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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197414573
Report Date: 05/06/2026
Date Signed: 05/06/2026 07:27:36 PM

Document Has Been Signed on 05/06/2026 07:27 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:KIDSVILLE U.S.A.FACILITY NUMBER:
197414573
ADMINISTRATOR/
DIRECTOR:		PERERA, MAUREENFACILITY TYPE:
830
ADDRESS:8472 CORBIN AVENUETELEPHONE:
(818) 886-3508
CITY:NORTHRIDGESTATE: CAZIP CODE:
91324
CAPACITY: 24TOTAL ENROLLED CHILDREN: 12CENSUS: 7DATE:
05/06/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:44 AM
MET WITH:Director Maureen PereraTIME VISIT/
INSPECTION COMPLETED:
07:40 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 5/6/26 at 9:44 am, Licensing Program Analyst (LPA) Jeanine Lipsey, and Licensing Program Manager (LPM) Emiko Bell conducted an unannounced Annual Random visit, which is required due to the Center being a military-approved Center. LPM/LPA met with Director Maureen Perera, who let LPM/LPA into the facility and who guided LPM/LPA on a tour of the facility. LPM/LPA provided the Director with a copy of the LIC 125 Entrance Checklist to help facilitate the inspection. Facility is currently licensed for a capacity of 24 infants.

RM 1 with 4 infants and 2 staff
RM 2 with 3 infants with 2 staff

This is an infant program which consists of 2 classrooms: 1 playground and 1 sleep area. Facility operation hours are Monday to Friday from 7:00AM to 6:00 PM. All areas identified on the Facility Sketch were inspected. LPA observed all the required posting in the office and in each classroom.

Director 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.

The following was observed during the tour of the facility:

page 1 of 4

NAME OF LICENSING PROGRAM MANAGER: Betty Bell
NAME OF LICENSING PROGRAM ANALYST: Jeanine Lipsey
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/06/2026
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 6
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 6
Document Has Been Signed on 05/06/2026 07:27 PM - It Cannot Be Edited


Created By: Jeanine Lipsey On 05/06/2026 at 04:29 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
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: KIDSVILLE U.S.A.
FACILITY NUMBER: 197414573

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/06/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101439(h)(2)
Infant Care Center Fixtures, Furniture, Equipment and Supplies
(h) Infant changing tables shall: (2) Have raised sides at least three inches high.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
POC Due Date: 06/06/2026
Plan of Correction
1
2
3
4
Type B
Section Cited
CCR
101439(h)(4)
Infant Care Center Fixtures, Furniture, Equipment and Supplies
(h) Infant changing tables shall: (4) While in use, be placed within arm's reach of a sink.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation the licensee did not comply with the section cited above in that the changing table is not within arms reach of the sink which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/06/2026
Plan of Correction
1
2
3
4
Licensee will make it so the sink is within arms reach of the changing table and send proof by POC date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Betty Bell
NAME OF LICENSING PROGRAM MANAGER:
Jeanine Lipsey
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/06/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/06/2026


LIC809 (FAS) - (06/04)
Page: 3 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: KIDSVILLE U.S.A.
FACILITY NUMBER: 197414573
VISIT DATE: 05/06/2026
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
Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting, and ventilation were evaluated. Infants have their own cubby to store their belongings. Infants also have their own storage for all diapering needs.

LPM/LPA discussed the Safe Sleep regulations with Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA/LPM also informed the Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

The parents provide linens, and the facility washes the linens weekly or as needed. Each crib and mat are occupied by only one infant at time and cribs are kept free from all loose articles including blankets and pillows and there are no objects hanging above or attached to the crib. Infants are not swaddled while in care. Staff physically checks on sleeping infants every fifteen minutes and documents any signs of distress which includes, but is not limited to flushed skin color, increase in body temperature, restlessness, and labored breathing in the Brightwheel app. Documentation for infants up to 12 months includes sleeping position if it is other than on their back. LPA observed the Individual Infant Sleeping Plan for each infant up to 12 months of age in the files. Infants up to 12 months of age are placed on their backs for sleeping. Staff-infant ratio requirements are being met while infants are sleeping. The floors in the facility are clean and safe. All materials accessible to infants were observed to be toxic-free. Disinfectants, cleaning solutions, medication and other items that are dangerous to infants, were rendered inaccessible to infants. Carbon monoxide and smoke detectors were observed and tested and are operable.

All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish, rodents, and/or any other vermin. All storage containers for solid waste, including moveable bins, have tight-fitting covers that are kept on, and are in good repair.

Per Director there are no firearms or weapons stored on the premises. LPA/LPM did not observe pools or bodies of water at the facility.

---Page 2 of 4

NAME OF LICENSING PROGRAM MANAGER: Betty Bell
NAME OF LICENSING PROGRAM ANALYST: Jeanine Lipsey
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2026
LIC809 (FAS) - (06/04)
Page: 4 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: KIDSVILLE U.S.A.
FACILITY NUMBER: 197414573
VISIT DATE: 05/06/2026
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
Per Director there are no firearms or weapons stored on the premises. LPAs did not observe pools or bodies of water at the facility.

Outdoor playground equipment is in a safe condition, free of sharp, loose or pointed parts. All areas around or under high climbing equipment, slides, and similar equipment are cushioned with material that absorbs a fall. LPA observed foam rubber cushioning in the yard have two holes which could cause trip hazard. A tree on the outdoor playground provides natural shade. LPM/LPA advised that no infants shall be left without the supervision of a teacher at any time.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 201 O, 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.

Five infants’ files were reviewed. Inspection of required forms was made and documented on the LIC 857. All five files were observed to be complete with the documents required as listed on the Entrance Checklist. The Child Care Facility Roster for the enrolled infants was reviewed and is current. Sign-In and Sign-Out sheets were reviewed on the Brightwheel app. Each person who signed the infants in/out of the facility were observed to have used their full legal signature and the time of day was recorded. All the infants present were signed in.

Six staff files were reviewed. Inspection of required forms was made and documented on the LIC 859. All six files were observed to be complete with the documents required as listed on the Entrance Checklist.

Menus were observed to be posted. LPA reminded the Director that bottles, dishes and containers of food brought by the infant's authorized representative shall be labeled with the infant's name and the current date.

The Disaster drill log was available; the last drill was conducted in April. First Aid supplies were observed in each of the classrooms. According to the Director, no medications are administered to the infants. The isolation area for any infant who becomes ill is located in the crib area.

page 3 of 5

NAME OF LICENSING PROGRAM MANAGER: Betty Bell
NAME OF LICENSING PROGRAM ANALYST: Jeanine Lipsey
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2026
LIC809 (FAS) - (06/04)
Page: 5 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: KIDSVILLE U.S.A.
FACILITY NUMBER: 197414573
VISIT DATE: 05/06/2026
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/.

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.

Director 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.

Exit interview conducted and report was reviewed Director Maureen Perera . A notice of site visit was given and must remain posted for 30 days.

---Page 4 of 4

NAME OF LICENSING PROGRAM MANAGER: Betty Bell
NAME OF LICENSING PROGRAM ANALYST: Jeanine Lipsey
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2026
LIC809 (FAS) - (06/04)
Page: 6 of 6