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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198005675
Report Date: 11/30/2023
Date Signed: 11/30/2023 12:43:34 PM

Document Has Been Signed on 11/30/2023 12:43 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:WALNUT VALLEY PRESCHOOL AND EARLY LEARNING CENTERFACILITY NUMBER:
198005675
ADMINISTRATOR:CHRISTINE GARCIAFACILITY TYPE:
850
ADDRESS:841 S. GLENWICK AVE.TELEPHONE:
(909) 595-1261
CITY:WALNUTSTATE: CAZIP CODE:
91789
CAPACITY: 72TOTAL ENROLLED CHILDREN: 63CENSUS: 42DATE:
11/30/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Christine GarciaTIME COMPLETED:
12:45 PM
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On November 30, 2023, Licensing Program Analyst (LPA) Carolyn Tuba conducted a case management inspection due to an Unusual Incident Report (UIR) submitted by the facility on 11/3/2023. LPA met with Site Supervisor, Christine Garcia. LPA was guided by the Site Supervisor on a tour to obtain the census of 42 children with 7 staff members. During the visit Program Director, Paula Gutierrez joined the inspection visit and LPA conducted consultation with Program Director and Site Supervisor.

The incident was reported to the Department within the required 24 hours of occurrence. It came to the facility’s attention that Witness #1 (W1) alleged that she witnessed an incident at the facility's playground on November 2, 2023, at approximately 11:30 am, with a preschool child who attends the facility and a staff who works at the facility. LPA conducted interviews with Site Supervisor, Staff #1 (S1) #2 (S2) #3(S3), #4 (S4), Child #2 (C2) and Witness #1 (W1) on a prior visit of 11/8/2023, as well as attempted to interview Child #1 (C1), but who did not qualify due to their verbal skills. LPA interviewed Program Director, Paula Gutierrez via the telephone on 11/14/2023 who shared video footage of the alleged incident on the date of 11/2/2023 at approximately 11:35 am. LPA conducted an interview with Staff #5 (S5) via telephone on 11/17/2023. After reviewing the video footage there was evidence that S5 had removed C1 from an activity abruptly, which infringed the personal rights of C1. LPA gave resources to assist staff on methods on how to redirect children.

The following deficiency listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiency that are being cited need to be cleared to protect the children’s health & safety.



Type A - A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent. Site Supervisor was provided with a copy of the parent Acknowledgement of Receipt of Licensing Reports Form during this visit.
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE: DATE: 11/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/30/2023
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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Document Has Been Signed on 11/30/2023 12:43 PM - It Cannot Be Edited


Created By: Carolyn Tuba On 11/30/2023 at 11:18 AM
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: WALNUT VALLEY PRESCHOOL AND EARLY LEARNING CENTER
FACILITY NUMBER: 198005675

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/30/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/08/2023
Section Cited
CCR
101223(a)(1)

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(a) The licensee shall ensure that each child is accorded the following personal rights:
(1) To be accorded dignity in his/her personal relationships with staff and other persons. This requirement is not met as evidenced by: Based on record review, facility did not comply with the section
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Retraining staff #5 with training videos, online seminars, directives from School District. Site Supervisor will submit a list to LPA indicating which trainings were provided along with staff's signature indicating that retarining has been completed by 12/8/2023.
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cited above where staff infringed on the personal rights of a child, which poses an immediate health, safety or personal rights risk to persons in care.
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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.
SUPERVISOR'S NAME:Ana Chico
LICENSING EVALUATOR NAME:Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:
DATE: 11/30/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/30/2023


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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: WALNUT VALLEY PRESCHOOL AND EARLY LEARNING CENTER
FACILITY NUMBER: 198005675
VISIT DATE: 11/30/2023
NARRATIVE
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Notice of site visit was given to the Site Supervisor and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Site Supervisor, Christine Garcia.
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:

DATE: 11/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2023
LIC809 (FAS) - (06/04)
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