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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019478
Report Date: 08/05/2025
Date Signed: 08/05/2025 01:50:33 PM

Document Has Been Signed on 08/05/2025 01:50 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:PUENTE AVE PRESCHOOL ICC LLCFACILITY NUMBER:
198019478
ADMINISTRATOR/
DIRECTOR:		KIMBERLY NGUYENFACILITY TYPE:
830
ADDRESS:14032 DILLERDALE AVETELEPHONE:
(626) 338-3464
CITY:LA PUENTESTATE: CAZIP CODE:
91746
CAPACITY: 50TOTAL ENROLLED CHILDREN: 50CENSUS: DATE:
08/05/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Site Supervisor, WendyTIME VISIT/
INSPECTION COMPLETED:
01:50 PM
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On 8/5/2025 at 9:15am an unannounced Annual/Required Inspection was conducted by Licensing Program Analysts (LPAs) Monica Ruiz and Mary Silva. LPAs announced purpose of the visit and met with Facility Representative, (FR), Kimberly Nguyen. Entrance Checklist (LIC 125) was provided. Facility is currently licensed for a capacity of 50 children and per Facility Roster reviewed have 47 enrolled, 15 infants and 32 toddlers. FR confirms Facility Roster is current.
The program currently operates Monday thru Friday from 6 AM to 6PM. LPAs were guided on a tour of the facility, both indoors and outdoors. Facility also has a preschool, and a school age program attached (198020594 and 198019699). LPAs observed each program to have separate entrances/exits at time of inspection. Required postings were observed to be posted on the wall in the director’s office and in each classroom.
The facility is made up of 4 classrooms: Infant A-B, Infant C, Toddler 1-2, and Toddler 3. LPAs observed 6 staff with 13 infants and 21 toddlers with 6 staff. Total census of 33 children and 12 teachers at time of inspection.
Beginning at 10AM furniture and equipment were inspected for age appropriateness and good repair. LPAs observed surfaces in classrooms to be safe and clean. There are age-appropriate tables and chairs, with rounded edges, that have been maintained at time of inspection.
LPAs observed a variety of age-appropriate washable toys that encourage auditory, visual, and tactile stimulation and manipulative skills. Equipment, toys and materials are in good condition and in sufficient quantity to allow children present to fully participate in planned activities.
Telephone service, heating, lighting and ventilation were evaluated. LPAs discussed washing requirements and labelled cubbies for children's belongings.
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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Monica Ruiz
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 08/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/05/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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: PUENTE AVE PRESCHOOL ICC LLC
FACILITY NUMBER: 198019478
VISIT DATE: 08/05/2025
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LPAs observed infant program (198019478) to have a separate sleeping area, equipped with 6 cribs that comply with Title 22 Safe Sleep requirements. LPAs observed diaper changing tables to have a mat that is wipeable, appropriate thickness, and placed within arm’s reach of a sink. FR discussed diaper changing procedures with LPAs which includes cleaning and sanitation protocols after each use.
LPAs observed infant sleeping area to be separated from the play area by a gate and a plastic half partition making Infant Room sleeping area to be fully visible.
Per FR, linens for cribs are provided by the facility and washed weekly.
LPAs observed sheets/blankets stored in children’s cubbies and in storage closets.
Availability of drinking water was reviewed. LPAs observed a plastic pitcher of drinking water in each room.
Age appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, area safety and sanitation. LPAs observed bathrooms available in Toddler 1-2 and Toddler 3. LPA observed diaper changing tables in both infant rooms.
Hazardous items including poisonous cleaning compounds were stored inaccessible to children.
LPA observed a first aid kit is kept in each classroom and inventoried for necessary supplies.

At 11AM, LPAs tested carbon monoxide detector located in Toddler 1-2 classroom and observed it to be operable at time of inspection. LPAs observed fire extinguishers are present in the facility. LPA discussed requirement to have fire extinguishers serviced annually and to conduct regular checks of smoke and carbon monoxide detectors to ensure they are operable.

Disaster drill log was posted and last drill conducted 7/2/2025. Isolation area for sick children is in the office. There is a restroom available for children to use. Per FR, they currently have no infants or toddlers enrolled that require medications.

Beginning at 11:30 AM, outdoor equipment was inspected for safety, cushioning material, good repair and age appropriateness. LPAs observed play areas to be separate from preschool program play areas. LPAs observed surface of outdoor play areas to be safe and maintained for activities planned. LPA observed a variety of age appropriate toys available such as tricycles, bike path, play houses. LPA observed age appropriate structures that have been bolted down to the ground and there is cushioning material below that are well maintained at time of inspection. Required shade and fencing were inspected. LPA advised that the infants need to be within the direct care and supervision, including visual supervision of the teacher(s) at all times. LPAs observed drinking water in pitchers available outdoors for infants cups to be refilled by staff. Play area was inspected for hazards and inaccessibility to bodies of water; no bodies of water or hazards observed. page 2

NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Monica Ruiz
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2025
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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: PUENTE AVE PRESCHOOL ICC LLC
FACILITY NUMBER: 198019478
VISIT DATE: 08/05/2025
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Facility provides breakfast, lunch and one snack. LPAs observed lunches stored in separate containers with infant's names clearly labeled. LPA observed bottles for infants to be stored in the refrigerator in Infant 1-2 and Infant 3 classrooms. Infant bottles have been pre-made and clearly labeled with each infants' names. Snack/Lunch menus were reviewed and observed to be posted. Food and snacks were reviewed for availability, quantity and appropriateness to children in care. LPAs discussed appropriate labelling of decanted food. Food preparation areas were toured for safety, cleanliness and proper equipment. Trash cans used to discard food have tight fitting lids at time of inspection.
Teacher-child ratios were observed and staff names recorded. Care and supervision were evaluated to determine if the basic needs of children are met and appropriate. Sign-in and out sheets and procedures were reviewed. Personal Rights of children were observed by LPAs at time of inspection.
Beginning at 11:45 AM, staff and children’s records were reviewed for completeness. Inspection of required forms was made and documented on LIC 857 for children and LIC 859 for staff. CPR card expires on 1/27/2026 for Director, K. Nguyen. Staff present have proof of the AB 1207 Mandated Reporter Training certificate on file. All staff and employees have obtained a criminal record clearance or criminal record exemption and associated to the facility at time of inspection.
The following were discussed:
LPA advised of the requirement to report Unusual Incidents and/or injuries to the parent/guardian and to CCL within the time frame specified by the regulation, this includes any changes as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your location.

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

Facility Representative was reminded that all adults 18 and over in the facility, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed facility. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Monica Ruiz
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2025
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: PUENTE AVE PRESCHOOL ICC LLC
FACILITY NUMBER: 198019478
VISIT DATE: 08/05/2025
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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.

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.

LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

LPA discussed the safe sleep regulations with Facility Representative and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.

LPA also informed Facility Representative 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.

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/.

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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Monica Ruiz
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2025
LIC809 (FAS) - (06/04)
Page: 6 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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: PUENTE AVE PRESCHOOL ICC LLC
FACILITY NUMBER: 198019478
VISIT DATE: 08/05/2025
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FR 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.

The facility was found in compliance per Title 22 regulations, there will be no deficiencies cited today, 8/5/2025.

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

Exit interview was conducted and report was reviewed with the Facility Representative, Kimberly Nguyen

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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Monica Ruiz
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2025
LIC809 (FAS) - (06/04)
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