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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019832
Report Date: 11/10/2021
Date Signed: 11/10/2021 10:38:07 AM

Document Has Been Signed on 11/10/2021 10:38 AM - 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:LEAPS AND BOUNDSFACILITY NUMBER:
198019832
ADMINISTRATOR:LORENA VASQUEZFACILITY TYPE:
850
ADDRESS:13921 AMAR ROADTELEPHONE:
(626) 960-3485
CITY:LA PUENTESTATE: CAZIP CODE:
91746
CAPACITY: 70TOTAL ENROLLED CHILDREN: 47CENSUS: 29DATE:
11/10/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:05 AM
MET WITH:Director, Lorena VasquezTIME COMPLETED:
10:40 AM
NARRATIVE
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On 11/10/2021 at 10:05 a.m., Licensing Program Analyst (LPA) Jose Guzman conducted an unannounced case management inspection. A risk assessment was conducted when entering the facility. There was a total of 29 children present with 4 staff.
During the course of an inspection, LPA was informed, through interviews conducted on 10/27/2021 and 10/28/2021, that school age and preschool children comingle during the opening hours until school age children are taken to the elementary school campus. Director confirmed that children did in fact comingle at the facility. Based on the above, the facility is being cited. Please refer to 809D for documentation of deficiencies.

A copy of this report must be provided to the authorized representatives of all currently enrolled children and must also be provided to newly enrolled children for the next 12 months. The report shall be provided no later than the next business day or the next day the child is in care.

The Acknowledgement of Receipt of Licensing Reports (LIC 9224) shall be signed and kept in each of the children’s records. Web site address to obtain forms, review quarterly updates, review Title 22 & Health & Safety Codes is: www.ccld.ca.gov.

The Notice of Site Visit (LIC 9213) must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Exit interview was conducted with Director, Lorena Vasquez.
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Jose Guzman
LICENSING EVALUATOR SIGNATURE: DATE: 11/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/10/2021
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 11/10/2021 10:38 AM - It Cannot Be Edited


Created By: Jose Guzman On 11/10/2021 at 10:06 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: LEAPS AND BOUNDS
FACILITY NUMBER: 198019832

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/10/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/10/2021
Section Cited
CCR
101538.3(b)

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In combination programs, ... school-age ... children shall be physically separated from child care center children. This requirement is not met as evidenced by:
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Director will provide a written declaration with the understanding that school age and preschool children must be physically separate at all times.
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Based on interview and record review, the director allowed school age and preschool children to comingle which poses an immediate health, safety or personal rights risk to children 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:Jose Guzman
LICENSING EVALUATOR SIGNATURE:
DATE: 11/10/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/10/2021


LIC809 (FAS) - (06/04)
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