<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191598532
Report Date: 11/10/2025
Date Signed: 11/10/2025 01:15:31 PM

Document Has Been Signed on 11/10/2025 01:15 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:HACIENDA LA PUENTE/HEAD START-KWIS SITEFACILITY NUMBER:
191598532
ADMINISTRATOR/
DIRECTOR:		LUZ GUADRONFACILITY TYPE:
850
ADDRESS:1925 S. KWIS AVE.TELEPHONE:
(626) 933-2137
CITY:HACIENDA HEIGHTSSTATE: CAZIP CODE:
91745
CAPACITY: 40TOTAL ENROLLED CHILDREN: 40CENSUS: 27DATE:
11/10/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Denise Villacres Special Assignment TeacherTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 11/10/2025 Licensing Program Analyst (LPA) Mariah Aguirre and Licensing Program Manager (LPM) Christina Gableman conducted an unannounced annual inspection at the above facility. Upon arrival at 9:00AM LPA and LPM met with Denise Villacres, Special Assignment Teacher. At 9:15AM, LPA and LPM were led on a tour of the facility. This is a HeadStart program consisting of 2 classrooms, HS1 and HS2 with 40 children enrolled. Per Special Assignment Teacher and upon LPA and LPM’s observation, there are 27 children present with 5 teachers. Per Special Assignment Teacher, the facility operates Monday-Friday and children in HS 1 are a part of a full day class, with hours of operation being 8:00AM to 2:00PM and children in HS 2 are a part of a half day class, with the first class operating from 8:00AM to 11:00AM, and the second class operating from 12:30PM to 3:30PM.

LPA observed all required forms/publications to be posted by the entrance. Snacks/ lunch menus were reviewed to ensure that they are being posted a week in advance where it is visible for the child’s authorized representative. Menus for the past 30 days are available and posted on the classroom wall. Per Special Assignment Teacher, children in HS1 are provided with breakfast, lunch, and one snack. Children in the morning session of HS2 are provided with breakfast and children in the afternoon session of HS2 are provided with lunch.

LPA and LPM entered and inspected both HS1 and HS2 classroom. While touring the classroom, LPA observed the rooms to have clean and safe floors, with rugs for the children to sit on. Per Special Assignment Teacher, daily vacuuming is done for the rugs, and twice a year janitorial staff shampoo the rugs. LPA and LPM observed the classrooms to have safe toys and safe play structures. LPA and LPM observed the classrooms to be free of any hazardous equipment. The doors in both classroom have an alarm that sounds when the door open and an individual exits the classrooms, alerting staff that the door has been opened.

Page 1 of 4

NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Mariah Aguirre
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 11/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/10/2025
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 8
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)
Page: 2 of 8
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: HACIENDA LA PUENTE/HEAD START-KWIS SITE
FACILITY NUMBER: 191598532
VISIT DATE: 11/10/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
LPA and LPM observed the classroom furniture to be in good condition, and each chair to have a label with each child’s name. All storage containers for solid waste were observed to have tight-fitting covers and are in good repair throughout the facility. Sufficient individual storage space for children was observed as cubbies were available to children with their names on them, where they can store backpacks, napping equipment, and water bottles. First aid supplies are available and complete if use is needed. Facility has a functioning carbon monoxide detector that meets the necessary requirements issued by the state. The facility’s fire alarm is interconnected, and a fire extinguisher was observed to be serviced on July 1st 2025. Disaster drills are conducted at the facility every other month, and the last disaster drill was conducted on October 16th 2025. Disaster drill logs are readily available for review.

Restrooms are available for the children to use. Fully functioning toilets and sinks are available for children’s use, and toilet paper and soap are fully stocked and available for children’s use.

Per special assignment teacher, children do not bring their own food to the facility, the facility provides the children with all meals and snacks. Upon LPA and LPMs observation, staff in the classroom go to the school kitchen to pick up the meals and snacks, and distribute the food to the children while wearing gloves. Per Special Assignment Teacher, all milks are stored in the staff fridge, and returned to the school’s kitchen at the end of the day. LPA observed all foods to be available in quantity, and appropriateness to children in care.

LPA observed the outdoor play area. The play area was observed to have proper play equipment and is maintained in a safe condition and is free of hazards. All play structures were observed to be properly enforced but were observed to have spider webs on all play structure areas. Per Special Assignment Teacher, the students were not using the play structures because of the spider webs, and a request for pressure washing was submitted to janitorial staff and they are currently waiting for a response. As a result, LPA and LPM issued a technical advisory advising the Special Assignment Teacher to ensure the spider webs are cleaned and the play structures are observed for any possible hazards daily.

Teacher- child ratios were observed to be in accordance with Title 22 regulations. Staff names were recorded, and all children were observed to be under visual supervision of a teacher during the tour. The facility is within the conditions, limitations, and capacity specified on the license. All areas identified on the facility sketch were inspected.

Page 2 of 4

NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Mariah Aguirre
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2025
LIC809 (FAS) - (06/04)
Page: 3 of 8
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: HACIENDA LA PUENTE/HEAD START-KWIS SITE
FACILITY NUMBER: 191598532
VISIT DATE: 11/10/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
LPA and LPM reviewed facility records to be complete. Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of day the child is being dropped off and picked up. Upon review, it was seen that 2 children’s individuals signing the child in and out did not use their full legal signature. LPA and LPM are issuing a technical advisory, and informed Special Assignment teacher that all legal representatives picking up and dropping off the child must use their full legal name when signing the sign in and out sheet. Criminal record clearance for all staff was reviewed. Verification of CPR and First Aid, as well as health preventative practices were reviewed. The childcare center’s fully qualified staff qualified to act in the director’s absence Is complete and on file. Educational background, required trainings, and experience for staff present at the facility were reviewed and complete. A collection of random children’s files was reviewed to ensure completeness. Children’s files were complete.

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 not completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. LPA provided facility the information to have Water Sampling registered.

Page 3 of 4

NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Mariah Aguirre
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2025
LIC809 (FAS) - (06/04)
Page: 4 of 8
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: HACIENDA LA PUENTE/HEAD START-KWIS SITE
FACILITY NUMBER: 191598532
VISIT DATE: 11/10/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
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 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 child care by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

While conducting the exit interview, Special Assignment Teacher notified LPA and LPM that a substitute teachers assistant is assigned to HS2 at this time, as they are currently recruiting for a full time teachers assistant.

After conducting the annual inspection and signing the report, LPA and LPM were made aware that a majority of children in HS1 had hand foot and mouth (HFM) last week, and it was not reported to the department. LPA and LPM were also made aware of one child in HS2 having HFM and during our visit, two more children were sent home with HFM and have not yet reported it to the department. As a result, LPA MAguirre and LPM CGableman issued one type B citation for failure to report the outbreak to the department. LPA and LPM advised staff that in the event an outbreak of HFM occurs with three or more children, they are required to report the outbreak to the department.

A notice of site visit was given and must remain posted for 30 days.

Exit interview was conducted and report was reviewed with Special Assignment Teacher Denise Villacres at 12:25PM. A copy of this report was provided, and no citations are being issued at this time, but two technical advisories are being issued. Appeal Rights were given at the time the exit interview was conducted.

Page 4 of 4

NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Mariah Aguirre
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2025
LIC809 (FAS) - (06/04)
Page: 5 of 8
Document Has Been Signed on 11/10/2025 01:15 PM - It Cannot Be Edited


Created By: Mariah Aguirre On 11/10/2025 at 01:11 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: HACIENDA LA PUENTE/HEAD START-KWIS SITE
FACILITY NUMBER: 191598532

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/10/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
101212(d)(1)(e)


This requirement is not met as evidenced by: facility failed to report an epidemic outbreak of Hand Foot and Mouth to the department.
(d) Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. In addition, a written report containing the information specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event.

(1) Events reported shall include the following:
(e) epidemic outbreaks
Deficient Practice Statement
1
2
3
4
Based on observation, the site supervisor did not comply with the section cited above in 4 out of 4 instances which poses an immediate risk to the health and safety of children in care.
POC Due Date: 11/12/2025
Plan of Correction
1
2
3
4
Report all confirmed cases of Hand Foot and Mouth (including teacher) to the department using LIC 624 by POC date above.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Christina Gabelman
NAME OF LICENSING PROGRAM MANAGER:
Mariah Aguirre
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/10/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/10/2025


LIC809 (FAS) - (06/04)
Page: 8 of 8