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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198005309
Report Date: 06/24/2025
Date Signed: 06/24/2025 05:01:17 PM

Document Has Been Signed on 06/24/2025 05:01 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:FIRST EVANGELICAL CHURCH OF CERRITOSFACILITY NUMBER:
198005309
ADMINISTRATOR/
DIRECTOR:		GRACE CHIN LEE LINFACILITY TYPE:
850
ADDRESS:11330 E. 166TH ST.TELEPHONE:
(562) 865-2424
CITY:CERRITOSSTATE: CAZIP CODE:
90703
CAPACITY: 87TOTAL ENROLLED CHILDREN: 87CENSUS: 33DATE:
06/24/2025
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:50 AM
MET WITH:Licensee, Grace Chin Lee LinTIME VISIT/
INSPECTION COMPLETED:
05:05 PM
NARRATIVE
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On 06/24/2025, Licensing Program Analysts (LPA) Jonnisha Culbert conducted an unannounced case management annual continuation inspection at the facility noted above. LPA met with Facility representative, Grace Chin Lee Lin and discussed the purposes of today's visit. They guided analyst on a tour of the facility. This is a preschool center located on the premises of First Evangelical Church of Cerritos. The program operates Monday through Friday from 7am to 6pm. It offers care to children age two until entry into first grade. Present during today's inspection were Facility Representative, five staff, and forty-two Children.
The following is a combination of information that was collected from visits on 05/21/2025, 06/16/2025, and 06/24/2025. Upon arrival, LPA observed all required postings in a prominent publicly accessible area.
All areas used by children were inspected for safety.  Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting, and ventilation were evaluated. The facility uses central heating and air for ventilation. Lighting was observed to be in operable condition. LPA observed age-appropriate toys. Children have their own cubby in each classroom to store their belongings. Cots are available to children for napping. Per Facility Representative, the isolation area is in the room near front door (sick bay). Children who are sick utilize restroom inside of the room. LPA observed an appropriate number of toilets and sinks available for children.
On 05/21/2025 at approximately 9:35am LPA observed water on the floor and a wet towel underneath a sink in the rectangle classroom. Per representative the towel stays on the floor underneath the sink to collect the water children splash on the floor. LPA advised representative to add a slip proof mat to avoid children from slipping and falling. In another children's restroom, LPA observed a trash bin with enough water gathered inside of it to fill the grooves around the bottom edge of the bin.  Per representative, the water collected
NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Jonnisha Culbert
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/24/2025
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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Document Has Been Signed on 06/24/2025 05:01 PM - It Cannot Be Edited


Created By: Jonnisha Culbert On 06/24/2025 at 01:38 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: FIRST EVANGELICAL CHURCH OF CERRITOS
FACILITY NUMBER: 198005309

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/24/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101239.1(c)(2)
Napping Equipment
(c) Each cot or mat shall be equipped with a sheet to cover the cot or mat and, depending on the weather, a sheet and/or blanket to cover the child. (2) Bedding shall be individually stored so that each child's bedding is identifiable and no child's used bedding comes into contact with other bedding.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above and children's bedding are stored inside of individual pillow cases that are the same. LPA observed that pillow cases were placed on the sheet of top cop making some childrens pillow cases come in contact with used bedding which poses a potential health and safety risk to persons in care.
POC Due Date: 05/15/2025
Plan of Correction
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During visit, representative placed each pillow case inside of plastic bags to ensure no child's used bedding comes in contact with other bedding.
Type B
Section Cited
CCR
101238(a)(2)
Buildings and Grounds
(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. (2) The licensee shall safely dispose of water and any disinfectants/solutions that have been used for cleaning.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above and LPA observed a trash bin with enough water gathered inside of it to fill the grooves around the bottom edge of the bin. Per facility representative, the water inside of the bin was from cleaning which poses a potential health and safety risk to persons in care.
POC Due Date: 05/15/2025
Plan of Correction
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LPA observe the bin removed during visit.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Warren Birks
NAME OF LICENSING PROGRAM MANAGER:
Jonnisha Culbert
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/24/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/24/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/24/2025 05:01 PM - It Cannot Be Edited


Created By: Jonnisha Culbert On 06/24/2025 at 01:38 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: FIRST EVANGELICAL CHURCH OF CERRITOS
FACILITY NUMBER: 198005309

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/24/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216.1(c)(1)
Teacher Qualifications and Duties
(c) To be a fully qualified teacher, a teacher shall have one of the following: (1) Twelve postsecondary semester or equivalent quarter units in early childhood education or child development completed, with passing grades, at an accredited or approved college or university; and at least six months of work experience in a licensed child care center or comparable group child care program.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record reiew, the licensee did not comply with the section cited above in one out of eight staff are missing twelve postsecdonary semester of equivalent quarter units in early childhood education or child development completed..at accredited or approved college or university. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/08/2025
Plan of Correction
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Per facility representative, they will send proof that staff 3 completed the required semester or quarrter units and email the proof to LPA J. Culbert by plan of correction date.
Type B
Section Cited
CCR
101220(a)
Child's Medical Assessments
(a) Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child. This medical assessment enables the licensee to assess whether the center can provide necessary health-related services to the child.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record reiew, the licensee did not comply with the section cited above and durnig record review LPA observed that child 1 is missing physician report form, LIC 701, which poses a potential health and safety risk to persons in care.
POC Due Date: 08/04/2025
Plan of Correction
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Per facility representative, they will have child 1's parent obtain a completed physician report and email the proof to LPA J. Culbert by plan of correction 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.
Warren Birks
NAME OF LICENSING PROGRAM MANAGER:
Jonnisha Culbert
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/24/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/24/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/24/2025 05:01 PM - It Cannot Be Edited


Created By: Jonnisha Culbert On 06/24/2025 at 01:38 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: FIRST EVANGELICAL CHURCH OF CERRITOS
FACILITY NUMBER: 198005309

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/24/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101223(a)(2)
Personal Rights
(a) The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, LPA observed that the bathroom floor in room was wet on 05/21/2025, 06/16/2025, and 06/24/2025. Water appeared to be coming up from underneath floor tile when tile was stepped on. Per facility representative, continous flushing cause the water to come out in wet the floor. This is potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/24/2025
Plan of Correction
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Per facility representative, they will tempoarily switch rooms while they wait for the plumbing to be fixed. When it is fixed LPA will conduct a plan of correction visit to ensure that floor remains dry when toilet is flushed.
Type B
Section Cited
HSC
1596.7995(a)(1)
(a) (1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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No Citation issued under this regulation
POC Due Date: 07/24/2025
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Warren Birks
NAME OF LICENSING PROGRAM MANAGER:
Jonnisha Culbert
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/24/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/24/2025


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: FIRST EVANGELICAL CHURCH OF CERRITOS
FACILITY NUMBER: 198005309
VISIT DATE: 06/24/2025
NARRATIVE
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inside came from when they cleaned up. This is a health and safety risk to person in care. LPA advised representative to remove the wet towel and trash bin.
On 05/21/2025 at approximately 9:37am LPA observed several pillow cases stacked along the wall stacked on top of a cot. Per representative, they put each child's bedding inside of pillow cases to prevent children's bedding from touching one another. This is a potential safety and health risk to persons in care. LPA reminded representative that, "each child [shall have] an individual permanent or portable storage space for his/her clothing, personal belongings and/or bedding.
 Availability of indoor and outdoor drinking water was observed in classrooms via sippy and disposable cups.  Per Facility Representative, water is provided via filtered water from kitchen drinking water station. LPA verified that the lead testing was completed in accordance with written directive outlined in Provider Information Notification (PIN) 21-21.1-CCP.
Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Disinfectants and cleaning solutions were in multiple location and were made inaccessible to children during visit. Per Facility representative, no child currently enrolled require medication, but if medication was stored it will be kept in an appropriate area that is inaccessible to children. Poisons were not observed during visit. Per Representative, there are no poison on the premises. LPA reminded Facility Representative that if poisons are purchased, they are to remain in an area that is locked and inaccessible to children.  A carbon monoxide detector was observed and is operable. LPA observed fire alarm pull stations.

Disaster drills were logged and available.  The last drill was conducted on 03/24/2025. Menus are posted one month in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request. LPA inspected the food preparation area. The kitchen was observed to be clean and free of litter. Food supplies were observed to be in good condition. The facility provides snacks and lunch.

The outdoor playground area was evaluated. LPA observed all areas around and under high climbing equipment and similar equipment are cushioned with black rubber mulch. LPA observed a canopy used for shade. Per Facility Representative, the facility manager cleans the playground. Availability of outdoor drinking water was observed. Please refer to report written on 05/21/2025 regarding outdoor drinking water.
NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Jonnisha Culbert
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2025
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: FIRST EVANGELICAL CHURCH OF CERRITOS
FACILITY NUMBER: 198005309
VISIT DATE: 06/24/2025
NARRATIVE
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Per Facility Representative, there are no pools or bodies of water on the premises.

Children’s Records were reviewed for completeness. During record review, LPA observed two out of two records. Child 1 record was missing Physician Report form 701. This is a potential health and safety risk to persons in care. Children's roster was reviewed and is current. Parents sign children in and out on via sign in sheet.
On 06/24/2025 at approximately 10:30am LPA reviewed sign in sheet and observed that four children were not signed in by parent. LPA reminded licensee of regulation.

Staff records were reviewed. LPA observed eight out of eight staff records. During staff record review, LPA observed that two out of eight staff were missing Health Screening form LIC 503, and Staff 2 LIC 503 was incomplete.  Facility Representative does not have proof of completion or Health and Safety Training. Staff 3 is missing the qualification for a Teacher.  Staff 6 Personnel Record form LIC 501 is incomplete, and Staff 7 Personnel Record is missing from file. This is a potential health and safety risk to persons in care. Facility Representative has proof of immunization against pertussis and measles. LPA observed representative has completed Adult and Pediatric First Aid/CPR AED on 06/08/2024. Mandated reporter training was completed on 07/28/2023.

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
NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Jonnisha Culbert
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2025
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: FIRST EVANGELICAL CHURCH OF CERRITOS
FACILITY NUMBER: 198005309
VISIT DATE: 06/24/2025
NARRATIVE
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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

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 childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

Five Type B deficiencies were cited during today’s visit.

Appeal rights and a notice of site visit was given. The notice of site visit must remain posted for 30 days.
Exit interview conducted and report was reviewed with the Facility Representative, Grace Chin Lee Lin.
NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Jonnisha Culbert
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2025
LIC809 (FAS) - (06/04)
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