191670880-5-14-2025-54-CC-ACAN-DGNSMN-20250514140015

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191670880
Report Date: 05/14/2025
Date Signed: 05/14/2025 02:00:51 PM

Document Has Been Signed on 05/14/2025 02:00 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:	ASI, INC. CSUDH CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	191670880
ADMINISTRATOR/ DIRECTOR:	CANDACE MANANSALA		FACILITY TYPE:	850
ADDRESS:	1000 E VICTORIA		TELEPHONE:	(310) 243-1015
CITY:	CARSON	STATE: CA	ZIP CODE:	90747
CAPACITY: 65	TOTAL ENROLLED CHILDREN: 61	CENSUS: 40	DATE:	05/14/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:25 AM
MET WITH:	CANDACE MANANSALA / ADMINISTRATOR		TIME VISIT/ INSPECTION COMPLETED:	02:05 PM

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On 5/14/43 Licensing Program Analysts (LPAs) Ashley Calderon and Tyler Reyes conducted an unannounced random/annual inspection. LPA met with Director Candace Manansala who allowed LPA's entrance into the facility. LPA's disclosed the purpose of todays inspection.

This is a preschool program with a toddler component. The preschool program consists of three classrooms and the toddler component consists of three classrooms. The facility operates from Monday through Thursday 7:30AM to 5:30PM and Fridays 7:30Am to 3:00PM. LPA's observed 10 toddlers present and 28 preschool children. All staff present have a valid criminal record clearance and are associated to the facility. Facility was within teacher- children ratio(s).

All areas identified on the facility sketch were inspected. The toddler component is physically separate from the preschool program and each component has their own entrance. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. The facility has central air and heating. Children have their own cubby to store their belongings. Children in both programs are provided with cots for napping. Per Director, bedding is washed at the facility, each classroom has a schedule wash day that occurs weekly.

In the toddler component there is one restroom with one toilet, two portable potties, a diaper changing table and two sink. For the preschool program there are three restrooms with a total of 6 toilets and 5 sinks. Age appropriate sinks and toilets were inspected for availability and good repair in all restrooms. General sanitation was observed in each restroom. (P1)

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/14/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025

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: ASI, INC. CSUDH CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 191670880
	VISIT DATE: 05/14/2025

NARRATIVE

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Availability of indoor/ outdoor drinking water was observed in classrooms via portable water jug and cups. Facility gets water delivered from Sparkletts Co. The facility completed the lead testing in drinking water on 3/2/23.

Disinfectants and cleaning solutions were observed in areas accessible to the children: Staff Lounge at 9:59am by LPA Calderon and Reyes in addition during the tour of room 114 bathroom at 10:21am had 3 products placed on the floor and laundry room was observed unlocked at 10:22am 2 cleaning solutions in the cabinets. Pictures taken, deficiency Type A cited.

There are (0) children on medication in the toddler component and there are (5) preschool children who take medications. Room 116 has medications stored in classroom in a high to reach area that is inaccessible. There is a Nurse room that has a locked cabinet with stored mediations and this room is used as an isolation area for a child waiting to be picked up and there is a staff restroom for ill children to use next to the nurse's station as well. Records was reviewed for LIC9221 Administration of Medication records.

Records for children were reviewed and found complete. Staff files were reviewed and 2 out 5 staff had expired Mandated Reporter Training certificates deficiency cited Type B and all other documentation's in files were in place. There was at least 1 staff (administrator ) with a valid Pediatric First Aid and CPR expires: . 2/2026

There is an operable carbon monoxide detector that was tested and found operable. Facility has a central fire / smoke alarm and get inspected by Cal Fire. Fire extinguishers are available throughout the facility and they were last serviced in August 2024.

The outdoor playground areas were evaluated. The toddler component playground is physically separate from the preschool program playground. In both playgrounds, all areas around or under high climbing equipment and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in both playgrounds. LPA discussed the importance of keeping outdoor yard free of hazards. There are no pools or bodies of water at the facility.

(P2)

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/14/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025

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: ASI, INC. CSUDH CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 191670880
	VISIT DATE: 05/14/2025

NARRATIVE

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Menus are posted at least one week in advance where it is visible by the child's authorized representative posted in classrooms. LPA inspected the food preparation area. The facility provides breakfast, lunch and PM snack and is on Food Program.

Parents sign in via an app and a QR code. Per Director, staff are notified via the app when a child is signed into the center. Disaster drill log was available, last drill was conducted on 5/13/25. Food and snacks were reviewed for availability, quantity and appropriateness to children in care. Food preparation areas were toured for safety, cleanliness and proper equipment. Menus are posted at least one week in advance where it is visible by the child's authorized representative. LPA inspected the food preparation area and facility is on a food program. The facility provides breakfast, lunch and PM snack.

First Aid Kit/ supplies are available in each classroom and throughout the facility, consolation was provided on supplies needed in the kit like 1st Aid Manual.

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.

(P3)

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/14/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025

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: ASI, INC. CSUDH CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 191670880
	VISIT DATE: 05/14/2025

NARRATIVE

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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and

administrative records. For IMS information see PIN 22-02-CCP. 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 child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Based on this information the following deficiencies on the LIC 809 D are being cited today 5/14/25, 1 Type A and 1 Type B. LPA Calderon and Reyes informed facility representative Candace Manansala that this report dated 5/14/25 document(s) (1) Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care. Also, LPAs Calderon and Reyes informed the facility representative to provide a copy of this licensing report dated 5/14/25 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with facility representative Candace Manansala. (Pg 4/ End)

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE:

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE:

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 05/14/2025 02:00 PM - It Cannot Be Edited

Created By: Ashley Calderon On 05/14/2025 at 01:13 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: ASI, INC. CSUDH CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 191670880
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/14/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

101238(g)

Buildings and Grounds

(g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observations, the licensee did not comply with the section cited above in tour room 114 bathroom at 10:21am had 3 products placed on the floor and laundry room was observed unlocked at 10:22am 2 cleaning solutions in the cabinets which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 05/15/2025
	Plan of Correction
1 2 3 4	Program Director immediately locked doors were products were found and moved products to inaccessible areas to ensure all cleaning products are centrally stored and inaccessible to children in care. Program Director will review product lables and any products with directions keep out of reach of children will be relocated, latches will be placed and they will palce a work order. Progam Director will provide proof of work order and latches where cleaning products are stored by POC Due Date via email to LPA Calderon.

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.

	Denise Gibbs
NAME OF LICENSING PROGRAM MANAGER:

	Ashley Calderon
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/14/2025

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 05/14/2025 02:00 PM - It Cannot Be Edited

Created By: Ashley Calderon On 05/14/2025 at 01:18 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: ASI, INC. CSUDH CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 191670880
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/14/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in (2) of (5) staff members did not have proof of Mandated Reporting Training Certificate which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/21/2025
	Plan of Correction
1 2 3 4	Program Director will ensure all employees have a current Mandated Reporter Training Certificate readily available. Program Director will submit proof of Mandate Reporter Training Certificate for staff 1 (S1) and S2 by POC Due Date via email to LPA Calderon.

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.

	Denise Gibbs
NAME OF LICENSING PROGRAM MANAGER:

	Ashley Calderon
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/14/2025

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025

LIC809 (FAS) - (06/04)

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