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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191500276
Report Date: 08/29/2025
Date Signed: 08/29/2025 02:57:25 PM

Document Has Been Signed on 08/29/2025 02:57 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:GOLDEN WEST PRESCHOOLFACILITY NUMBER:
191500276
ADMINISTRATOR/
DIRECTOR:		EMILY NALASAFACILITY TYPE:
850
ADDRESS:10248 ALONDRA BLVD.TELEPHONE:
(562) 866-5616
CITY:BELLFLOWERSTATE: CAZIP CODE:
90706
CAPACITY: 77TOTAL ENROLLED CHILDREN: 77CENSUS: 19DATE:
08/29/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Amy Nalasa, DirectorTIME VISIT/
INSPECTION COMPLETED:
03:15 PM
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Licensing program Analyst Alicia Mooberry conducted an unannounced Annual/Random Inspection on 08/29/2025. Facility is currently licensed for a capacity of 77 children age 2-6 years. The entrance to the facility is locked and parents enter using a code system. The program currently operates Monday thru Friday from 6:30 AM to 6:00 PM. LPA met with facility representative, Emily Nalasa, who guided LPA on tour of facility. There were 19 children present supervised by 4 staff.

The facility consists of three classrooms: Room 1, Room 2 and Room 3. Per Director, Room 2 is currently not being used due low enrollment.


All areas identified on the facility sketch were inspected. LPA observed the following classroom ratios: Room 1 (0 teachers and 0 children); Room 2 (Zero Teachers and Zero children); Room 3 ( 1 teacher and 8 children), Outdoor Play Area (1 qualified teacher and 1 Aid with eleven children). LPAs observed teacher-child ratios in compliance and staff fingerprints have the required clearances at this time.

LPA observed telephone service, heating, lighting and ventilation to be satisfactory. Children have adequate cubby storage for their belongings. Napping mats are stored appropriately with bedding removed or cots placed not touching. The facility provides sheets and weekly laundering, parents provide blankets. LPA observed filtered drinking water with drinking cups and children's personal water bottles readily available in the classrooms and outside in play ground. Age appropriate restrooms, sinks and toilets were inspected for good repair, water temperature, toilet paper, safety and sanitation. All available toilets and sinks are in operable condition. LPA reminded Director to always store items such as lysol, hand sanitizer, cleaners and similar items in inaccessible areas or locked cabinets. The indoor classrooms have surfaces that appear to be clean and safe and there are age appropriate toys and reading material for children to use. ----Page 1 - Report continues

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Alicia Mooberry
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 08/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/29/2025
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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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: GOLDEN WEST PRESCHOOL
FACILITY NUMBER: 191500276
VISIT DATE: 08/29/2025
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There are first aid supplies in each classroom. Carbon monoxide detectors and smoke detectors are present and functional in the facility. The fire extinguishers have been serviced within the last 12 months. The office is used as an isolation area for ill children and there are comfortable accommodations available for children while they wait pick up.

The facility (indoor and outdoors) operates on the grounds of a church building, however the facility has completely separate operations. The outdoor play area is enclosed and surrounded by the building and exit gates are at least five feet high. Areas around and under climbing equipment have mats and grass to cushion a fall. All play equipment, toys, materials and surfaces accessible to children appear to be age appropriate and toxic free.

Lunch and Snack menus are posted at least one week in advance and are visible to an authorized representative. The facility provides breakfast, lunch and PM snack. The kitchen were food is prepared was inspected, food items were reviewed for availability, quantity, expiration/best by dates and appropriateness for children in care. LPA observed the kitchen to be in sanitary condition. Chemicals and cleaners are stored in cabinet under sink away from food preparation areas. LPA informed Director and Kitchen staff to constantly assess expiration dates on food items that are removed from original packaging and document. LPA observed trash receptacles have tight fitting covers.

Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are locked and/or inaccessible.

LPA observed digital sign in and sign out to ensure children are being properly signed in and signed out by the authorized representative. All children present were signed in by authorized representative. LPA conducted a Children's Records Review for completeness and to ensure children have proper forms such as Identification and Emergency forms, Immunization records, Health History, Personal Rights, Parents Rights etc.on file. The children's roster was available and current.

Staff Records were reviewed to ensure the following: Criminal record clearance or criminal record exemption, education credits, current CPR/First Aid and health preventative practices, proof of immunization against pertussis and measles and influenza and/or flu declination, Mandated Reporter training, LPA observed at least one staff member to have current EMSA approved CPR/1st aid.

----Page 2 Report Continues

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Alicia Mooberry
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2025
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: GOLDEN WEST PRESCHOOL
FACILITY NUMBER: 191500276
VISIT DATE: 08/29/2025
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretation and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (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.

Licensee 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.



LPA informed Director to log onto web site www.ccld.ca.gov to access forms, regulations and quarterly updates.
LPA reviewed Lead Testing report completed on 10/26/24. LPA observed that the lead testing was incomplete and did not include water fountains located in one of children's play yards. LPA observed that the faucets have been covered with plastic material until they are tested. LPA observed that the facility provides filtered drinking water from a water delivery service. Due to the two water faucets are functioning but not used for drinking, this poses a potential risk to the health and safety of children in care.

LPA referred facility representative to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.


One B violation is cited as a result of this inspection in accordance to Title 22 regulation and Lead Testing Mandate.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/tion-process.

Exit interview was conducted with Director Amy Nalasa and a copy of Appeal Rights (LIC 9058) was discussed and provided. Notice of Site Visit was provided and needs to be posted for 10 Days.

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Alicia Mooberry
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2025
LIC809 (FAS) - (06/04)
Page: 4 of 5
Document Has Been Signed on 08/29/2025 02:57 PM - It Cannot Be Edited


Created By: Alicia Mooberry On 08/29/2025 at 02:32 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: GOLDEN WEST PRESCHOOL
FACILITY NUMBER: 191500276

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/29/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.16(a)(1)
Lead Testing
(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in that 2 water fountains located in one of the children's play area were not tested for lead which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/29/2025
Plan of Correction
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Per director, the water fountains are not used for drinking, since the facility provided filtered water to children. The director has covered the water drinking fountains in the play yard to make inaccessible to children in care. The 2 water drinking fountains will be tested for lead. Proof of testing and results will be sent to LPA by 9/5/25
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:
Alicia Mooberry
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/29/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/29/2025


LIC809 (FAS) - (06/04)
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