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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020743
Report Date: 08/14/2024
Date Signed: 08/14/2024 05:39:46 PM

Document Has Been Signed on 08/14/2024 05:39 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:
198020743
ADMINISTRATOR/
DIRECTOR:		FLORES, MARIAFACILITY TYPE:
840
ADDRESS:13628 LOMITAS AVE.TELEPHONE:
(626) 295-2110
CITY:LA PUENTESTATE: CAZIP CODE:
91746
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 10DATE:
08/14/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:20 PM
MET WITH:Maria FloresTIME VISIT/
INSPECTION COMPLETED:
05:45 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 took a census of 10 children present with 1 staff. Licensee arrived at the facility at approximately 3:00 pm.

During the visit at approximately 2:25 pm. LPA was taking the census and observed a child who ran from the school-age classroom into the preschool classroom and opened the door to the infant classroom and was observed hiding behind some children’s furniture. LPA observed that the staff had not noticed and required that LPA inform staff that the child was in the infant classroom. Child was brought back to the school-age classroom by staff. LPA spoke to the staff person in the school-age program and she indicated that they keep the one door closed but the child must have ran out of the other door that leads into the staff workroom near the kitchen. LPA advised the importance of staff supervision and must be there at all times.

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.

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


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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
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: 198020743
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.

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)
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Document Has Been Signed on 08/14/2024 05:39 PM - It Cannot Be Edited


Created By: Carolyn Tuba On 08/14/2024 at 04:06 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: 198020743

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/14/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/19/2024
Section Cited
CCR
101229(a)(1)

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(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.
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School-age staff will watch supervision training modules and staff will write a reflection form of what they learned. Licensee will secure door with a child-proof lock and will provide staff forms and pictures of the secure door to LPA.
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This requirement is not met as evidenced by: LPA observing that child was left attended without direct supervision of an adult. This poses/posed a 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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