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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020970
Report Date: 02/23/2023
Date Signed: 02/24/2023 03:36:50 PM

Document Has Been Signed on 02/24/2023 03:36 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:BLOSSOM GARDEN LEARNING ACADEMYFACILITY NUMBER:
198020970
ADMINISTRATOR:MEGHA SAHNIFACILITY TYPE:
850
ADDRESS:101 S. ATLANTIC BLVDTELEPHONE:
(626) 627-2318
CITY:ALHAMBRASTATE: CAZIP CODE:
91801
CAPACITY: 75TOTAL ENROLLED CHILDREN: 75CENSUS: 45DATE:
02/23/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:45 PM
MET WITH:Megha SahniTIME COMPLETED:
04:55 PM
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Licensing Program Analyst (LPA) Seung Lee conducted an unannounced case management inspection. Upon arrival LPA Lee met with Director Megha Sahni. The purpose of the inspection was to obtain additional information from the facility regarding an incident reported to the regional office.

The department received a incident report from this facility on 02/22/2023 for an incident that occurred at the facility on 02/21/2023. During the inspection LPA Lee spoke to the Director and made observations regarding the incident.

Based on the information that was verified during the inspection and the information on the incident report, LPA Lee did not observe any type of deficiencies that warranted a citation at this time.

The notice of site inspection must remain posted for a period of 30 days during hours of operation. Failure to maintain posting will result in a civil penalty of $100.00 dollars.

Exit interview conducted with Director Megha Sahni. Appeal rights discussed and explained.
SUPERVISORS NAME: Guangorena Claudia
LICENSING EVALUATOR NAME: Seung Lee
LICENSING EVALUATOR SIGNATURE: DATE: 02/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/23/2023
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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