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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020970
Report Date: 09/13/2023
Date Signed: 09/13/2023 04:27:51 PM

Document Has Been Signed on 09/13/2023 04:27 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
L.A. DAY CARE-EAST, 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: 37DATE:
09/13/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Megha Sahni TIME COMPLETED:
04:30 PM
NARRATIVE
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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 more information regarding an incident report that was provided by the facility on 09/11/2023. During the course of this inspection, LPA Lee reviewed footage, reviewed documents, and made observations in regards the incident. LPA Lee observed during the file review and during and interview with the Director that the parents of Child#1 was informed about this incident by the facility on 09/12/2023. Staff#1 was written up by the facility Director on 09/11/2023.

On 09/07/2023, Child#1 was left unattended in the hallway of the facility for about 5 minutes. LPA observed that Child#1 was with other children and Staff#1 in the hallway and walking back to their classroom. While Staff#1 and the other children began to walk down the hallway towards their classroom, Child#1 and another child became separated from the group. The two children were observed to be looking at some sort of toy castle that was located near the main entrance of the hallway. LPA observed the other child that was with Child#1 running back to the group after realizing the rest of the class was walking back to the classroom. Child#1 seemed to be focused on the toy castle for about a few minutes and then was observed to be squatting near the toy castle while looking around before a parent of another child observed Child#1 while signing in their child. The parent took Child#1's hand and brought both children to a classroom. LPA observed that Child#1 was left unattended for about 5 minutes. This is an immediate risk to children in care.

The notice of site inspection along with this report must remain posted for a period of 30 days during hours of operation. Failure to maintain posting and this page of the report for 30 days will result in a civil penalty of $100.00 dollars. The Director was advised that an LIC 9224 must be signed by all current parents of children in care for the preschool program and any new parents for 1 year starting from todays date.

Exit interview conducted with Director. Appeal rights discussed and explained.
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Seung Lee
LICENSING EVALUATOR SIGNATURE: DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/13/2023
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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Document Has Been Signed on 09/13/2023 04:27 PM - It Cannot Be Edited


Created By: Seung Lee On 09/13/2023 at 03:39 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: BLOSSOM GARDEN LEARNING ACADEMY
FACILITY NUMBER: 198020970

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/13/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/14/2023
Section Cited
CCR
101229(a)(1)

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Care and Supervision.

No child(ren) shall be left without the supervision, including visual observation, 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
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The Director stated that she will have a meeting with the staff about doing headcounts of children after any activity oustide the classroom.
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evidenced by the fact that Child#1 was left unattended in the hallway of the facility for 5 minutes. This is an immediete risk to childreni n 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:Claudia Guangorena
LICENSING EVALUATOR NAME:Seung Lee
LICENSING EVALUATOR SIGNATURE:
DATE: 09/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/13/2023


LIC809 (FAS) - (06/04)
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