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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020965
Report Date: 03/20/2026
Date Signed: 03/20/2026 01:16:40 PM

Document Has Been Signed on 03/20/2026 01:16 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:DORRIS PLACE ELEMENTARY CSPPFACILITY NUMBER:
198020965
ADMINISTRATOR/
DIRECTOR:		ISMAEL BERVERFACILITY TYPE:
850
ADDRESS:2225 DORRIS PLACETELEPHONE:
(323) 222-9185
CITY:LOS ANGELESSTATE: CAZIP CODE:
90031
CAPACITY: 20TOTAL ENROLLED CHILDREN: 16CENSUS: 11DATE:
03/20/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Teacher, Gabriela MartinezTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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On Friday, March 20, 2026, Licensing Program Analyst (LPA) Staicy Perry conducted an unannounced annual inspection and met with Principal, Rios Delia, who guided LPA Perry to the classroom and then was greeted by teacher, Gabriela Martinez. LPA was guided on a tour of the facility. Census was taken and LPA Perry observed 13 children with Staff #1 and Staff #2 supervising the children. Per teacher, Gabriela Martinez there are currently 16 children enrolled. Teacher Gabriela Martinez took over the inspection once inside the classroom. This is an LAUSD state preschool program located in RM 11 on the premises of Dorris Place Elementary School. This program is on Monday through Friday 8:00 am to 2:30 pm.

This is a preschool program that serves children ages THIS IS A PRESCHOOL PROGRAM SERVING CHILDREN AGES 2 TO 5 YEARS OLD. Facility has 2 waivers on file. LPA did observe waivers to be posted and followed. Facility have a waiver on file for the preschool program children located in Room 11 will be using the same restroom as the LAUSD Early Transitional Kinder program children located in Room 12, the bathroom is located in between both classrooms. and also, a waiver on file for the playground that is shared with Dorris Place Elementary preschool program to share their play yard space with Los Angeles Unified School District's Early Transitional Kindergarten programs which will be Kinder Room 15 and Room 16, along ETK classroom and Room 12 located on the premises of Dorris Place Elementary School. Facility is using a staggered outdoor play schedule.



Sign in and out takes place at the main entrance gate area. All areas identified on the facility sketch were toured and inspected both indoors and outdoors. Teacher and child ratio were observed, and present staff are fingerprinted cleared. LPA Perry also observed daily health checks being conducted.
NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Staicy Perry
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/20/2026
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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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: DORRIS PLACE ELEMENTARY CSPP
FACILITY NUMBER: 198020965
VISIT DATE: 03/20/2026
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Furniture and equipment were inspected for age appropriateness and good repair. LPA Perry observed age-appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age-appropriate toys accessible to children. Telephone service, heating, lighting and ventilation were evaluated. Children store their belongings in their backpack inside of their cubbies. Per Teacher, Gabriela Martinez, the isolation area is located in the nurse’s office. In the nurse’s office a mat can be placed on the floor for an ill child and the staff restroom is readily available if an ill child requires it. Age-appropriate sinks and toilets were inspected for availability and good repair in all restrooms. LPA observed that the facility has carbon monoxide detector which was tested and is in operable condition. General sanitation was observed. Availability of indoor drinking water was observed. LPA observed cleaning solutions stored inside the classroom locked cabinet at the top with a lock making it inaccessible for children to reach and open. LPA Perry observed a step trash bin with a lid in classroom. First Aid supplies were observed in the classroom hanging from an emergency disaster preparedness pack.

All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish, rodents, and/or any other vermin. All storage containers for solid waste, including movable bins, shall have tight-fitting covers that are kept on, and in good repair.

Outdoor playground equipment was observed. All areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard. Availability of outdoor drinking water was observed.

All individuals present have obtained a criminal record clearance or criminal record exemption. All staff have received an active criminal record clearance as a condition of their employment with the Los Angeles Unified School District. There is at least one person trained in CPR and Pediatric First Aid present during this inspection, which expires on July 1, 2027, for Teacher Gabriela Martinez.

Children’s Records were reviewed for completeness; Inspection of required forms was made. Children’s files were observed to be complete. Staff files were reviewed for completeness. LPA Perry was able to review immunizations, MRT, CPR and did observe teacher, Gabriela Martinez, to have her Child Development Site Supervisor Permit on file . LPA will review complete staff files at a later time and date. If staff files were to be incomplete during the time and date that LPA reviews files, a case management inspection will occur at the facility to reflect the incomplete files. Children's roster was reviewed and is current. Sign-In and Sign-Out sheets were reviewed. Children presents were signed in. Disaster drill log was available, last drill was conducted on 5/6/2026.

NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Staicy Perry
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2026
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: DORRIS PLACE ELEMENTARY CSPP
FACILITY NUMBER: 198020965
VISIT DATE: 03/20/2026
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LPA Perry observed that food menus were posted. LPA Perry advised that menus must be posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request. Preschoolers are provided with breakfast and lunch by the Los Angeles Unified School District.

The following documents were posted in a prominent, publicly accessible area at the facility: Facility License, Notification of Parents' Rights (PUB 393), Personal Rights (LIC 613A), Menu, and Earthquake Preparedness (LIC 9148). PUB 269 Child Passenger System Poster, and Daily Schedule. Waivers were also observed to be on file.

Items discussed during this visit:

1. The following items are prohibited by Licensing: Refused Entry to a Facility or Any Part of a Facility is a violation of Section 1596.852, 1596.853 or 1597.09. Regulations 101238 (g) (2), The Presence of an Excluded Individual, Fire Clearance Violations, Accessible Bodies of Water, Accessible Firearms, Ammunition or Both

2. Breakfast/Lunch/Snack Menus: Menus are required to be posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days must also be available upon request.

3. Current Children’s Roster: Each childcare facility shall maintain a current roster of children who are provided care in the facility. The roster shall include the name, address, and daytime telephone number of the child's parent or guardian, and the name and telephone number of the child's physician. This roster shall be available to the licensing agency upon request.



4.LIC 311A - Records to be Maintained at the Facility: LPA advised that forms, regulations, and quarterly updates can be accessed on the Child Care Licensing website at: www.ccld.ca.gov.

5.Pediatric First Aid and CPR: At least one person trained in Pediatric First Aid and CPR and EMSA approved must be present.

6.Designated Staff: The name of the childcare center director or fully qualified teacher(s) designated to act in the director's absence must be on file.
NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Staicy Perry
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2026
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: DORRIS PLACE ELEMENTARY CSPP
FACILITY NUMBER: 198020965
VISIT DATE: 03/20/2026
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7.Qualifications: Educational background, training, and/or experience for each staff present must be available for review

8. Immunization Requirements: Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles or influenza declination

9.Children’s Records: must be available for review; including but not limited to, the following: Name, address, and telephone number of the child's authorized representative and of relatives or others who can assume responsibility for the child if the authorized representative cannot be reached when necessary.

10.Staff Records: must be available for review; background clearance, LIC 503 Health Screening report, LIC 9108 Statement Acknowledging Requirement to Report Child Abuse, Staff Qualifications, LIC 9050 Employee Rights, LIC 501 Personnel Record, AB 1207 Mandated Child Abuse Certification, MMR, TDAP, TB, influenza or influenza declination.

Licensee Teacher Gabriela Martinez 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.

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 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.). 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 licensee [or facility representative] 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 verified that LEAD results were completed and had no exceedance. LPA also observed results to be posted.

NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Staicy Perry
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2026
LIC809 (FAS) - (06/04)
Page: 5 of 7
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: DORRIS PLACE ELEMENTARY CSPP
FACILITY NUMBER: 198020965
VISIT DATE: 03/20/2026
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LPA discussed the safe sleep regulations with licensee Teacher Gabriela Martinez 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 licensee [or facility representative] of the importance of checking for and removing any 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 provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. 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/.

Teacher Gabriela Martinez was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

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.

Teacher Gabriela Martinez. was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.

NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Staicy Perry
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2026
LIC809 (FAS) - (06/04)
Page: 6 of 7
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: DORRIS PLACE ELEMENTARY CSPP
FACILITY NUMBER: 198020965
VISIT DATE: 03/20/2026
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LPA reviewed with Teacher Gabriela Martinez the LIC 311A, Records to be Maintained at the Facility, for child’s records, personnel records, administrative records, and documents to be posted. Entrance Checklist was provided to the applicant.

Teacher Gabriela Martinez was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

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/communitycare-licensing/subscribe and select the Child Care option to receive email communication.

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.

Currently the facility complies with Title 22 regulations. No deficiencies will be issued on this date, 3/20/2026.

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

Exit interview conducted and report was reviewed with Teacher Gabriela Martinez. Appeal rights provided and discussed.

NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Staicy Perry
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2026
LIC809 (FAS) - (06/04)
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