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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198005683
Report Date: 03/18/2025
Date Signed: 03/18/2025 01:58:40 PM

Document Has Been Signed on 03/18/2025 01:58 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:MONTEBELLO GARDENS HEAD STARTFACILITY NUMBER:
198005683
ADMINISTRATOR/
DIRECTOR:		MARIANA SANCHEZFACILITY TYPE:
850
ADDRESS:4700 PINE ST.TELEPHONE:
(562) 908-1073
CITY:PICO RIVERASTATE: CAZIP CODE:
90660
CAPACITY: 42TOTAL ENROLLED CHILDREN: 42CENSUS: 0DATE:
03/18/2025
TYPE OF VISIT:Case Management - Annual ContinuationANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Vicky BermudezTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
NARRATIVE
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Licensing Program Analyst (LPA) Veronica Martinez Garza conducted an announced annual continuation visit to the Montebello Unified School District Head Start Headquarters located at 8432 Birchbark Ave Pico Rivera, CA 90660 on 03/18/25 at 01:00pm. The purpose of this inspection is to review staff files as they were not available for review at the Montebello Gardens facility during the required Annual/Random inspection conducted on 02/11/25. LPA met with Vicky Bermudez, Program Specialist who provided LPA with staff files for review.

LPA reviewed 06 staff files and LPA issued the Review of Staff Records (LIC 859) to the facility representative during this inspection. The LIC 859 documents the staff’s files that were reviewed during this inspection.

Per the granted waiver dated 12/27/24, the MUSD Head Start programs may keep health screening and immunizations records for all 15 licensed facilities at the MUSD Human Resource Department; however, staff files must be available for the LPA to review during the annual inspection or within a two-day window which include: staff qualifications, employee rights, statement acknowledging requirement to report child abuse, Mandated Reporter Training AB1207 and Pediatric CPR/FA. The above-mentioned files were not available during the LPAs annual inspection dated 02/11/25 or within two-day window.

The following deficiencies were cited in accordance with Title 22 of the California Code of Regulations and Health & Safety Codes. Please see 809D for documentation of deficiencies.

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 was conducted, and a copy of this report was provided to Vicky Bermudez.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE: DATE: 03/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/18/2025
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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Document Has Been Signed on 03/18/2025 01:58 PM - It Cannot Be Edited


Created By: Veronica Martinez-Garza On 03/18/2025 at 01:21 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MONTEBELLO GARDENS HEAD START
FACILITY NUMBER: 198005683

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/18/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Request Denied
Type B
Section Cited
CCR
101217(d)
Personnel Records
(d) All personnel records shall be maintained at the child care center and shall be available to the licensing agency for review.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above in staff files were not available for review during LPAs annual inspection on 02/11/25 and within a two-day window per the approved waiver dated 12/27/24 which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/01/2025
Plan of Correction
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Per program specialist and director, an appeal will be submitted to the Regional office.
Section Cited
Deficient Practice Statement
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POC Due Date:
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.
SUPERVISOR'S NAME:Ana Chico
LICENSING EVALUATOR NAME:Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:
DATE: 03/18/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/18/2025


LIC809 (FAS) - (06/04)
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