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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020742
Report Date: 08/14/2024
Date Signed: 08/14/2024 05:12:28 PM

Document Has Been Signed on 08/14/2024 05:12 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:BRIGHT STARS CARE AND EDUCATION CENTER LLCFACILITY NUMBER:
198020742
ADMINISTRATOR/
DIRECTOR:		FLORES, MARIAFACILITY TYPE:
850
ADDRESS:13628 LOMITAS AVE.TELEPHONE:
(626) 295-2110
CITY:LA PUENTESTATE: CAZIP CODE:
91746
CAPACITY: 17TOTAL ENROLLED CHILDREN: 17CENSUS: 10DATE:
08/14/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:20 PM
MET WITH:Maria FloresTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
NARRATIVE
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On 8/14/2024 at 2:20 pm an unannounced Case Management – Deficiencies inspection was conducted by Licensing Program Analyst (LPA) Carolyn Tuba who was there to conduct a separate inspection visit and during the course of the investigation a separate deficiency was discovered. A Covid risk assessment was conducted. LPA met with staff due to Licensee, Maria Flores was not available and LPA took a census of 10 children with 1 staff and (2) additional adults. Licensee arrived at the facility at approximately 3:00 pm.

During the visit at approximately 2:30 pm. LPA was checking staff criminal clearance and discovered the adult individual was not on the clearance list for the preschool license. LPA spoke to the Licensee over the phone who stated that the individual was a volunteer, however LPA observed the adult individual was diapering a child in care without direct supervision from another staff member. LPA spoke to the adult individual who stated that they had worked there before but LPA checked and there were no fingerprints on file. LPA advised Licensee that volunteers are an individual who assist at the facility no more than 16 hours and requires direct supervision from a qualified staff member. The volunteer may not assist with diapering or be left alone with children in care. LPA observed another adult but after interviewing the individual determined that they were indeed volunteering.

The following deficiency listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiency that are being cited need to be cleared to protect the children’s health & safety. Civil Penalties have been assessed. This is a repeat violation from a previous visit on 3/18/2024.

One (1) Type A - A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent. Licensee/Director was provided Page 1 of 2

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE: DATE: 08/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/14/2024
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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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: BRIGHT STARS CARE AND EDUCATION CENTER LLC
FACILITY NUMBER: 198020742
VISIT DATE: 08/14/2024
NARRATIVE
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with a copy of the parent Acknowledgement of Receipt of Licensing Reports Form during this visit. A copy of the Parent Notification Requirements was also provided to the licensee/Director. LPA provided regulation of individuals who considered volunteers at the facility.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee, Maria Flores.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 08/14/2024 05:12 PM - It Cannot Be Edited


Created By: Carolyn Tuba On 08/14/2024 at 04:13 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: BRIGHT STARS CARE AND EDUCATION CENTER LLC
FACILITY NUMBER: 198020742

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/14/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/15/2024
Section Cited
CCR
101216(i)(1)

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Personnel Requirements (i)Prior to employment or initial presence in the child care center, all employees and volunteers subject to a criminal record review shall:
(1) Obtain a California clearance or a criminal record exemption as required by law or Department regulations.....
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Per Licensee adult when volunteer and adhere to the regulations of volunteering at the facility.
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This requirement is not met as evidenced by: Based on LPA checking and adult did not have fingerprints on file and LPA observed individual diapering a child in care without supervision so cannot be classified as a volunteer. This poses an immediate Health and Safety 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:Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:
DATE: 08/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/14/2024


LIC809 (FAS) - (06/04)
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