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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400455
Report Date: 12/16/2025
Date Signed: 12/16/2025 12:03:23 PM

Document Has Been Signed on 12/16/2025 12:03 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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:LBUSD CARVER-CHILD DEVELOPMENT CENTERFACILITY NUMBER:
198400455
ADMINISTRATOR/
DIRECTOR:		STEPHANIE STEPHENSFACILITY TYPE:
850
ADDRESS:5335 PAVO STTELEPHONE:
(562) 421-7015
CITY:LONG BEACHSTATE: CAZIP CODE:
90808
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 14DATE:
12/16/2025
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Cristabel Rodriguez, Program CoordinatorTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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Licensing Program Analysts (LPAs) Alicia Mooberry and Elka Chavez conducted an announced case management inspection due to Licensee requesting a classroom relocation. LPAs met with Facility Representative Cristabel Rodriguez, Program Coordinator, who guided analysts on a tour of the facility. This facility is located at Carver Elementary school in the city of Long Beach. There were 14 children and 4 staff present on this day.
This facility is currently licensed in Room K1 with a capacity of 24 children age 2-5 years. The facility representative is requesting to relocate from Room K1 to Room 1103 and maintain their current capacity of 24 children. Facility Representative is requesting the use of a temporary enclosed area to be used for outdoor activity space. The enclosed area is located across from Room 1103. Fire clearance is currently pending final approval.

LPAs measured the indoor classroom and outdoor activity space. Total indoor activity space measured 844.90 square feet, which is sufficient to accommodate the licensed capacity of (24) Children.

This program will continue to serve children ages 2 years to 5 years and operate Monday through Friday from 7:30AM to 3:30PM to hold two part time sessions from 8:00-11:0 and 12:00-3:00.

Parents will enter to the left of the main entrance. The sign in area will be located at the entrance of the classroom. There is drinking water readily available in the class via a water jug and disposable cups. There is an operable water faucet in the classroom and additional water fountains by the proposed shared bathroom.


Furniture and equipment were inspected for age appropriateness and good repair.
Page 1 -----Report continues
NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Alicia Mooberry
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/16/2025
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 3
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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: LBUSD CARVER-CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 198400455
VISIT DATE: 12/16/2025
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 LPAs observed all indoor activity space to be complete with safe, age-appropriate furniture and equipment, including tables, chairs, cubbies, bookshelves, and other activity supplies for the children. LPAs observed all hazardous items to be inaccessible to children. There are no bodies of water or weapons on the property. Carbon Monoxide detector was observed and tested, First aid kit was observed and inventoried, a medication box will be installed on wall by sink.

LPAs observed a total of (5) sinks and (2) toilets available for children’s use in the shared bathroom. LPAs observed 2 toilets inside the shared bathroom. Per FR there are 1 additional toilet that will be installed. These are sufficient to accommodate the requested capacity of (24) children.

The facility currently has a fully fenced playground area. Fencing is chain link and measures at least four feet high. The total square footage for all the outdoor activity space is 5,376 square feet which is sufficient to accommodate the requested capacity. The facility representative stated shade will be provided via a canopy that will be moved from playground of Room K1. There are sufficient outdoor age-appropriate toys and play equipment available on the K1 playground which will be moved to enclosed playground. Drinking water is available via water dispenser and cups and well as child's own water bottle. LPAs observed no hazardous items on the playground, and advised FR to ensure staff check for hazards such as holes in grassy area. The facility representative, Cristable Rodriguez was reminded that any changes to the facility must be reported to and approved by Community Care Licensing.


The following corrections are needed prior to the issuance of the license:
1. Make the toilets in the shared bathroom age appropriate.
2. Approved fire clearance needs to be submitted to the department
3. Waivers for outdoor play area and shared bathrooms need to be approved by department.
4. Toys and canopy to be placed in the play area.
5. Construction will be completed in the shared bathroom including adding 1 toilet.

No deficiencies were cited today. A notice of site visit was given to the facility representative and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.
Exit interview conducted and report was reviewed with the Cristable Rodriguez, Program Coordinator.
NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Alicia Mooberry
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2025
LIC809 (FAS) - (06/04)
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