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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198401159
Report Date: 02/06/2025
Date Signed: 02/06/2025 01:14:02 PM

Document Has Been Signed on 02/06/2025 01:14 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:BETHANY MANOR DEVELOPMENT & LEARNING CENTERFACILITY NUMBER:
198401159
ADMINISTRATOR/
DIRECTOR:		RENEE KOSKAFACILITY TYPE:
860
ADDRESS:12110 E WALNUT STTELEPHONE:
(562) 868-1517
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY: 64TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
02/06/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Renee KoskaTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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On 02/06/2025 at 9:30 am, Licensing Program Analysts (LPAs), Elka Chavez and Andrea Carter conducted an announced Pre-Licensing inspection for a Change of Location request. Upon arrival, LPAs met with Applicant Representative, Renee Koska. Applicant, Bethany Manor Foundation, Inc., has requested to relocate from their existing licensed Preschool Program (198015952) located at 15415 S. Pioneer Blvd. Norwalk, CA 90650.

The Applicant is requesting to serve 64 children: (64) Preschoolers from 2 to 5 years old in classrooms: 23, 30, 31, 32 and 33. Hours of operation will be Monday, Wednesday and Friday from 9:00 am to 12:00 pm. This facility was observed to be located on the property of Norwalk La Mirada Unified School District’s Cesar Chavez Elementary School. The facility is accessed through the parking lot on Rosecrans Avenue. There is also a head start program with facility number 198015619 on the same premises operating in rooms 42 and 43.

LPAs informed applicant representative that staff are required to maintain direct visual supervision of the children at all times during indoor and outdoor activities. When medications are on site, applicant representative stated that they will be stored in a secured location within the office area. Fully equipped first aid kits are located in each classroom. There is an operational carbon monoxide detector on site located in classroom 23. All required licensing documents were observed posted near the entrance of classroom 30. Children will be signed in and out in classroom 30.
LPAs continued to tour the facility and measured all indoor and outdoor activity space. The total preschool indoor activity space measured was 4268.85 square feet, which is sufficient to accommodate the requested overall capacity of 64 children.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Elka Chavez
LICENSING EVALUATOR SIGNATURE: DATE: 02/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/06/2025
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
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: BETHANY MANOR DEVELOPMENT & LEARNING CENTER
FACILITY NUMBER: 198401159
VISIT DATE: 02/06/2025
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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. Drinking water will be available to children via bottled water and disposable cups. LPAs observed all hazardous items to be inaccessible to children. There are no bodies of water or weapons on the property. Fire clearance was granted on 01/24/2025.

LPAs observed a total of 7 sinks and 9 toilets available to the preschool children. These are sufficient to accommodate the requested capacity of 64 preschool children. The restroom is located in the main building and is designated for this program. There is a separate staff restroom equipped with a toilet and a sink that is accessible to staff in the main building of Cesar Chavez Elementary School. The isolation area for children who are ill will be located in the office which is located near classroom 23. The ill children will use the staff restroom.

Parents will provide snack for children due to dietary restrictions and the facility also has snack items available if needed. Children will have their snack in classroom 30. LPAs observed a refrigerator, sink and 2 microwaves in the classroom.

The facility currently has a fully fenced playground. The fencing surrounding the playground area is made of wrought iron fencing which was observed to be at least four feet high. The preschool outdoor area calculated to be 13,468 square feet, which can accommodate the requested preschool capacity. There is adequate shade in the outdoor activity area. There is a play structure in the outdoor activity area. The area was previously used by the Cesar Chavez Elementary school’s kindergarten prigram. Per Applicant Representative, the program will mainly use the Gross Motor Classroom (room 23), for gross motor activities. Drinking water will be available via bottled water and disposable cups. LPAs observed all hazardous items on the playground to be inaccessible to children. Applicant Representatives was reminded that any changes to the facility must be reported to and approved by Community Care Licensing.

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).
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Elka Chavez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2025
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: BETHANY MANOR DEVELOPMENT & LEARNING CENTER
FACILITY NUMBER: 198401159
VISIT DATE: 02/06/2025
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Applicant representative 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 is violated.

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 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, available at: http://www.ada.gov/childqanda.htm

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

No corrections are needed. A license for (64) children: Preschoolers from ages 2 to 5 years old will be granted upon a final file review.

Exit interview conducted and report was reviewed with the Applicant Representatives, Renee Koska.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Elka Chavez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2025
LIC809 (FAS) - (06/04)
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