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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198005306
Report Date: 05/14/2026
Date Signed: 05/14/2026 11:50:18 AM

Document Has Been Signed on 05/14/2026 11:50 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:HOLY NAME OF MARY SCHOOLFACILITY NUMBER:
198005306
ADMINISTRATOR/
DIRECTOR:		ELVIA MONTANEZFACILITY TYPE:
850
ADDRESS:124 S. SAN DIMAS CANYON ROADTELEPHONE:
(909) 542-0449
CITY:SAN DIMASSTATE: CAZIP CODE:
91773
CAPACITY: 40TOTAL ENROLLED CHILDREN: 38CENSUS: 32DATE:
05/14/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Elvia Montanez, DirectorTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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On 05/14/26 at 8:30am, Licensing Program Analyst (LPA) Diana Ortiz conducted an unannounced annual random inspection of the above facility and met with Director Elvia Montanez who guided LPA on a tour of the facility. This is a preschool program that operates Monday through Friday from 7:55AM to 3PM. All areas identified on the facility sketch were toured and inspected both indoors and outdoors. Census was taken and LPA observed 32 children, and five (5) staff present during today’s inspection. Per Director, there are currently 38 children enrolled. LIC 125 Entrance Checklist provided.

The following documents were posted in a prominent, publicly accessible area at the facility (front entrance): Facility License, Notification of Parents' Rights (PUB 393), Personal Rights (LIC 613A), and Earthquake Preparedness (LIC 9148). PUB 269 Child Passenger System Poster, Menu, and Daily Schedule.

The preschool program consists of two (2) classrooms. The following classrooms were inspected: 3’s Classroom: 14 children and three (3) staff present. LPA observed two (2) toilets and four (4) sinks located within the classroom. 4’s Classroom: 18 children and two (2) staff present. LPA observed three (3) toilets and four (4) sinks located within the classroom. LPA observed that each child has an individual, labeled storage space for personal belongings. Teacher-child ratios were observed to be in accordance with Title 22 Regulations. Staff names were recorded. Licensed facility is within the conditions, limitations, and capacity specified on the license.

Classrooms were inspected to ensure that the floors have a surface that is safe and clean. All materials and surfaces accessible to children are toxic free. Napping equipment such as mats and bedding were inspected for good condition, appropriate storage, and cleanliness.

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NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Diana Ortiz
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/14/2026
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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: HOLY NAME OF MARY SCHOOL
FACILITY NUMBER: 198005306
VISIT DATE: 05/14/2026
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Mats are used for napping. LPA observed each child have their own assigned mat. Children bring their own bedding, which is sent home at the end of each week (or when needed) to be laundered.

Sign in and out takes place in the entrance area of each classroom. The facility utilizes paper sign-in/sign-out sheets. Records were reviewed to ensure that individuals signing children in and out provide a full legal signature and accurately document the time of entry and exit. LPA reminded Director that parents/guardians are required to use their full legal signature when signing children in and out each day. The facility is able to provide copies of sign-in/sign-out sheets upon request.

LPA toured the playground area. LPA observed that the outdoor playground equipment is in a safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under high climbing equipment, slides, and similar equipment is cushioned by a soft rubber material that absorbs a fall; climbing apparatuses are single level only and were observed to be age appropriate (2-5 years). There is adequate shade in the play yard. Per Director, children use their water bottles during outdoor playtime and water cups are available for children as well. LPA advised that no children should be left without the supervision of a teacher at any time.

This facility offers AM snack, and lunch to all children in care. The facility utilizes a catering program through Revolution Foods, which parents/guardians may choose to participate in. Per Director, catered meals are delivered to the school site, and a staff member transports the food to the preschool classrooms for distribution. If parents/guardians elect not to utilize the catering program, they provide a labeled lunch for their child, which is stored in the child’s designated cubby. Snacks are maintained in each classroom within a locked cabinet. Menus were reviewed to ensure they are posted at least one week in advance and visible to authorized representatives.

Drinking water is readily available to children in care both indoor and outdoors. Per Director children bring their water bottles from home and the facility also provides water from a faucet which is located in each classroom. LPA observed all water bottles are labeled with the children’s name and paper cups.

All storage containers for solid waste, including movable bins shall have tight-fitting covers that are kept on, and in good repair. LPA observed that all trash cans used to discard food have tight fitting lids. The facility was observed to be free of flies, other insects, and rodents.


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NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Diana Ortiz
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2026
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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: HOLY NAME OF MARY SCHOOL
FACILITY NUMBER: 198005306
VISIT DATE: 05/14/2026
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Per Director, the designated isolation area for ill children is located within the teacher area of each classroom, where children may wait until a parent or authorized representative arrives. Chairs and mats are available for children requiring rest. If needed, ill children utilize the staff restroom located in the hallway.

Smoke detectors and carbon monoxide were present in each classroom. LPA observed a fully charged and serviced fire extinguisher in each classroom. The fire extinguishers were last serviced on 08/08/2025, and service tags were attached. Per Director, emergency disaster drills are conducted monthly. Emergency drill was last conducted on 04/14/2026. Facility Representative states there are no weapons/firearms, or bodies of water on the premises. LPA did not observe weapons/firearms or bodies of water during today’s inspection. There are First Aid kits available in each classroom and supplies were inventoried and found to be in good condition.

LPA was informed that there are currently two (2) children requiring medication. Per Director, an IMS plan is maintained on file, which was reviewed by LPA, and consultation was provided. LPA observed that medication is stored in each classroom within a locked medication box that is inaccessible to children. LPA advised the Director that medication should be returned to the parent/guardian when the child is disenrolled from the facility or when the medication has expired.

Children’s records were reviewed to ensure that Identification and Emergency form and a medical assessment are on file and were found to be complete.

Criminal Records Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed. There is at least one person trained in CPR and Pediatric First Aid present during this inspection. The review of Staff records was documented on the LIC 859. Staff present had proof of the AB 1207 Mandated Reporter Training certificate on file.

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.

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NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Diana Ortiz
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2026
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: HOLY NAME OF MARY SCHOOL
FACILITY NUMBER: 198005306
VISIT DATE: 05/14/2026
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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 as specified in Health and Safety Code section 1597.16. 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 (Interim Licensing Standards) outlined in PIN 21-21.1-CCP. Lead test completion was on 03/05/2024. CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES

LPA referred facility representative to the Department website for lead: Lead Toxicity Prevention and Water Testing Information (https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information)

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing 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: 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 childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California. During the exit interview, Facility Representative, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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.

Based on the LPA`s observations and record review, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies are being cited on today’s visit, 05/14/26.

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

Exit interview conducted and report was reviewed with Director, Elvia Montanez.


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NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Diana Ortiz
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2026
LIC809 (FAS) - (06/04)
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