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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021577
Report Date: 09/16/2024
Date Signed: 02/26/2025 12:06:53 PM

Document Has Been Signed on 02/26/2025 12:06 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:WILLARD PAYNE HEAD START/STATE PRESCHOOLFACILITY NUMBER:
198021577
ADMINISTRATOR/
DIRECTOR:		ALMA GONZALESFACILITY TYPE:
860
ADDRESS:2850 N. MOUNTAIN VIEW RD.TELEPHONE:
(626) 652-4250
CITY:EL MONTESTATE: CAZIP CODE:
91732
CAPACITY: 16TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
09/16/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Jennifer CamargoTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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*This report was originally completed under facility 191593625 in error*

On 09/16/2024 at 10:35 am, Licensing Program Analyst (LPA), Crystal Green conducted an announced Case Management inspection for a change in licensed capacity. Upon arrival, Licensing Staff met with Facility Representative Jennifer Camargo. This facility is currently licensed as a Head Start program with a capacity of 42 children serving ages 3 until entry into kindergarten in classrooms 1 and 2. The Licensee, Mountain View School District, has requested to reduce their licensed capacity and add a new toddler program serving 16 children from ages 18 to 36 months in classroom 1 and 2. The licensee plans to only offer childcare services under the toddler program also known as the Early Head Start program at this location.

This Facility is located on the premises of the Willard Payne Elementary School. There is a designated pickup and drop off location for parents which will be located in the front office of the elementary school. The parents will be escorted to their child classroom.

The Facility hours of operation are Monday to Friday from 8am to 2:30pm. There were no children present during today’s inspection. All indoor and outdoor activity space utilized for the children was inspected today. LPA informed Facility staff that staff are required to maintain direct visual supervision of the children at all times during indoor and outdoor activities.

LPA continued to tour the facility and measured the indoor activity space. The total indoor activity space measured is 1,400.90 square footage, which is sufficient to accommodate the requested capacity. LPA observed all indoor activity space to be complete with safe, age-appropriate furniture and equipment, including tables, chairs, cubbies, napping cots, bookshelves, and other activity supplies for the children. Report Continues Page 1 of 2.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE: DATE: 09/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/16/2024
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 2
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: WILLARD PAYNE HEAD START/STATE PRESCHOOL
FACILITY NUMBER: 198021577
VISIT DATE: 09/16/2024
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Drinking water is available for the children via a filter water fountain located between classroom 1 and 2. LPA observed all hazardous items to be inaccessible to children. There are no bodies of water or weapons on the property.

LPA observed a total of 3 sinks and 3 toilets available for children’s use. There are (4) additional sinks available within the classroom for children’s use. These are sufficient to accommodate the licensed capacity of 16 children. LPA also observed a changing table located within both classroom 1 and classroom 2.

The facility currently has a fully fenced playground area made of wrought iron which was observed to be at least four feet high. Total outdoor activity space measured to be 4,711.32 square footage, which is sufficient to accommodate the requested increase in the toddler capacity. Shade is provided via shade canopies. There are sufficient outdoor age-appropriate toys and play equipment available on the playground. LPA observed a play structure located within the playground suited for children from ages 2 to 5 years old that was made inaccessible by being surrounded by an orange mesh net. Facility Representative was reminded that any changes to the facility must be reported to and approved by Community Care Licensing.

No corrections are needed. A license for a total of 16 children serving ages 18 to 36 months in classroom 1 and 2 will be granted upon a final file review. Facility Representative was reminded that any changes to the facility licensed capacity or programs served must be reported to and approved by Community Care Licensing.

A notice of site visit was given to facility representative, Jennifer Camargo, and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.


Report Ends Page 2 of 2.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:

DATE: 09/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2