduct and document a disaster drill and email an updated drill log to LPA MAguirre via email by POC due date above.
Type B
Section Cited
CCR
101429(a)(2)(B)
Responsibility for Providing Care and Supervision for Infants
(B) Staff shall physically check on sleeping infant(s) every 15 minutes and document the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in 3 out of 5 instances as infants 1-3 did not have a curent 15 minute sleep log on file, which poseses a potential risk to the health, safety, and personal rights of infants in care,
POC Due Date: 08/27/2026
Plan of Correction
1
2
3
4
Licensee will begin documenting a 15 minute sleeo log for all infants in care effective immediately, and will email proof of a 15 minute sleep log for all infants enrolled by end of day of POC due date above.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Christina Gabelman
NAME OF LICENSING PROGRAM MANAGER:
Mariah Aguirre
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/27/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/27/2026


LIC809 (FAS) - (06/04)
Page: 7 of 9
Document Has Been Signed on 08/27/2026 01:22 PM - It Cannot Be Edited


Created By: Mariah Aguirre On 08/27/2026 at 12:00 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: GATEWAY MONTESSORI & PRESCHOOL LLC
FACILITY NUMBER: 198020819

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/27/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(g)(1)
Personnel Requirements
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in 1 out of 3 instances, as staff #3 does not have a health screening report or immunization record on file, which poseses a potential risk to the health, safety, and personal rights of infants in care.
POC Due Date: 09/10/2026
Plan of Correction
1
2
3
4
Licensee will submit required documents for staff #3 by POC due date above to LPA MAguirre via email.
Type B
Section Cited
CCR
101221(b)(8)
Child's Records
(b) Each record shall contain information including, but not limited to, the following: (8) Medical assessment, including ambulatory status as specified in Section 101220, and the following health information:

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in 2 out of 5 instances, as child #3 and #4 do not have a medical assessment on file, this poseses a potential risk to the health and safety of infants in care.
POC Due Date: 09/10/2026
Plan of Correction
1
2
3
4
Licensee will obtain a medical assessment from all parents of enrolled infants by POC due date above, maintain the medical assessment in all infants files and submit proof of correction to LPA MAguirre 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.
Christina Gabelman
NAME OF LICENSING PROGRAM MANAGER:
Mariah Aguirre
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/27/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/27/2026


LIC809 (FAS) - (06/04)
Page: 8 of 9
Document Has Been Signed on 08/27/2026 01:22 PM - It Cannot Be Edited


Created By: Mariah Aguirre On 08/27/2026 at 12:00 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: GATEWAY MONTESSORI & PRESCHOOL LLC
FACILITY NUMBER: 198020819

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/27/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101220.1(g)
Immunizations
(g) The licensee shall document each child's immunizations and shall maintain such documentation in the center for as long as the child is enrolled.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in 5 out of 5 instances as no infants enrolled have an immunization record on file, which poseses a potential risk to the health and safety of infants in care.
POC Due Date: 09/10/2026
Plan of Correction
1
2
3
4
Licensee will obtain an immunization record for all infants enrolled, maintain in the infants files, and submit proof of correction to LPA MAguirre via email by by POC due date above.
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.
Christina Gabelman
NAME OF LICENSING PROGRAM MANAGER:
Mariah Aguirre
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/27/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/27/2026


LIC809 (FAS) - (06/04)
Page: 9 of 9