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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197412826
Report Date: 05/02/2024
Date Signed: 05/02/2024 11:40:42 AM

Document Has Been Signed on 05/02/2024 11:40 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:STONEHURST ELEMENTARY SCHOOL STATE P.S.FACILITY NUMBER:
197412826
ADMINISTRATOR/
DIRECTOR:		IMPERIALE, JILLFACILITY TYPE:
850
ADDRESS:9851 STONEHURST AVENUE RM. 2TELEPHONE:
(818) 767-8014
CITY:SUN VALLEYSTATE: CAZIP CODE:
91352
CAPACITY: 24TOTAL ENROLLED CHILDREN: 14CENSUS: 14DATE:
05/02/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Principal Ruth Kim TIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Roxana Lopez conducted an unannounced poc inspection (plan of correction) to insured that the Type A and Type B deficiencies cited on 4/18/2024 have been cleared. LPA met with Principal Ruth Kim, who guided analysts on a tour of the facility.The following was observed:

- Facility was observed to be in ratio 3 staff with 14 children

- Teacher aide was under direct supervision of a Teacher

- The LIC 9224 Acknowledgement was observed to be on file

LPA’s advised the licensee how to access forms, regulations and quarterly updates on the Child Care Licensing Website at: www.ccld.ca.gov.

LPA advised Principal that written plan to maintain in compliance is still pending. LPA cleared deficiencies on this date. LPA issued POC clearance letter during the visit.

At this time, the licensee is in compliance with California Code of Regulations Title 22. Therefore, no deficiencies are being cited.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with Principal, Ruth Kim

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE: DATE: 05/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/02/2024
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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