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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019065
Report Date: 02/17/2022
Date Signed: 02/17/2022 05:53:30 PM

Document Has Been Signed on 02/17/2022 05:53 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:BLOOMING FLOWERS CHILD CARE CENTERFACILITY NUMBER:
198019065
ADMINISTRATOR:THOMAS, JAZMYNEFACILITY TYPE:
850
ADDRESS:680 E. ARROW HIGHWAYTELEPHONE:
(562) 805-0005
CITY:POMONASTATE: CAZIP CODE:
91767
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 14DATE:
02/17/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Licensee Elaine DavisTIME COMPLETED:
06:00 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
An unannounced in-person Case Management-Deficiencies inspection was conducted on this date by Licensing Program Analyst (LPA) Emiko Bell in order to cite for deficiencies observed during an inspection. Licensee Elaine Davis arrived at 10:00 am.

Upon LPA's arrival, LPA was greeted by staff Destiny Carcoba, who permitted LPA to enter the Center and who guided LPA to Lead Teacher Antoinette Jordan.

LPA and staff wore face coverings the duration of the inspection as a precautionary measure against COVID-19. The COVID screening questions were posed and all were responded to with "No."

A citation is being issued for children not wearing face coverings, as mandated by the LA County Department of Public Health while children are indoors; they are not required outdoors or while children are napping or eating or drinking. .

From 09:15-09:25, Lead Teacher Antoinette Jordan.then guided LPA on a tour to take census. There were eight children in the multi-purpose room with one staff and on the playground, there were six children with Rebecca Meza. As Rebecca Meza does not have teacher qualifications, staff-child ratio was not met.
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Betty Bell
LICENSING EVALUATOR SIGNATURE: DATE: 02/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/17/2022
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 4
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: BLOOMING FLOWERS CHILD CARE CENTER
FACILITY NUMBER: 198019065
VISIT DATE: 02/17/2022
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
 Page 2/2

Rebecca Meza is not associated to the facility. She has Criminal Background Clearance through CCL, as she is the licensee of a family child care home. She was alone on the playground with
the children until 10:00 am. As she is not associated to the facility, a citation has been issued and a $100 civil penalty has been assessed.

A third citation is being issued because Director Jazmyne Thomas has been out on medical leave since pre-COVID (March 2020). No one has been designated to replace her.

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 conducted and report was reviewed with Licensee Elaine Davis..

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Betty Bell
LICENSING EVALUATOR SIGNATURE:

DATE: 02/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2022
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 02/17/2022 05:53 PM - It Cannot Be Edited


Created By: Betty Bell On 02/17/2022 at 04:12 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: BLOOMING FLOWERS CHILD CARE CENTER
FACILITY NUMBER: 198019065

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/17/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/28/2022
Section Cited
CCR
101215.1(f)(1)

1
2
3
4
5
6
7
Child Care Center Director Qualifications and Duties
If the child care center director is absent for more than 30 consecutive calendar days, the substitute director shall meet the qualifications of a director.

-This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Licensee Elaine Davis stated she will send LPA Bell the Director's packet by the close of business on 02/28/22.
8
9
10
11
12
13
14
Director Jazmyne Thomas has been out since before March 2020 and though there is a Lead Teacher, the substituate director Antoinette Jordan still has not been designated as director.
*This poses a potentil health, safety and/or personal rights risk to the children in care.*
8
9
10
11
12
13
14
Type B
02/28/2022
Section Cited
CCR101223(a)(2)

1
2
3
4
5
6
7
Personal Rigths
To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.

-This requirement is not met as evidenced by:
LPA observed that children were not wearing face coverings, even while indoors.
1
2
3
4
5
6
7
Licensee Elaine Davis stated she will hand the parents and staff a letter and have them sign for it and placed the signed copies in each child's file as well as provide LPA Bell with a copy of the lettetr by the close of business on 02/28/22.
8
9
10
11
12
13
14

*This poses a potentil health, safety and/or personal rights risk to the children in care.*
8
9
10
11
12
13
14
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:Claudia Guangorena
LICENSING EVALUATOR NAME:Betty Bell
LICENSING EVALUATOR SIGNATURE:
DATE: 02/17/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/17/2022


LIC809 (FAS) - (06/04)
Page: 4 of 4
Document Has Been Signed on 02/17/2022 05:53 PM - It Cannot Be Edited


Created By: Betty Bell On 02/17/2022 at 04:34 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: BLOOMING FLOWERS CHILD CARE CENTER
FACILITY NUMBER: 198019065

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/17/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/28/2022
Section Cited
CCR
101170(e)(2)

1
2
3
4
5
6
7
CRIMINAL RECORD CLEARANCE
All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility:
Request a transfer of a criminal record clearance as specified in Section 101170(f) .-This requirement is not met as evidenced by:
1
2
3
4
5
6
7
LIcensee Elaine Davis stated that she will associate Rebecca Meza to the license. She will email LPA the packet by COB on 02/28/22.
8
9
10
11
12
13
14
Rebecca Meza is a licensee of a FCCH. Upon LPA's arrival, she was alone on the playground supervising six children. She is not associated to the facility, as verified on the Facility Personnel Report Summary. A civil penalty of $100 has been assessed.
*This poses a potentil health, safety and/or personal rights risk to the children in care.*
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Claudia Guangorena
LICENSING EVALUATOR NAME:Betty Bell
LICENSING EVALUATOR SIGNATURE:
DATE: 02/17/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/17/2022


LIC809 (FAS) - (06/04)
Page: 3 of 4