198020405-3-26-2025-33-CC-AEIN-DF5TG2-20250326144225

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020405
Report Date: 03/26/2025
Date Signed: 03/26/2025 02:42:34 PM

Document Has Been Signed on 03/26/2025 02:42 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:	DISNEY CHILDREN'S CENTER		FACILITY NUMBER:	198020405
ADMINISTRATOR/ DIRECTOR:	ELISHA GONZALEZ		FACILITY TYPE:	850
ADDRESS:	625 PAULA ST		TELEPHONE:	(818) 931-5437
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91201
CAPACITY: 182	TOTAL ENROLLED CHILDREN: 182	CENSUS: 110	DATE:	03/26/2025
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:40 PM
MET WITH:	Elisha Gonzalez, Director		TIME VISIT/ INSPECTION COMPLETED:	02:45 PM

NARRATIVE

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Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced case management inspection on 03/26/25 at 12:40 PM, due to an incident that occurred on 03/10/25. Upon LPA’s arrival to the facility LPA met with Elisha Gonzalez, director who guided LPA on a tour of the facility. The licensee also operates an infant program (198020404) on the same premises. During this inspection 110 children were present in the facility with 24 staff.

Alleged Incident took place on 03/10/25. Per Elisha Gonzalez, Director, she called Regional Office on 03/11/25 at 10:49 AM and talked to Victoria DeLa Rosa and she took the facility information and informed facility that Officer of the day, Mariah Aguirre will call her back, but she did not receive a call back. On 03/12/25 Elisha Gonzales contacted Regional Office again and reported the incident. The facility reported the incident within the required 24-hour time frame.

LPA observed the area where alleged incident took place. LPA conducted interviews with three staff. LPA obtained copies of Name to Face Report for child#1 for 03/10/25, staff#1, 03/10/25 tracking report, and two pictures from child#1 that was taken on 03/10/25 at 10:35 AM and 10:44 AM.

Based on LPA observations and interviews which were conducted and record reviews, child#1 went to the Big Yard on 03/10/25 at 10:18AM. Per staff#1, when she went to the Big Yard to let the staff#4 know that she was going on her AM break, she observed child#1 on the yard. Per staff#1 when she went on her AM break in the laundry room, she did not observe any child in the classroom. Based on staff attendance sheet, staff#1 went on her AM break at 10:51 AM. Per staff#1, when she came back from laundry room to the classroom prior her 15 minutes break end, she heard a noise and observed child#1 in the classroom who stated is alone.

REPORT CONTINUES ON NEXT PAGE 1 OF 2

NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Anomeh Eivazian
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/26/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/26/2025

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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: DISNEY CHILDREN'S CENTER	FACILITY NUMBER: 198020405
	VISIT DATE: 03/26/2025

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Child#1 came to the classroom anytime between 10:51AM and was found by staff#1 in the classroom at 11:07 AM. No staff member observed how and when child#1 went to the classroom. Child#1 was unsupervised on 03/10/25 approximately, anytime between 10:51AM to 11:07 AM, for approximately 16 minutes.

Based on LPA observations and interviews which were conducted and record reviews, the preponderance of evidence standard has been meet, therefore the above allegation is found to be Substantiated at this time. California Code of Regulations, 101229(a) (1)-- Responsibility for Providing Care and Supervision--(a)The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation is being cited on the attached LIC9099D.

LPA Anomeh Eivazian informed Director, Elisha Gonzalez that this report dated 03/26/25 documents 1 Type A citation. Type A citation which shall be posted for 30 consecutive days as there is immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Eivazian informed the director to provide a copy of this licensing report dated 12/26/25 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

The notice of site visit was posted where the parent/guardian of children enter and exit the facility. This notice shall remain posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.

Exit interview was conducted with Director, Elisha Gonzalez.

REPORT END 2 of 2

NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Anomeh Eivazian
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/26/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/26/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/26/2025 02:42 PM - It Cannot Be Edited

Created By: Anomeh Eivazian On 03/26/2025 at 12:44 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: DISNEY CHILDREN'S CENTER	FACILITY NUMBER: 198020405
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/26/2025

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 03/27/2025 Section Cited CCR 101229(a)(1)	1 2 3 4 5 6 7	Responsibility for Providing Care and Supervision--(a)The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). This requirement was not met as evidenced by…	1 2 3 4 5 6 7	Per director, staff are required to follow facility directive and all the time take the children to the outdoor in two small groups. A written plan will be submitted to LPA Eivazian by 03/27/25 via email.
	8 9 10 11 12 13 14	Per staff interviews, on 03/10/25 Child#1 was unsupervised approximately, anytime between 10:51AM to 11:07 AM, for approximately 16 minutes. This poses an immediate health, safety and personal right 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.

	Christina Gabelman
NAME OF LICENSING PROGRAM MANAGER:

	Anomeh Eivazian
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/26/2025

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/26/2025

LIC809 (FAS) - (06/04)

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