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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400655
Report Date: 05/20/2025
Date Signed: 05/20/2025 04:58:16 PM

Document Has Been Signed on 05/20/2025 04:58 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:KINDERONE PRESCHOOLFACILITY NUMBER:
198400655
ADMINISTRATOR/
DIRECTOR:		KANG, YINGJIAOFACILITY TYPE:
850
ADDRESS:19023 NORWALK BLTELEPHONE:
(562) 684-8576
CITY:ARTESIASTATE: CAZIP CODE:
90701
CAPACITY: 65TOTAL ENROLLED CHILDREN: 47CENSUS: 38DATE:
05/20/2025
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:05 AM
MET WITH:Facility RepresentativeTIME VISIT/
INSPECTION COMPLETED:
05:15 PM
NARRATIVE
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On 05/20/2025 at 9:05am, Licensing Program Analysts (LPA) Jonnisha Culbert attempted to conduct an unannounced case management annual continuation inspection at the facility noted above. LPA met with Facility representative discussed the purposes of the visit and provided them with an Entrance checklist for Child Care Centers (LIC 125). They guided analysts on a tour of the facility. This is a preschool center with a Toddler component which consists of 3 classrooms. The program operates Monday through Friday from 8 am to 6pm. The program offers care to children 18 months to 6 years old. Present during today's inspection were Facility Representative, seven staff, one volunteer, and 38 Children.

The following is a combination of information collected from visits on 03/07/2025 and 05/20/2025. Upon arrival, LPA observed all required postings in a prominent publicly accessible area.

All areas used by children were inspected for safety. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting, and ventilation were evaluated. The facility uses central heating and air for ventilation. Lighting was observed to be in operable condition. LPA observed age-appropriate toys. Children have their own cubby in each classroom to store their belongings. Cots are available to children for napping. Per Facility Representative the isolation area is in the office. Children who are sick utilize staff restroom if needed. LPA observed an appropriate number of toilets and sinks available for both toddlers and preschoolers.

Availability of indoor and outdoor drinking water was observed in classrooms via sippy cups. Per Facility Representative, water is provided via filtered water from kitchen sink. LPA verified that the lead testing was completed in accordance with written directive outlined in Provider Information Notification (PIN)

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Jonnisha Culbert
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/20/2025
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.

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Document Has Been Signed on 05/20/2025 04:58 PM - It Cannot Be Edited


Created By: Jonnisha Culbert On 05/20/2025 at 03:23 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: KINDERONE PRESCHOOL
FACILITY NUMBER: 198400655

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/20/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) 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. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 1 out of 1 volunteer did not have immunizations which poses a potential health and safety risk to persons in care.
POC Due Date: 06/20/2025
Plan of Correction
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Per Facility Representative, volunteer will obtain immunizations and they will email proof to LPA J. Culbert by plan of correction date.
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
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Based on record review, the licensee did not comply with the section cited above in 1 out of 7 staff did not have health screening which poses a potential health and safety risk to persons in care.
POC Due Date: 06/20/2025
Plan of Correction
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Per Facility Representative, they will have staff 1 obtain the form and they will email the form to LPA J. Culbert by plan of correction date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Warren Birks
NAME OF LICENSING PROGRAM MANAGER:
Jonnisha Culbert
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/20/2025


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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: KINDERONE PRESCHOOL
FACILITY NUMBER: 198400655
VISIT DATE: 05/20/2025
NARRATIVE
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21-21.1-CCP.

Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Disinfectants and cleaning solutions were made inaccessible to children. Per Facility representative, no child currently enrolled require medication, but if medication was stored it will be kept in an appropriate area that is inaccessible to children. Poisons were not observed during visit. Per Representative, there are no poison on the premises. LPA reminded Facility Representative that if poisons are purchased, they are to remain in an area that is locked and inaccessible to children. A carbon monoxide detector was observed and is operable. LPA observed fire alarm pull station near the entrance of the facility.



Disaster drills were logged and available. The last drill was conducted on 04/30/2025. Menus are posted one month in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request. LPAs inspected the food preparation area. The kitchen was observed to be clean and free of litter. Food supplies were observed to be in good condition. The facility provides snacks and lunch.

The outdoor playground area was evaluated. LPA observed all areas around and under high climbing equipment and similar equipment are cushioned with mulch. Trees provide adequate shade on the playground. LPA observed a canopy in the toddler play area. Per Facility Representative, Teachers check sandbox daily for hazards and it is cleaned weekly. Availability of outdoor drinking water was observed. Per Facility Representative, there are no pools or bodies of water at the facility.

Children’s Records were reviewed for completeness. During record review, LPA observed that 3 out of 3 records reviewed were complete. Children's roster was reviewed and is current. Parents electronically sign children in and sign out via ProCare app. LPA reviewed sign in and sign out app and observed that parents used electronic signature to sign children in and out.

Staff records were reviewed. LPA observed 8 out of 8 staff present records and 1of of 1 volunteer record. During staff review LPA observed that 1 out 9 staff did not have Health screening form (LIC 503). This is a potential health and safety risk to persons in care. 1 out 1 Volunteer was missing proof of immunizations. This is a potential health and safety risk to persons in care. Facility Representative file was complete with
NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Jonnisha Culbert
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: KINDERONE PRESCHOOL
FACILITY NUMBER: 198400655
VISIT DATE: 05/20/2025
NARRATIVE
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incorrect CPR. LPA reminded Representative that if Pediatric First Aid and CPR is not administered by Red Cross or American Heart Association, Emergency Medical Services Authority (EMSA) stickers are required.

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.

Facility representative 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.

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 outlined in PIN 21-21.1-CCP

LPA discussed the safe sleep regulations with facility representative 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 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Jonnisha Culbert
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: KINDERONE PRESCHOOL
FACILITY NUMBER: 198400655
VISIT DATE: 05/20/2025
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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/.

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

Two Type B deficiency was cited during today’s visit.

Appeal rights and a notice of site visit was given. The notice of site visit must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Facility Representative.

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Jonnisha Culbert
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
LIC809 (FAS) - (06/04)
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