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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021035
Report Date: 06/25/2025
Date Signed: 06/25/2025 11:13:49 AM

Document Has Been Signed on 06/25/2025 11:13 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:SPARK PRESCHOOLFACILITY NUMBER:
198021035
ADMINISTRATOR/
DIRECTOR:		SHANNON GALEFACILITY TYPE:
850
ADDRESS:1260 N. VERMONT AVETELEPHONE:
(323) 422-9690
CITY:LOS ANGELESSTATE: CAZIP CODE:
90029
CAPACITY: 58TOTAL ENROLLED CHILDREN: 52CENSUS: 0DATE:
06/25/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Shannon Gale, DirectorTIME VISIT/
INSPECTION COMPLETED:
11:15 AM
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On June 25, 2025, Licensing Program Analysts (LPA) Joanne Solorio-Campos, conducted an unannounced Case Management-Incident Report visit. LPA met with Director Shannon who guided LPA on a tour of the facility. LPA observed 0 children and 0 staff present during this visit as the school is closed for 2 weeks. The department received an unusual incident report on 6/11/25 via email for an incident that occurred on 6/10/25. Per Title 22 Regulations the report was reported in a timely manner.

During today’s visit, LPA conducted interviews with the Director Shannon, observed the classroom and door where the incident occurred (photo of door taken) and obtained pertinent documents.

LPA toured the facility and entered the classroom where the incident occurred. Director explained the incident occurred at the end of the day during pick-up time. The children were transitioning from outdoor play into the classroom. During time of the incident there were 7 children and two staff present. S#1 opened the classroom door and waited for everyone to go in. S#1 then turned around to close the door. As S#1 was closing the door they did not realize that C#1 turned back and was standing right behind them with her hand placed in the hinge. As the door closed Child#1 got her right middle finger caught in the door. Staff immediately responded, and administered first aid. The parent was notified, and C #1 was picked up within 4 minutes as mother was already on the way. The child was taken to the ER and 3 staff from the facility accompanied C#1. C#1 received a few stiches on the finger and a full arm cast was put in place. The child returned to the facility June 12, 2025 with medical clearance stating no restrictions. Parents were provided with an incident report from the facility and LPA obtained a copy.

After interviews, observation of the areas and observed documentation of the injury, it was determined that staff were unable to prevent the injury from happening; therefore, there is no preponderance of evidence to determine that a regulatory violation occurred, the incident was determined to be an accident. No deficiencies or civil penalties are being cited at this time.

Exit interview conducted and report reviewed with Director Shannon Gale.

A notice of site visit was provided, and appeal rights were provided and discussed.

NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Joanne Solorio Campos
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/25/2025
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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