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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198012408
Report Date: 02/10/2026
Date Signed: 02/10/2026 02:04:43 PM

Document Has Been Signed on 02/10/2026 02:04 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:PACIFIC AVENUE EDUCATION CENTERFACILITY NUMBER:
198012408
ADMINISTRATOR/
DIRECTOR:		YURITZY VAZQUEZFACILITY TYPE:
850
ADDRESS:440 W. LOMITA AVE.TELEPHONE:
(818) 547-0103
CITY:GLENDALESTATE: CAZIP CODE:
91204
CAPACITY: 89TOTAL ENROLLED CHILDREN: 82CENSUS: 66DATE:
02/10/2026
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Adiana Hernandez, Program SupervisorTIME VISIT/
INSPECTION COMPLETED:
02:20 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
Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced Required- 3 year inspection on 02/10/2026 at 10:00 AM. LPA met with Adriana Hernandez, Program Supervisor. LPA provided Adriana Hernandez with a copy of the Entrance Checklist for Child Care Centers form (LIC 125). Program Supervisor guided LPA on a tour of the facility. Per program supervisor, Adriana Hernandez her office is on this site and she is present on the site all the time. This is a state preschool program which consists of 4 classrooms, Room P1(1107), Room 32, Room 34, and Room 35. This facility is located on Pacific Avenue Education Center property that belongs to Glendale Unified School District. Facility operation hours are from Monday to Friday from 6:30 AM to 6:00 PM. There are school age and Elementary programs on this site. All the programs are under Glendale Unified School District. Per Program Supervisor, currently there are 82 children enrolled in the program.

All areas identified on the Facility Sketch were inspected. Upon arrival, the following staff were present during this inspection; Room 1107 (3-5 years old): 34 preschoolers were in the classroom with 6 staff and classroom break in to two groups and one group went outside for outdoor playtime, Room 32 (2 years old): 7 preschoolers in the classroom with 4 staff, Room 34 (2 years old): 10 preschoolers in the classroom with 3 staff, and Room 35 (3-5 years old): 15 preschoolers in the classroom with 2 staff. The facility was observed to be within the license capacity and limitations. All children were observed to be under visual supervision of a teacher at all times. The following was observed during the tour of the facility:

LPA observed the facility to be clean, safe, sanitary and in good repair. Per Site Supervisor cleaning crew clean the classrooms daily after school hours. Furniture and equipment was inspected for age appropriateness and good repair, free of sharp, loose, or pointed parts. All indoor classrooms were inspected to ensure that the floors have a surface that is safe and clean. Telephone service, heating, lighting
REPORT CONTINUES ON NEXT PAGE 1 OF 5
NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Anomeh Eivazian
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 02/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/10/2026
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
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: PACIFIC AVENUE EDUCATION CENTER
FACILITY NUMBER: 198012408
VISIT DATE: 02/10/2026
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
and ventilation were evaluated. Children have their own cubby to store their belongings in each classroom. Linens are laundered by the facility each week on Friday or as needed. Parents take blanket home on Friday or as needed and return it on Monday. Napping equipment (cots) were observed to be stored within the each classroom. Age appropriate sinks and toilets were inspected for availability and good repair in all restrooms. General sanitation was observed. Availability of indoor drinking water was observed in the classroom. Per Program Supervisor children use water bottles indoor and outdoor. Teacher use water bottles or Brita filtered water dispenser to refill children's bottles. Per program supervisor, parents drop off/pick up children from the classroom. Per Program Supervisor, Room 1107 parents can drop off/pick up children either by side gate by using their personal code or through office, and Rooms 32/34/and 35 children enter the facility through the office main entrance and parents walk children to their classrooms.

Disinfectants, cleaning solutions, medication, and other items that are dangerous to children, were inaccessible to children. Program Supervisor states there are no poisons stored at the facility. Per Program Supervisor there are connected carbon monoxide detector in each classroom. LPA observed required posting information were posted in each classroom by the entrance.

All kitchen areas/food preparation areas and food storage areas in each classroom are kept clean and are free of litter, rubbish, rodents, and/or any other vermin. Trash cans used to discard food have tight fitting lids or solid waste bags shall be discarded immediately after each meal.

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 are cushioned with rubber cushioning material that absorbs a fall; climbing apparatuses are single level only. There is adequate shade in the play yard. Availability of outdoor drinking water was observed. Per Program Supervisor children take their water bottles outside during outdoor play time. LPA observed staff took children water bottles outside and placed on a rolling white tray. LPA advised that no children shall be left without the supervision of a teacher at any time.

On 12/11/25, LPA Eivazian informed Program Supervisor, Adriana Hernandez, based on H&S code: 1596.804, Permit children with exceptional needs, as defined in Section 8205 of the Education Code, who are enrolled in separate programs or classrooms from nondisabled children to use outdoor play spaces simultaneously with nondisabled children without first seeking a waiver of Section 101238.2 of Title 22 of the California Code of Regulations.
REPORT CONTINUES ON NEXT PAGE 2 OF 5
NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Anomeh Eivazian
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2026
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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: PACIFIC AVENUE EDUCATION CENTER
FACILITY NUMBER: 198012408
VISIT DATE: 02/10/2026
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
The Program Supervisor states that there are no bodies of water on the premises and LPA did not observe any bodies of water during this inspection. Program Supervisor states there are no weapons or firearms on the premises.
Program Supervisor, Adriana Hernandez 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.

Seven Children’s Records were reviewed for completeness; Inspection of required forms was made and documented on the LIC 857. 7 out of 7 reviewed files were completed.

There is at least one person trained in CPR and Pediatric First Aid present during this inspection. LPA also reviewed six staff records. The review of six Staff records was documented on the LIC 859 and completed. Staff present had proof of the AB 1207 Mandated Reporter Training certificate on file. Staff present had proof against TB, measles, pertussis, and influenza. All staff have been given on the-job training sanitation principles, housekeeping, including universal health precautions.

Children's roster was reviewed and is current. Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. Per program supervisor parents sign in/out children on the tablet that is placed in each classroom by the entrance door. Facility utilize EZchildtrack for sign in/out. During this inspection 66 children were present, and all 66 children were singed in. LPA reviewed the sign in/out sheet by program supervisor on classroom 1107 tablet. Disaster drill log was available, last drill was conducted on 01/28/26.

Menus are posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request. Snacks were reviewed for availability, quantity and appropriateness to children in care. Per Program Supervisor, meals are prepared by Glendale Unified School District. Food are serviced in individual and family style based on the food of the day. The facility provides AM and PM snack, and hot lunch. Children enrolled also have option to bring their own lunch.
REPORT CONTINUES ON NEXT PAGE 3 OF 5
NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Anomeh Eivazian
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2026
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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: PACIFIC AVENUE EDUCATION CENTER
FACILITY NUMBER: 198012408
VISIT DATE: 02/10/2026
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
First Aid supplies were observed in each classroom in a cabinet. According to Program Supervisor, medication is only administered to a child when accompanied with a doctor's note and is stored in the child’s classroom. The facility was observed to be equipped with an isolation area for any child who becomes ill and it is located in the Nurse office. The ill child will use the staff restroom by the Nurse office during isolation which is disinfected immediately after use per Site Supervisor.

LPA discussed the safe sleep regulations with program supervisor 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 also informed program supervisor 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. Per program supervisor, they serve children 2-5 years old.

Medication: This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. 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/. Plan of operation for incidental medical services on file. Submitted 07/17/17.

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. Facility completed water lead testing 04/17/23 and 03/25/24, and no lead exceedances after 03/25/24 testing.
REPORT CONTINUES ON NEXT PAGE 4 OF 5
NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Anomeh Eivazian
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2026
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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: PACIFIC AVENUE EDUCATION CENTER
FACILITY NUMBER: 198012408
VISIT DATE: 02/10/2026
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
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.
LPA referred program supervisor 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)

LPA advised the licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.

Program Supervisor 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.



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.

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

Exit interview conducted and report was reviewed with the Program Supervisor, Adriana Hernandez.
END OF REPORT PAGE 5 OF 5
NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Anomeh Eivazian
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2026
LIC809 (FAS) - (06/04)
Page: 6 of 6